The elderly population was one of the most affected groups with the Covid-19 situation, not only because they are at risk group but also because they are becoming more and more isolated.
The Portugal News investigated the reality of nursing home residents and the impact of the General Health Direction (DGS) guidelines in three different institutions in the Algarve.
Maria de São José Louro, technical director of the Casa de Repouso e Saúde of São Brás de Alportel, guarantees that they are trying to minimise all risks; however, she is the first to admit the psychological problems that this causes.
One of the DGS’s regulations is prophylactic isolation - common to all the nursing homes - when residents move to outside the nursing home to, for example, visit a doctor or go to a hospital, they have to stay and isolate for 14 days upon return.
“If they stay at the hospital for less than 24 hours, they are required, according to DGS guidelines, to complete 14 days of prophylactic isolation. If they are hospitalised for more than 24 hours, they must be subjected to a Covid-19 test, but even with a negative result they must be quarantined for 14 days. 14 days in a room can have a severe effect on the physical and psychological situation”, she said. The same process happens when they are admitted.
This nursing home is specialised in receiving patients with Alzheimer’s disease. “We have 59 residents, of which 21 have Alzheimer”, said the director.
She explains that people with Alzheimer are always moving, “imagine someone moving towards the door for many hours, the cognitive part is compromised and is alarmed”. With the isolation, “they change sleep schedules, they sleep in the afternoon”, and she adds that it is “very difficult to give them an active routine, so for many reasons the impact that these 14 days have on people in isolation is a huge loss of capacity”.
Measures to prevent the contagion of Covid-19 have limited activities that require social interaction, especially with people from outside the nursing home, and have restricted visits from families. “Visits are made abroad using an acrylic barrier”, explained the director.
Video calls aren’t always a good solution. “Video calling for these people has a negative result; they have a very high level of dissatisfaction, especially for the family”, she said, and justifies that people with Alzheimer cannot pay attention and interact with the conversation on the screen.
At the Monte Da Palhagueira - Country House Nursing & Retirement Homes in the Algarve, 100% of the residents are foreign and a lot of them are used to communicating with their families by video calls because of the distance. Residents who have family living in Portugal and who are used to family contact were more surprised. “The human touch is essential”, explained Alexandre Neves, the General Manager of Monte da Pagalheira.
Monte da Pagalheira is a village with an associated nursing home, in order to create a family atmosphere, in both. “In the village people have almost total independence, we help as much as necessary, but with independence. We have nurses 24 hours a day, 7 days a week“, he said. This concept allows, for example, couples to live close to each other, one can be in the village and another in the nursing home “if one needs more support and the other is still in a very independent state”, he explains.
In his opinion, the pandemic situation highlighted Portugal even more as a safe destination to enjoy retirement age and confesses that the waiting list for Monte da Pagalheira keeps growing as demand increases. Also, village residents, because they have their own house’s, still make their living independent and keep in touch with the outside, they only saw the number of social activities decrease, in order to comply with the DGS guidelines.
In Lagoa, João Carlos Pereira, the president of Centro Popular de Lagoa, also has other concerns. Due to the alarmism of the media “those who are autonomous and were on the waiting list, end up giving up because they don’t want to feel like they are in prison”, he said.
However, he ensured that nursing homes “are not a dark place, as it seems now in the media”. The space is open, users can move around as much as possible and the nursing home always tries to promote some activities, always according to the safety measures. But, of course, “we have to comply with the rules in order to guarantee safety”, he said.
To finish, Maria de São José Louro made an appeal: “Social security and DGS should talk to those on the ground: visits through the window without social contact are nothing, and the elderly were used to a lot of affection, this is all very cold” she said while adding that “another six months like this and i don’t know how the residents will be able to cope”.
All the three nursing homes confirmed that they don’t have any registered positive cases of coronavirus.