It’s already hard for care workers to cope with Covid outbreaks that kill residents they have known for years. Guilt that they may possibly have caused it only makes things worse.
That is the anxiety faced by many, according to a carer who has spoken to the Guardian from the midst of a care home outbreak which has so far claimed 12 lives.
“You turn it over and over in your mind,” they said. “You think, what did I do when I went to the petrol station, what did I do in different bits of the care home and there’s a voice in your head saying you’ve killed these people.”
Covid death rates in care homes across England and Wales have risen as high as last May and while almost all care home residents have now been vaccinated, the worst impact of the new, more transmissible variants of the virus has only recently been felt.
When Lesley (not their real name) came back on shift after isolation having tested positive last month, the home was on a crisis footing with half of the residents infected.
“It was shocking, when I walked back in. The first four doors I saw all had Covid, Covid, Covid on them,” they told the Guardian, requesting anonymity. “Then I started to talk to colleagues and realised how bad it was.”
Residents seemed very scared as fatalities mounted up.
“One woman said ‘I just wish I knew who gave to me’,” Lesley said. “I said I think it could have been me.”
When not working Lesley only goes out for essentials and wears disposable masks and gloves. When the consequence of infection can mean the deaths of people you care for, it is hard not to become obsessive.
“The past two days off it has been bouncing around my head a lot,” they said. “You start to get obsessive about particles. You think about all the different ways they can get spread, deposited on surfaces … You talk to your colleagues and they give you a bit of perspective and they say it might not have been you. And there’s truth in that, but it doesn’t sit well.”
The feeling of guilt is “really horrible”.
The home accepted a number of residents from hospital, albeit with negative Covid tests, and ambulance workers sometimes come and go. But guilt among assiduous workers thrives – a semi-submerged emotion storing up future mental health problems.
Lesley, like about half of care workers in the UK, earns less than the living wage, in their case, £8.76 an hour – less than a checkout worker at Tesco. At the home, the staff only get £96 a week statutory sick pay if they fall ill – even with Covid. Many take holiday in order to keep their earnings up if that happens.
Colleagues also fear taking the virus back into their own homes, especially if they live with vulnerable family members. It creates high states of anxiety, but they keep going because “it’s a job and we need the money, and we don’t want to let anyone down”.
Carers see up close the consequences of Covid.
“A lot of people are getting weaker and waxier and slipping away,” Lesley said.
On one recent night shift, Lesley sat with a dying resident whose breathing was becoming more and more ragged.
“I sat holding her hand or with my hand on her shoulder letting her know she was not alone,” Lesley said. “Her daughter called on the lady’s phone to see how she was. She could hear the ragged breathing, and got very upset.
“I tried to let her know, your mum’s not alone. Yes, she is dying, but she is not dying alone. It’s important for people to know that there is still quite a high quality of care and there is a lot of love that people are putting into it. A lot of tears, but a lot of love.”
After the woman died the carers “washed her, put her into her nightie, brushed her hair and tried to make her look as nice and peaceful as possible.”
They made a note of the rings on her fingers for the undertaker, “had a little tear”, and moved on to look after the next person.
“We normally lose one every few weeks but lately, it’s a daily occurrence,” Lesley said. “It is intense.”
