‘Social work without the social’: the heartbreaking impact of separation on care home residents

The past nine months have been an emotional rollercoaster both personally and professionally.  As a social worker, working as a best interests assessor, I wasn’t furloughed but I also wasn’t working on the ‘front line’ as it’s quite often termed.  I felt a bit stuck in limbo.

I was still expected to work my usual hours (albeit flexibly around home schooling commitments) and work through assessments at my normal rate or even faster, given that I didn’t have to factor in travel time anymore.

I was used to meeting people, which is what social work is all about. It’s the cliché but I went into social work to help people, I like meeting people and hearing their stories. So to carry on doing assessments and making big decisions in relation to people’s lives without even meeting them felt awful. It was certainly social work without the ‘social’.

New ways of working

We were advised not to visit care homes due to the risk of spreading coronavirus, advice that was given at the start of the first lockdown.  I had, however, already made some adjustments to my working pattern and had stopped visiting a couple of weeks earlier as I felt I shouldn’t be risking people’s health.  I never thought then that nine months on I still wouldn’t have set foot in a care home or met the people I was being asked to assess.

The guidance we received from the government in relation to Deprivation of Liberty Safeguards (DoLS) was to complete our assessments via video or phone call and to rely on information provided by the staff at the care homes and by family or friends.

Trying to assess someone’s mental capacity over video call (sometimes with freezing picture and poor sound quality) seemed impossible and very impersonal.”

I soon found new ways of working that helped and managed to set up a space at home where I could work with some privacy. Things ticked along in this new way, the first lockdown ended and family were able to visit their loved ones from a distance in the garden or outside the window. It felt ok for a short while.

Challenges of the second wave

Then things turned and the figures started rising again. The more assessments I completed and the more care home staff and family members I spoke to, the worse things seemed.

One man told me that, although his 86-year-old mother with dementia was doing ok and hadn’t had Covid-19, the other five people she would sit with at meal times had all died. I was heartbroken, not only for the lady who was now sitting alone at her dinner table but for the other five families who had lost loved ones.

Deaths in care homes have also had a huge impact on the care home staff. They have all worked so hard, under such impossible conditions, and are terrified of catching it and passing on to their residents.

They are tested weekly, (which isn’t the nicest experience), they then have to attempt to test the residents (monthly), which isn’t an easy task when the person they are trying to test doesn’t understand what they are doing and why they are doing it.

Relatives ‘in tears’ on the phone

As part of my assessments, I always phone family members (or friend or advocate) and these phone calls were getting tougher. Relatives would be in tears on the phone to me, telling me how much they missed their family member.

One daughter told me that she used to visit her 83-year-old dad every other day.  She used to go in at meal times to help him (he preferred her help to a staff member). She would always take him the newspaper and sit with him and read the sport. He had suffered from depression in the past, and now, with his dementia diagnosis, he would struggle to remember where he was living and why. His daughter would offer reassurance and he would settle down and feel happier about things.

The son of another lady I was asked to assess said when restrictions were relaxed he visited his mother in the garden but that his mum didn’t recognise him, partly due to wearing a mask (she was frightened) and partly due to the fact that she hadn’t seen him for over three months and her mental health (dementia) had declined. Initially, she thought her son was her husband. He had sadly passed away seven years ago. Her son hasn’t visited since as it was too upsetting for both of them.

Regular testing of social workers needed

The impact on people living in care homes has been devastating, not only for the people who live there but for their families and for the care home staff. I do a hard job and I’ve always had challenging days, but the experience of this will stay with me forever.

The first lockdown was difficult, however, the past six months have got harder and harder and I feel the full extent of the damage that has been caused, not only by the virus, but by the restrictions on seeing loved ones is yet to be seen.”

Right now, we need more from our MPs and public bodies. We need them, and the public, to better understand the role of social workers. A good start would be to support campaigns like Test, Safe Access, Promote Rights from the British Association of Social Workers, which calls for social workers to be regularly tested for Covid-19 so they can get past blanket restrictions put on by many care homes, in order to safely access and promote the rights of the vulnerable.

The writer is a mental health social worker and best interests assessor, who has chosen to remain anonymous.