La France a commencé à lever son interdiction des coronavirus pour les visites familiales dans les maisons de soins infirmiers lundi alors que d'autres pays européens aux prises avec la pandémie de coronavirus tentent également d'équilibrer les problèmes de sécurité et la compassion.
Après plus d'un mois de réclusion, les 7 000 foyers de soins pour personnes âgées de France ont été informés qu'ils pourraient reprendre les visites des membres de leur famille à partir de lundi mais dans des conditions strictes pour assurer la sécurité de leurs résidents.
As the elderly are particularly vulnerable to Covid-19, any physical contact will be strictly prohibited. But the government hopes that even eye contact will bring “comfort” to isolated residents and their distressed loved ones.
The move comes days after President Emmanuel Macron ordered an exception to one of the world’s tightest locks, asking his government to ensure that families are allowed “to see the sick at the end of their care.” life, to be able to say goodbye to them ”.
Older people around the world make up a disproportionate share of the victims of the new coronavirus, a highly infectious virus that has turned state-funded retirement homes into time bombs.
Deaths in nursing homes represent more than a third of the 19,000 coronavirus deaths in France – the figures the government is now meticulously documenting after weeks of pressure. Just under half of nursing homes across the country were affected, with more than 15,000 confirmed cases among patients and 8,900 among staff between March 1 and April 14.
“Lonely and depressed”
To protect the elderly, nursing homes have been operating in a vacuum for over a month now, their residents isolated in their rooms. But experts have warned that internment can lead to another type of toll.
L'infirmière auxiliaire Sophie Marconet a déclaré des semaines d'isolement pesaient lourdement sur le moral des résidents de sa maison de retraite alsacienne dans l'est de la France durement touchée, où l'isolement a été imposé début mars - une semaine avant le reste de la France.
“They are alone and depressed. In some cases, a “slip syndrome” (rapid deterioration of health) has appeared, “she explained to FRANCE 24.” Many do not understand why they are kept in forced isolation, why they eat alone in their room, and why no one comes to see them. “
Marcenat and his colleagues organize Skype sessions with families whenever possible. They also answer regular phone calls from worried and eager news parents. But there is only so much camaraderie they can provide. The foreclosure put an end to group meals in the dining room and all other forms of social life.
Marc Bourquin of the Fédération hospitalière de France, who oversees public nursing homes, said residents need to have visitors, especially if restrictions related to the coronavirus stay in place for months.
“When workers see that someone is losing their taste for life because they cannot see their families, we need to find a progressive way to allow minimal contact,” Bourquin told the Associated Press. “The risk of the virus will not go away until there is a vaccine. We cannot condemn these people to never see their loved ones again. “
>> Covid-19 in retirement homes in France: “Saying goodbye makes all the difference”
Experts have argued that contact is just as essential for families, especially when they risk losing a loved one. In an interview with France Inter radio last week, psychiatrist Serge Hefez stressed the importance of being able to be with his loved ones at the time of his death. Hefez himself lost his mother while she was locked up in a nursing home.
“All the dignity that our loved ones have at the end of their life is when we are with them, hold their hands, reassure them, stay close to them during this passage from life to death; but many are deprived of it, “he said. “We are losing our humanity and entering a kind of barbarism with an overprotective hygiene system even if death is part of the rhythm of life. “
Balance physical and psychological health
Pascal Champvert, head of AD-PA, the main French association representing directors of retirement homes, spoke in favor of easing restrictions on family visits, noting that the psychological health of many residents is is severely degraded after weeks of isolation.
“We must find a balance between the physical and psychological security of our inhabitants,” he told the French daily La Croix. “Even if we continue to protect them as much as possible from Covid-19, we believe there is an urgent need for them to be able to reconnect with their families. “
As of Monday afternoon, none of the health centers contacted by FRANCE 24 had resumed family visits, with staff suggesting that logistics were still under discussion.
Announcing the new measures a day earlier, Health Minister Olivier Véran said visits would be limited to two family members per resident and would not begin until security measures are in place.
Véran assured the public that retirement homes across the country have finally received the necessary protective gear after weeks of desperate shortage.
In his care home in Alsace, Marcenat confirmed that masks and gloves were more readily available, although dresses were still missing. But she was skeptical about resuming family visits without endangering the people in her care.
“I think it is too early to start the visits again, despite the sadness and anxiety expressed by the families and of course our residents,” she said. “It is too early for comfort. “
>> As the coronavirus infiltrates retirement homes in France, a “tsunami” of deaths is counting
Sophie Santandrea, of the French private retirement homes group Synerpa, was also cautious about allowing visits.
“It will depend on the protocols that are in place, and whether they are very clear and sufficient” to protect everyone from exposure to the virus from visitors, Santandrea told AP.
” It’s a question of survival “
Other European countries, home to the world’s oldest population, are faced with the same ethical dilemma – one that the Dutch Minister of Health, Hugo de Jonge, described as “the devil’s dilemma”.
Germany, which has fared better than most so far, allows patients in nursing homes to receive a visitor for up to an hour a day, and does not restrict visits to palliative care facilities for those approaching the end. Other countries are making provisional steps in this director, while meeting strong resistance.
En Grande-Bretagne, où la pénurie d'équipement de protection individuelle, ou EPI, a été particulièrement aiguë, les agents de santé ont mis en garde contre l'assouplissement des règles pour soulager la douleur des familles.
“From that moment on, I am very worried that we do not have enough PPE for the staff to protect themselves, not to mention making it easier to give it to parents so that they can see their loved ones during care end of life, “Donna Kinnair, executive director of the Royal College of Nursing, told AP.
There was similar opposition last week when the Belgian government said it would allow a healthy visitor for each resident of a nursing home, Prime Minister Sophie Wilmes warning that people “may die of loneliness.” “
The government’s move has sparked a whirlwind of criticism amid shouts that would endanger lives, overburden staff, and divert doctors and nurses from already insufficient supplies of protective equipment. The plan has already been repealed in most of the regions that make up the Belgian federation.
Ursula von der Leyen, President of the European Commission, was unequivocal on the subject, warning that “contact with the elderly must be limited as much as possible”.
“I realize that it is difficult and that loneliness weighs heavily,” she said. “But it’s a matter of survival. “