Abstract
The COVID-19 pandemic has disproportionately affected care home residents internationally, with 19–72% of COVID-19 deaths occurring in care homes. COVID-19 presents atypically in care home residents and up to 56% of residents may test positive whilst pre-symptomatic. In this article, we provide a commentary on challenges and dilemmas identified in the response to COVID-19 for care homes and their residents. We highlight the low sensitivity of PCR testing and the difficulties this poses for blanket screening and isolation of residents. We discuss quarantine of residents and the potential harms associated with this. Personal Protective Equipment (PPE) supply for care homes during the pandemic has been suboptimal and we suggest that better integration of procurement and supply is required. Advance care planning has been challenged by the pandemic and there is a need to for healthcare staff to provide support to care homes with this. Finally, we discuss measures to implement augmented care in care homes, including treatment with oxygen and subcutaneous fluids, and the frameworks which will be required if these are to be sustainable. All of these challenges must be met by healthcare, social care and government agencies if care home residents and staff are to be physically and psychologically supported during this time of crisis for care homes.
Highlights
COVID-19 presents atypically in care home residents and up to 56% of residents may test positive whilst pre-symptomatic
We highlight the low sensitivity of PCR testing and the difficulties this poses for blanket screening and isolation of residents
In the UK, care homes have long been outside National Health Service (NHS) supply chains and their ability to procure Protective Equipment (PPE) has been hampered by the NHS adopting a monopoly purchaser role during the pandemic
Summary
The failure to provide care homes with adequate stocks of appropriate Personal Protective Equipment (PPE) has received much coverage in the lay media. This has been an issue in most countries and whilst root causes vary they are almost universally organisational. In the UK, care homes have long been outside NHS supply chains and their ability to procure PPE has been hampered by the NHS adopting a monopoly purchaser role during the pandemic. It is illogical for care homes to have to compete against the NHS for supplies to support an organised response to COVID-19, integration of procurement and supply chains are a logical response, at least for the duration of the pandemic
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
