By Chloe Bennett, Research Assistant in Ageing and Multi-morbidity
By the end of 2020 there were over 20,000 excess deaths in care homes in the UK. Care homes have been forced to adapt to meet this rise in palliative care needs and there is much to be learnt from the past year. The East of England and South London NIHR Applied Research Collaborations hosted a successful joint webinar on 25 May 2021 to explore: ‘What have we learnt about delivering high-quality palliative care in care homes during COVID-19?’
The pandemic has had an immense impact on care home staff wellbeing, with staff providing end of life and palliative care at an unprecedented rate.
Participants from the LESS COVID-19 study felt that they had lost part of their family when a resident died, a sentiment echoed by Anita Astle MBE. Staff wellbeing was discussed as being a high priority for care homes, with strategies such as debriefing, good teamwork and having time to rest and heal suggested to address this.
Covid-19 affected families visiting dying relatives. All speakers addressed the importance of visiting from friends and family when a person is nearing end of life, Anita Astle MBE poignantly describing the horrific experiences for residents, family and staff when this could not happen. Anna Bone highlighted the need for families and friends to be viewed as active contributors to care.
A key message described throughout the webinar by both speakers and attendees was the differences in support and provision. Local hospices and palliative care teams in some areas, but not all strengthened existing relationships to work collaboratively with care homes.
Analysis of recurring themes raised within a WhatsApp support group for care home staff proved how peer to peer support and learning could be a great source of support during the early stages of the pandemic across the country.
Next steps for research and practice
Throughout the webinar there was lively conversation on the chat feature, and this extended to the closing discussion. Panel members and attendees agreed that it is imperative for care home staff to be treated as equal partners when decisions are being made about palliative and end of life care support and provision in care homes. It was suggested that a key requirement for this to occur is creating a culture of mutual trust and respect between staff in care homes and commissioners and NHS staff.
Ensuring staff wellbeing was seen as a priority in the next 12-24 months. Care home managers should be supported to be aware of the signs of staff burnout and how to address it. Further research investigating how to address post pandemic burnout and working with policy makers are needed.
The webinar demonstrated the value of engaging with different people (members of the public, local authority representatives, policy makers and care home staff) interested in care homes to encourage their involvement and support with the pressing topics addressed in the webinar.