COVID-19: The Challenges of Keeping Adult Care Homes Safe

The recent news of the MINDSville@Napiri COVID-19 cluster is a stark reminder of the vulnerability of residential care centers during this pandemic.

This is not the first outbreak to occur at an adult care home in Singapore. Last year, cases were found in nursing homes such as Lee Ah Mooi Old Age Home and Orange Valley Nursing Home, which led to the mass-testing of thousands of residents and staff island-wide.

In this article, we will discuss several challenges that adult care homes face, especially in the context of Singapore.

Higher Contact Points

There may be higher risks involved in adult care homes, especially since many activities necessitate close physical contact between residents and staff.

Typically, there is a lot of physical contact between the resident and others, such as nurses, allied health staff, cleaners, auxiliary staff members and visitors.

In an interview with CNA, Professor Fisher, a senior infectious disease consultant at the National University Hospital, shared that adult disability homes are likely to be even more vulnerable to an outbreak, if “there is ‘more intensive support’ with more activities and contact.

Mental Wellbeing

However, adult care homes may have to do a balancing act as the human contact is an integral part in regulating the resident’s behaviours. While limiting social interactions can help reduce the risk of transmission, it comes with a compromise on the social wellbeing of both residents and staff members.

According to Mr Ardi S Hardjoe, the chief executive at Thye Hua Kwan Nursing Home, “contact, activities and interaction help fight against boredom, isolation and despair – which are potential consequences that must be avoided in institutional living”.

Besides the residents, it is also important to take into account the mental wellbeing of care home staff, who face challenges and exhaustion during the pandemic. This is consistent with Oliver Wyman’s findings, which describes how additional burden and day-to-day disruptions to working and staff living environments may impact on wellbeing and morale.

Continuity of Care

According to Oliver Wyman’s analysis, COVID-19 measures cause disruptions in where and how care and services are being rendered to patients.

Care homes have to implement safe distancing measures while working within the constraints of their existing infrastructure and design. For instance, these facilities may have to designate split zones to segregate their residents and staff members. This may also prove as a logistical challenge, especially if the facility has limited manpower and resources to keep up with the evolving pandemic situation. Furthermore, it is important to note that many homes still have dormitory-style accommodation, with six to 10 seniors in a room and up to 10 workers in a room. As such, operators had to retrofit their facilities, particularly in common areas, split zones, and staff accommodations.

Administrative Challenges

With the evolving situation and changes in regulations, care centre operators are challenged to to continually keep track and implement changes fast.

According to Mr Then Kim Yuan, the administrator of Lee Ah Mooi Old Age Home, all their previous emergency preparedness exercises that had been formulated with the Health Ministry (MOH) and Agency for Integrated Care (AIC) were not usable to tackle the COVID-19 incidents at his facility. Furthermore, he had to handle hundreds of phone calls from anxious family members and work round the clock to liaise with authorities.

Another difficulty will be ensuring that all visitors to the home are properly screened before they enter the premises. Prof Tambyah posited that there are many different vendors, service providers, and volunteers going in and out of these homes, and it may be a challenge to screen all of them or ensure all of them have been completely vaccinated.

Lack of Awareness

Professor Paul Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection suggested that another challenge in adult care facilities may be that “many individuals may not understand basic hygiene concepts”.

In addition, he said many of these facilities are short on manpower, making it difficult for staff members to practice “full proper hygiene” in between handling clients.

Prof Tambyah also suggested that “many residents may not be able to recognise symptoms of infections, especially if they are subtle – such as a loss of smell or taste”. This may lead to delayed detection of potential COVID-19 cases.

Moving Forward

The effects of the COVID-19 pandemic has raised important questions on the future of the care sector, especially in terms of industry best practices, regulations and technological innovation.

Here at FRIDAY.AI, we are committed to exploring new ways to contribute to the healthcare sector through technology. We believe that this is the best time to rethink our existing models of eldercare. This requires the active support and collaboration with all stakeholders in the healthcare industry.

Whether you’re a healthcare worker, management officer, investor, patient, regulator or anyone related to healthcare, we would like to hear your views on the existing care models and what you believe will be the future.

Connect with us or drop us an email – we’d love to chat!

Sources:

A. L. Gordon et al. (2020). Commentary: COVID in care homes—challenges
and dilemmas in healthcare delivery. Age and Ageing. 49, 701–705. doi: 10.1093/ageing/afaa113

Goh, Y.H. (2020, Oct 30). Valuable lessons from first brush with Covid-19 helps Lee Ah Mooi home deal with second incident. The Straits Times. https://www.straitstimes.com/singapore/valuable-lessons-from-first-brush-with-covid-19-helps-lee-ah-mooi-home-deal-with-second

Lin, C. (2021, June 4). COVID-19 cluster at MINDSville@Napiri: Why is it so hard to keep the virus out of adult care homes? CNA. https://www.channelnewsasia.com/news/singapore/covid-cluster-mindsville-napiri-adult-care-home-challenge-14946852?cid=FBcna&fbclid=IwAR3E-RsJNt1hTcdu96fHBP-HJbTidVuYF76pMvmxbELrQbgAYFQ1tQIQAtg

Oliver Wyman. (2020, October 30). COVID-19 Challenges spark opportunities for senior care in Singapore. https://www.oliverwyman.com/media-center/2020/oct/covid-19-challenges-spark-opportunities-for-senior-care-in-singapore.html

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