This guidance provides targeted clinical advice about COVID-19 to support those working with adults in long term care such as residents of nursing home and residential care settings (care homes). It should be read in conjunction with infection control guidance developed by Health Protection Scotland (HPS) for Social or Community Care and Residential Settings.
It is recognised that those who are in care are often frail with complex needs and varying levels of dependence. Current estimates are that there are over 40,000 residents in care homes across Scotland. The average age of residents is estimated to be 84 years. 50% of residents have a formal diagnosis of dementia, although the real numbers may be far higher. Ordinarily mortality rates for these residents is between 13 and 17% illustrating the vulnerability of the group.
Most of those in care homes will be at greater risk if they were to contract COVID-19 due to conditions such as frailty, cognitive impairment including dementia, physical disability, neurological and other conditions, and learning difficulties or multiple comorbidities. For many, hospital admission may be inappropriate – this means additional support within the care home setting may be necessary for the acutely unwell.
The long term care/residential care sector is vital to the wider health and care system and it is essential that it continues to function in a safe and effective way as it provides an appropriate alternative in some cases to more acute settings such as hospital care. It is therefore imperative that care homes continue to take admissions if it is clinically safe to do so. This guidance will support you in doing this.