Coronavirus: Working with dementia patients in a lockdown

Socially-distancing is tough when the person you're with can't understand why - and more importantly needs you to be close by.

It's a situation many people caring for those with dementia, both paid and informal, find themselves in.

The person with dementia, the home providing care and family members are all "equal partners in a relationship of care", according to Bernadine McCrory, the Northern Ireland director for Alzheimer's Society.

But, she added, when you "take away one of those partners, when families are unable to come in, it leaves it very difficult for the people with dementia to understand why they're not seeing that familiar face, why someone can't come and be with them, why someone can't give them a hug".

"Often, people with dementia are quite tactile, and all of that adds to the stress," she said.

"And the carers of people with dementia are telling us, too, it's affecting their mental wellbeing, not being able to be there for their loved one."

It is something nurses such as Kathy have become very familiar with.

A nurse of many years' standing, Kathy, whose name we have changed to protect her identity, now works in the private sector in a facility that is home to a number of elderly people with dementia.

It's one of the 69 care homes in Northern Ireland affected by Covid-19.

"The circumstances are very challenging and most of my patients would be very mobile, ambulant and would walk freely about the building," she said.

"But the thing is, when you think of patients with Covid-19 who are walking about, they are effectively human aerosols.

"You get them sneezing into your face and then they're talking to you; they have a runny nose, like the cold, and they just wipe their nose then wipe it on the desk or, you know, anywhere and everywhere."

There are hygiene policies in place to protect everyone in the home, especially at this time.

There is also national guidance on personal protective equipment (PPE), which indicates that staff should wear a fluid-resistant mask when in a situation where a two-metre distance is not possible.

Kathy is not sure that is enough.

"We take all precautions as well, with the cross-infection policy, and make sure our hygiene and everything is up to scratch but, like I say, when patients wander about, they wander in and out of rooms.

"With us being busy on the floor, it is hard to keep an eye and follow every patient where they're going, because they have the freedom to go around.

"So it is really very challenging, in the sense that if you have a Covid-19 patient who's wandering about, effectively that becomes a spreader.

"No matter what, I keep on sanitising and cleaning up the work area, the door handles and things like that just to keep everything as safe as possible."

That leaves her doing a lot of cleaning as well as her nursing work. With families cut off from their loved ones, there is pressure, too, to answer calls and give updates.

"We keep [the residents'] spirits up, we encourage them, we support them, because we are their only family at the moment, their own families can't visit."

She added: "I've been in nursing since I was a teenager, working in hospitals before coming here, and I've never encountered such a situation in my whole life."

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