Care homes were told to impose a blanket ‘do not resuscitate’ order on all of their residents during the peak of the UK’s coronavirus outbreak, according to a major study.
The survey, undertaken by the Queen’s Nursing Institute, found that while care homes were put under “constant” pressure to accept patients with Covid-19, they were also sometimes refused treatment from hospitals and GPs for elderly residents who became ill when the crisis was most severe.
One disturbing finding was that some homes were told hospitals had blanket “no admissions” policies during April and May – and some respondents reported that GPs and local managers imposed Do Not Resuscitate orders on residents “without discussion with residents, families or care home staff”.
The survey found that almost one in ten care homes were told to change resuscitation orders for patients, and that half of those cases occurred in centres for people with learning or cognitive disabilities.
Professor Alison Leary, director of the International Community Nursing Observatory, and professor of healthcare and workforce modelling at London South Bank University, said the findings were worrying and surprising.
“It is clear from this survey that the care home workforce has faced very challenging issues, she said. “‘I was quite surprised how many people reported issues with DNRs as I was expecting one or two, but that 10 % of the respondents raised an issue, because they were either blanket decisions for whole populations, or they were imposed without discussion with the care home or the family or the residents, and that is really worrying,” she said.
“These decisions were being made by NHS managers not clinicians. And this wasn’t just happening with elderly people, it was those with learning disabilities or cognitive problems of all ages.’ The decision were made without discussions with staff, residents or their families,” she noted.
The report from QNI said that one in five care homes said they received a patient from hospital who was positive for coronavirus, while 25% said it was “somewhat difficult or very difficult” to access care for their patients during the crisis.
Some nurses said that working under extreme pressure and facing daily deaths amounted to the worst time of their career.