Expert advice for Edinburgh care home staff



Care home workers in Edinburgh are being offered specialist support as they deal with unusually high death rates prompted by COVID-19.

Reflective debriefing sessions, facilitated by palliative care experts from the University of Edinburgh, are designed to help staff to cope as unprecedented numbers of residents lose their lives.

Facilitators say the online sessions are designed to make nurses, carers and ancillary staff feel more supported, and improve end-of-life care in care homes during the pandemic.

The online debriefings have been trialled at a nursing care home in Edinburgh and now other care homes are keen to take part. The new virtual sessions are based on face-to-face debriefings launched by the University-based researchers – who are also experienced nurses – 10 years ago.

Debriefings build staff confidence in speaking about death and dying, and enhance the way in which they interact with dying residents, the researchers say. Sessions can also increase staff awareness of how vital their role is, especially at a time when families are struggling to visit.

The team says care home workers are paying a huge emotional price during the coronavirus outbreak. Staff who have built close bonds with residents and their families, often over many years, are now dealing with frequent, and sometimes sudden, losses of life, and are grieving.

Figures released last week showed the number of care home residents in Scotland succumbing to the infection had doubled in a week. The numbers dying from COVID-19 in care homes in England and Wales more than quadrupled in the week ending 10 April, compared with the previous seven days.

Many care home staff have expertise in palliative care – a wide-ranging term that includes any approach providing care and support for people with a life-limiting illness. While many care homes provide staff training in end-of-life care education, it is not a statutory requirement.

Researchers say effective debriefing provides emotional support and enables staff to review and improve clinical practice. It also allows them to hone their skills and expertise in understanding the dying process.

Participants are encouraged to revisit their memories of residents who have recently died and to reassess the events and circumstances at the time of their death. Staff are supported in sharing their feelings about how events unfolded and as they reflect on whether anything might have been done differently.

Dr Jo Hockley, of the University of Edinburgh’s Usher Institute, said: “It’s important to recognise the fantastic work that care home staff do in palliative and end of life care. We hope these sessions will support staff as they respond to the many challenges they are encountering during the pandemic.”

Dr Julie Watson, of the University’s Department of Nursing Studies, added: “The pressure on care created by Covid-19 is placing huge emotional pressures on the care home workforce. Staff are having to deal with the stress not just on an eight or 12-hour shift, but when they go home as well.”

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