The nursing homes, weakened by the coronavirus, ready to face a heatwave?

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In the corridors of the Ehpad Parc de Mougins, of the Korian group, on Wednesday June 17, 2020 – F. Binacchi / ANP / BalthazarKorab

  • Summer, staff leave and the risk of heat waves represent a difficult period for nursing homes.
  • In times of coronavirus, after the hecatomb among residents, the fatigue of caregivers and fears about air conditioning, the heat peaks arouse some fears.
  • While the OECD has just pinned France for its understaffing in helping the elderly, and the Ministry of Health is organizing a “Ségur” supposed to put all the problems on the table, representatives of the sector hope that the government will not forget the care of the elderly in its recovery plan.

EDIT: As France begins the first scorching episode of its summer, the editorial staff offers you the re-reading of this article dating from the month of June. At that time, the country, which was emerging from confinement, was preparing to experience its first heat wave, well before the summer period. Ehpad severely affected by the Covid-19 epidemic feared the arrival of the mercury surge.

Sunglasses and sunscreen in the schoolbag or picnic bag. This weekend the thermometer will climb to over 40 degrees in some departments. A heat peak before which risks giving cold sweats to those who do not support the heat wave. In particular residents of accommodation establishments for dependent elderly people (Ehpad), just deconfined, very weakened by the coronavirus and particularly sensitive to heat.

A heat wave in a unique context

The nursing homes, which since the dramatic heatwave of 2003 have gone through a number of heat peaks, are now running in. “If we have 35 ° C for three months, it will be complicated, but if there are a few heat peaks, the teams know how to cope,” reassures Joachim Tavares, former director of nursing home and founder of the company Papyhappy, who advises seniors or their families in choosing their future accommodation. “Preparing for a heat wave has become routine,” adds Romain Gizolme, director of the Association of Directors at the Service of the Elderly (AD-PA).

However, the difficulty this year, and the guidelines indicate it, is that there could be restrictions on the use of air conditioning, as part of the epidemic. In fact, in collective places, such as catering establishments, which are often air-conditioned, the air flows risk increasing the transmission of the virus. What about the fan? Not better, as this article from our colleague explains. “It is stated in the directives that the fan can be used in the bedroom as long as the person is able to turn it off before someone comes in,” explains Romain Gizolme. You might as well say that many will have trouble … “

“These measures linked to the epidemic, legitimate, come into conflict with the measures to limit the risks in times of heat wave”

Third difficulty: “You have to ventilate the accommodation several times a day,” he continues. However, what is recommended during heat episodes is the reverse, open the windows at night and close during the day. These measures linked to the epidemic, legitimate, come into conflict with the measures to limit the risks in times of heatwave. “

Wearing a mask, which sends hot air and mist onto the glasses at 35 ° C, promises to be a new challenge for caregivers. And for the residents, with whom it will be necessary to redouble their patience and pedagogy to encourage them to wear it. “We have to do more regular hydration tours, offer water to residents or other drinks if they do not like water, adapt their clothing, list Joachim Tavares. When I was director of nursing home, there were still residents who went out in down jackets with 35 ° C… ”A new crisis situation during which vigilance will be required, especially since the elderly often lose the feeling of thirst. “And they are not used to drinking between meals, or eating cold, a salad for example,” he continues.

Exhausted staff

The other factor in the equation is the immense fatigue accumulated by the staff. Who alerted two years ago about their degraded working conditions, the toilet time cut short, listening prevented. Since then, they have been a little more drained by the strikes at the end of 2019, then by the Covid and its procession of overtime and anxiety. As for the residents, this tunnel of solitude also put them to the test. “These two months of confinement have been extremely complicated for many, so imagine for these elderly people confined for almost four months! », Recalls Romain Gizolme. They were locked up, far from their relatives, saw comrades die and caregivers all the time masked …

Activities have been interrupted, and may again be suspended in the event of hot weather. Of course, gentle gym can be done early in the morning in the shade in a garden (when there is one). “But any outside exit will be limited, which is a bit sad for the residents who have already lived in prison for the last few months.” After the coronavirus hecatomb, a heatwave could therefore prove to be catastrophic in nursing homes. “Every year, during a heat wave, 5,000 deaths in excess on average among the elderly, details the director of AD-PA. I do not see how it could decrease in a context which adds aggravating circumstances. “

A chronic understaffing

Especially since offering a glass of water or a damp cloth several times a day, “it’s human time,” he warns. The only way to be able to cope is with more arms! “Difficult to obtain at the time of the summer holidays, knowing that the chronic understaffing and the lack of attractiveness do not help …” We have a job that suffers from a negative image, regrets Joachim Tavares. And it is not easy to recruit trained and available people during the summer. “Even if it is already late to organize shifts,” it is now that it is played, press Romain Gizolme. It is necessary to strengthen these gated teams and to allow recruitments to prevent the risk of heat waves in nursing homes. The Minister of the Economy announced a 100 billion stimulus plan. It must integrate the home help sector. “

For him, all visionaries underline the urgency of the situation. “When we combine the Covid crisis, the arrival of heat, the Ségur de la Santé, the OECD report which points out the delay of France in this area, many elements should push the government to go in this area. meaning. “But Joachim Tavares wants to be optimistic:” the economic period is uncertain, maybe some, worried, will want to come and work among the nursing teams, cleaning, animation of nursing homes. Some students, volunteers during the health crisis, were able to discover the human side of these places, which will perhaps arouse new vocations. “

The (positive) lessons of the crisis

This crisis, which has forced us to move away physically, has allowed some families to reconnect thanks to digital tools. Ditto in nursing homes, even if smartphones remain rare. “We have seen some families install Messenger or Facetime on their parents’ cellphones so that they can talk to their grandchildren, illustrates Joachim Tavares. The crisis has made it possible to speed up the provision of technological tools, in particular tablets, calls to television, a digital postcard, etc. ”

In the link to caregivers also, the crisis has shown the interest of teleconsultations. As long as you are accompanied or sufficiently comfortable with digital technology to conduct a remote consultation on your own. And Joachim Tavares to imagine a future where technology will take more and more place in nursing homes. “Seniors are sometimes suspicious of telemedicine, but they are convinced when they see that it works, that it relieves emergency rooms, that it prevents them from going to the hospital where they can catch a disease, the Covid or other. “Even if the screen cannot replace human contact. “I think there has been a realization that we cannot leave our elders alone. Maybe it will make families want to come see their elderly parents more often. “

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