Activists demand better hospital visitation rules

Eimear Fitzgerald became an advocate for hospital and nursing home visits after her single mother died in a Covid outbreak last year, but she didn’t expect to continue doing so. 2022.

Now a volunteer with Care Champions, which helps families when a relative is in a hospital or nursing home, she said people in all 26 counties are still calling to say they can’t visit loved ones.

Strict visiting rules were introduced for all hospitals in March 2020, and although they have been eased significantly, an analysis of visiting rules in hospitals in Munster shows that a wide variety of restrictions are still in place.

The HSE updated this list as recently as Thursday.

Ms Fitzgerald said her parents had been living in nursing homes for around 15 years, her mother died in January 2021 and her father six years prior.

“Mammy died alone, we weren’t allowed in,” she said.

She died alone, that’s why I’m doing this now – so no one else goes through this.

“It’s just too much. We don’t want anyone else to suffer like we did, there are too many people still suffering today because of it.

Her father’s death also happened while she was in care, so she had that experience to compare to her mother’s death, she explained.

“You don’t believe the stories until you experience it yourself,” she said.

The term “guidelines” allows nursing homes and hospitals to do whatever they want.

“I was making a hospital appointment today for myself, and noticed on the literature that it always says you have to go to the hospital on your own.”

Eimear Fitzgerald, of the advocacy group Care Champions. Photo Moya Nolan

Most hospitals still use a visit-by-appointment-only system.

She said that while calls for help are not as frequent as last year, she still hears about restrictions at hospitals in every county. This includes that “carers are not allowed in,” she said.

“A date can only last 15 or 20 minutes, and also if the appointments are full, you don’t get an appointment that day and you have to try again the next day,” she said. declared.

“Everyone understands the steps that need to be taken to protect the vulnerable, so it’s just too much now. I was visiting someone in a hospital recently, and the only time you’re allowed in is between 5:30 p.m. and 6:30 p.m. It’s completely restrictive.”

Different hospital, different restrictions

Eileen Lynch, Fine Gael adviser for Macroom and member of the Southern Regional Health Forum, said hospitals in Munster were applying different restrictions, adding to the confusion for families.

She said she understands there are still risks associated with Covid-19 and the winter flu season, but urged hospitals to consider ways to work with this now.

I see no major reason why, with the exception of intensive care units, we shouldn’t go back to the visitation rules we had before Covid,” she said.

Families have come to him for help when they were given limited access to a relative who had been hospitalized for a long time.

“I don’t get as many inquiries about it as I did three or four months ago, but it’s still an issue, unfortunately,” she said.

Eileen Lynch, Fine Gael Councillor.
Eileen Lynch, Fine Gael Councillor.

Cork University Hospital advises visitors to contact the Ward Manager for an appointment.

Mercy University Hospital allows one visitor per patient, for patients who are critically ill or with special care needs, and for children in St Anne’s Children’s Ward. They advise contacting the clinical nurse manager of the service for specific requests.

South Infirmary Victoria University Hospital offers an online booking system, which can only be used by designated visitors with a ‘Visitor Access Identity’ number.

At University Hospital Kerry, visitors are permitted when a patient is in critical or end-of-life condition or in exceptional humanitarian circumstances. This must be agreed upon with an approval from the patient’s consultant and the department director.

Visits are permitted at University Hospital Limerick by booking on the ULHG Visitor App, from 2-4pm and 6-8pm daily. Exceptions may be granted on a case-by-case basis.

Visitors to Waterford University Hospital should arrange visits with the clinical nurse manager of the relevant department. Reasons for the visit may include when a patient is distressed by long periods of alone time.

“You see the lift people get when they have a visitor”

Amanda Casey, chief medical social worker at the Irish Association of Social Workers, said these variations were reflected across the country.

“There is a big difference in the approaches taken – depending on where your relative or loved one is admitted, you might experience a visitation in a very different way,” she said.

In his experience, people rely on visitors for social reasons and for help in understanding a new diagnosis or getting around.

“What we then observed was people obviously became very isolated, very lonely in some cases,” she said, referring to 2020 in particular.

I don’t think you can say someone got worse because they didn’t have a visitor, but when you see the improvement people get when they have a visitor, in terms of ‘mood and engagement, it’s very obvious that this can have a very positive impact.’

Visitors are given priority for end-of-life patients, and she said her colleagues are now reporting that case-by-case decisions are being made.

“I don’t think a general ‘yes or no’ can ever be applied, because people are so different,” she said.

Ms Casey urged families to raise issues directly with a hospital’s patient services and ask to speak to the consultant in charge of their parent.

“Don’t give up if it matters,” she said.

Unless people say it’s a problem, organizations may not recognize it as such.

Exemptions, especially for patients facing long hospital stays, must be granted for human rights and compassionate reasons, she said.

“There has to be room for local exemptions, and I know that’s difficult because people say it gets subjective and depends on the mood of the person making the decision, but I think it must be,” she said.

She highlighted the clinical rationale for the initial Covid-19-related limits and said in her recent experience that visitors are allowed for patients with dementia or intellectual disability.

The lack of visitors for vulnerable patients was raised with the Irish Examiner as a concern of healthcare workers who claimed to have seen families turned away or given extremely limited time.

Hospitals could consider using antigen tests to reassure everyone, she suggested.

“If something like the pandemic were to happen again, there are examples from other jurisdictions where they were able to identify peers

partners,” she said.

We have to be creative about how we do things in the future. I would certainly feel like it has to be different.

“It’s something that haunts me”

Lucie Kavanagh saw the benefits of a hospital visit when her brother fell critically ill in February 2020, weeks before the pandemic hit.

“He had had very, very severe food poisoning,” she said.

“It started off relatively simple, but he got very seriously ill while he was in the hospital. The hospital was still quite busy, although not at the current scale, and he was transferred from one service to another.

He phoned her one morning to say he was in “excruciating pain”, and although he had been given painkillers, he was worried.

“When he got to the hospital, it looked like he did when I first brought him to A&E, so I went to talk to the nurse,” she said.

They were reassuring, but did not offer any new treatment immediately.

“I went back to them and said there was definitely something wrong,” she said.

It’s something that haunts me a bit because I didn’t even really realize how bad things were.

The nurses went for a doctor, who agreed that her brother needed surgery and she remembers being told he was in septic shock.

“Thank goodness he pulled through and spent three weeks in intensive care afterwards,” she said.

“What still haunts me is when we talked about it afterwards, he said he was so sick he didn’t really think about asking the nurses for help, that he wasn’t. able.”

He always stayed with me and I often thought that if he had been sick a few weeks later, there would have been no visitors.

Ms Kavanagh, living in Co Mayo, said the incident showed her how quickly things can change for a patient.

“The intensive care staff were absolutely fantastic, and even on the ward I couldn’t tell they were neglected, nobody expected that to happen,” she said.

“It felt like someone hadn’t spoken for him, it could have been missed and we could have lost him completely.”

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