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10 Oct 2022 'Mammy died alone. We weren't allowed in': Campaigners demand improved visiting rules in hospitals

“You don’t believe the stories until you experience it yourself,” said Eimear Fitzgerald.

Eimear Fitzgerald, from the advocacy group Care Champions. Picture: Moya Nolan

Eimear Fitzgerald became an advocate for hospital and nursing home visiting after her mother died alone during a Covid outbreak last year, but she never expected to be still doing this in late 2022.

Now volunteering with Care Champions, who assist families when a relative is in a hospital or nursing home, she said people from all 26 counties still call to say they cannot visit loved ones.

Strict visiting rules were introduced for all hospitals during March 2020, and while they have been noticeably relaxed, an analysis of visiting rules across Munster hospitals shows a broad variety of restrictions are still in place.

The HSE updated this list as recently as Thursday.

Ms Fitzgerald said her parents lived in nursing homes for about 15 years, her mother died in January 2021 and her father six years before that.

“Mammy died alone, we weren’t allowed in," she said. 

She died alone, that’s why I do this now — so nobody else should go through this.

“It is just too much. We want nobody else to suffer the way we did, there are too many people still suffering today as a result.” 

Her father’s death also took place while in care, so she had that experience to compare to her mother’s death, she explained.

“You don’t believe the stories until you experience it yourself,” she said. 

The phrase ‘guidelines’ allows nursing homes and hospitals to do what they want.

"I was making a hospital appointment today for myself, and I noticed on the literature it still says you must attend the hospital by yourself.” 

Most hospitals still operate an appointment-only visiting system.

She said while calls for help are not as frequent as last year, she still hears about restrictions at hospitals in every county. This includes that “carers are not being allowed in”, she said.

“An appointment might be only for 15 or 20 minutes, and also then if the appointments are full-up, you don’t get an appointment that day and you have to try again the next day,” she said.

“Everybody understands the measures which have to be taken in order to protect vulnerable people, so this is just too much now. I was visiting someone in a hospital recently, and the only time you are allowed in is between 5.30pm and 6.30pm. It is completely restrictive.” 

Different hospital, different restrictions

Fine Gael councillor for Macroom and member of the Regional Health Forum South, Eileen Lynch, said hospitals across Munster are applying different restrictions, adding to families’ confusion.

She said she understands there are risks still associated with Covid-19 and the winter flu season, but urged that hospitals consider ways to work with this now.

I don’t see any major reason as to why, with the exception of ICU units, we shouldn’t be reverting back to the visiting rules we had before Covid,” she said.

Families have asked her for help when they were given limited access to a relative who was long-term in hospital.

“I’m not getting as many requests about it as three or four months ago, but it is still an issue, unfortunately," she said.

Cork University Hospital advises visitors to contact the ward manager for an appointment.

The Mercy University Hospital allows one visitor per patient, for patients who are critically ill or have specific care needs, and for children on St Anne’s Children’s Ward. They advise contacting the clinical nurse manager on the ward for specific requests.

The South Infirmary Victoria University Hospital offers an online booking system, which can only be used by nominated visitors with a ‘visitor access identity’ number.

At University Hospital Kerry, visitors are allowed when a patient is critical or at end of life or under exceptional compassionate circumstances. This has to be agreed with a sign-off from the patient’s consultant and ward manager.

Visiting is allowed at University Hospital Limerick via booking on the ULHG visiting app, from 2pm-4pm and 6pm-8pm daily. Exemptions can be made on a case-by-case basis.

Visitors to University Hospital Waterford must arrange visits with the clinical nurse manager on the relevant ward. Reasons for visiting can include when a patient is distressed by long periods alone.

'You see the lift people get when they have a visitor'

The Irish Association of Social Workers head medical social worker Amanda Casey said these variations are reflected across the country.

“There is quite a difference in approaches being taken — depending on where your relative or loved one is admitted, you could experience visiting in a very different way,” she said.

In her experience, people rely on visitors for social reasons and assistance with understanding a new diagnosis or moving around.

“What we then observed is people obviously became very isolated, very lonely in some cases,” she said, referring to 2020 especially.

I don’t think you could say someone deteriorated because they didn’t have visitors, but when you see the lift people get when they have a visitor, in terms of their mood and engagement, it is very obvious it can have a really positive impact.” 

Visitors are prioritised for end-of-life patients, and she said colleagues now report case-by-case decisions being made.

“I don’t feel a blanket 'yes or no' can ever be applied, because people are so different,” she said.

Ms Casey urged families to raise issues directly with Patient Services in a hospital, and request to speak to the consultant in charge of their relative.

“Don’t give up if it’s important,” she said.

Unless people say this is a problem, then organisations may not recognise it as such.” 

Exemptions, especially for patients facing long stays in hospital, need to be made on human rights and compassionate grounds, she said.

“There has to be room for local exemptions, and I know that is difficult because people say it becomes subjective and about the mood of the person making the decision, but I think there does need to be,” she said.

She pointed to the clinical rationale behind the original limits linked to Covid-19, and said in her recent experience, visitors are allowed for patients with dementia or an intellectual disability.

The lack of visitors for vulnerable patients was raised with the Irish Examiner as a concern by healthcare workers who claimed to have seen families turned away or granted extremely limited time.

Hospitals could look at using antigen tests to reassure everyone, she suggested.

“If something like the pandemic were to happen again, there are examples from other jurisdictions where they have been able to identify peer

partners,” she said.

We need to be creative about how we do things in the future. I would certainly feel it needs to be different.” 

'It’s something that haunts me'

Lucie Kavanagh saw the benefit of hospital visiting when her brother fell seriously ill in February 2020, weeks before the pandemic hit.

“He’d had a very, very bad case of food poisoning,” she said.

“It started out relatively straightforward, but he got very seriously ill while he was in hospital. The hospital was still quite busy, even though not on the scale it is now, and he was moved from one ward to another.” 

He phoned her one morning to say that he was in “excruciating pain”, and while he had been given pain relief, he was worried.

“When he got to the hospital, he seemed like he had when I first brought him to A&E, so I went to speak to the nurse,” she said.

They were reassuring, but did not offer new treatment immediately.

“I went back to them again and said there was something really wrong,” she said. 

It’s something that haunts me a bit because I didn’t even really realise how bad things were.” 

The nurses fetched a doctor, who recognised her brother needed surgery and she recalls being told he was in septic shock.

“Thank God he got through it, and he was three weeks in intensive care afterwards,” she said. 

“What always haunts me about it is when we spoke about it afterwards, he said he was so ill he wasn’t really thinking of asking the nurses for help anymore, that he wasn’t capable of it.” 

It has always stayed with me, and I often thought if he had been ill a few weeks later, there wouldn’t have been any visitors.” 

Ms Kavanagh, living in Co Mayo, said the incident showed her how quickly things can change for a patient.

“The staff in ICU were absolutely fantastic, and even on the ward, I couldn’t say he was being neglected, nobody expected that to happen,” she said.

“It felt like if somebody hadn’t spoken up for him, it might have been missed and we could have lost him completely.”

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