When essential facilities close down, the effects can be devastating for those who rely on them in their daily lives. Day care centers for the elderly are one key example.
After clusters of COVID-19 infections were reported at some such facilities in Nagoya in March, the Nagoya Municipal Government requested that a total of 126 day care centers in two of the city’s wards close down for two weeks.
During that period, nursing care workers struggled to continue providing services for elderly people to maintain their health.
Honoka Rihabiri Day Service, a facility in Minami Ward where around 70 people are registered as users, was shut down upon request of the municipal government even though no one associated with the center was infected. Since many of the elderly users live alone, the center’s workers visited their homes to confirm their safety and offer care services, according to Masato Nakashima, 30, a physical therapist who heads the center.
Four workers separately visited the homes of almost all users, performing blood pressure and other health checks and giving guidance on physical exercise to prevent muscles from weakening.
The staff members were most concerned about whether the elderly people were eating properly, as some had symptoms of dementia and others were reluctant to go out to buy food.
When the care center is open, it provides users with bento lunches made at a nearby store. After getting permission from a public health center, the day care center staff delivered the boxed lunches to the homes of users who wanted them.
Haruko Hasegawa, 82, who lives alone in Minami Ward, was among those who received a lunch delivery.
“I was feeling lonely and worried, not being able to go anywhere, so I was thankful that he came to see how I was doing,” Hasegawa said, referring to Nakashima.
In normal circumstances, elderly users of the care facilities enjoy a variety of services including meals, guidance about exercise and help with bathing. But after the spread of the novel coronavirus, the health ministry made an exception so that day care centers can receive fees by visiting the homes of users to offer services or by checking in with them by phone instead.
Even so, the impact of the outbreak remains. Although Honoka reopened in late March, 10 users still refrained from receiving services at the facility.
One of the users even said neighbors looked coldly at those who go to day care centers, prompting the center to remove a sign with the facility’s name from its bus that picks up users.
The center’s income for March is likely to have dropped by 30 percent because of a decline in the number of users, dealing a heavy blow to its business, Nakashima said.
Nursing care managers who create care plans for the elderly also struggled to cope with the situation.
Shozo Okochi, 35, a care manager working in Minami Ward, tried to replace services at day care centers with home visits as much as possible while the centers were closed. But amid a chronic shortage of home care workers, it was difficult to dispatch new caregivers and, in many cases, he had to ask family members to take care of the users.
The situation was even more severe for households with an elderly person who had been infected with the virus.
Okochi was in charge of managing care services for a woman in her 70s who had been using a day care center where a COVID-19 cluster was reported. The woman tested positive, but she couldn’t be hospitalized because no hospital beds were available. During the four days she stayed at home waiting for a vacant bed, her family had to take care of her day and night because she couldn’t receive services from care workers.
Things grew even more complicated for care workers and care managers because the municipal government and public health centers refrained from disclosing information on infections, such as the names of day care centers where clusters were confirmed, for privacy reasons.
Okochi was told by the family of the woman in her 70s that she had tested positive, but there was a case in which a care manager visited the home of an elderly person without knowing that a family member living in the same house had been in close contact with a person who had tested positive and was in self-quarantine.
Since many elderly people use multiple day care facilities, a lack of sufficient information sharing could lead to further spread of infections.
“The central government has been aiming to establish a community-based comprehensive care system for the elderly under which medical and nursing care workers within the community work together. But information wasn’t shared this time, revealing the weakness of the current system,” Okochi said.
According to a survey conducted by the Japan Federation of Kaigo Business Providers on 1,862 elderly care business providers nationwide in May, roughly 60 percent of all facilities, or 90 percent of day care centers, said their business was affected by the coronavirus outbreak.
“Many providers, especially day care centers, are in a critical situation and need support in terms of management and information,” said Tatsuaki Takano, an associate professor of Toyo University who is well-versed in elderly care issues.
This section features topics and issues from the Chubu region covered by the Chunichi Shimbun. The original article was published May 27.
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