EDITORIAL

Future care homes must be less like care homes

One of the most immediate consequences of the Covid-19 pandemic is that the standard home for the elderly in Catalonia —which has proven to be a veritable source of infection and death— has been rendered obsolete. At the start of this year few could have anticipated that over 50 per cent of residents in Catalan care homes would be infected by a deadly virus and that nearly 6,400 of them would succumb to it. To put these shocking figures into perspective, about 16 per cent of all positive cases in Catalonia are care home residents and these make up nearly 40 per cent of the overall death toll. As a result, the Covid-19 catastrophe has forced the Catalan government to set up a working group to re-think the care home model, as some of the lessons from the pandemic are very clear and mean that a far-reaching review is necessary.

The first lesson has to do with the management model. Experts point out that new restrictions will make this business less profitable, as the so-called “cruise ship” model —with up to 200 residents sharing the same building and communal spaces— will no longer be an option. Therefore, the first decision to be made is about the precise involvement of the public administration in the future model.

At any rate, the new system should aim to delay, for as long as possible, the time when it becomes inevitable for someone to go into a care home. Everyone agrees that this must be the first change. Technology and the profile of future users should allow them to embrace home automation technology as the first solution. Next, it will be day care centres and the provision of care at home. After that we would resort to managed homes, where residents are autonomous but supervised, with on-site carers. And, eventually, care homes. The idea is to devise a bespoke itinerary for each person depending on their needs, thus avoiding the traditional care home concept as the only option that can be offered.

What should these facilities be like? To start with, it ought to be possible to separate residents into contact groups of 10-12 people, which would prevent a contagion from spreading. The architectural design should include more outdoor areas and easily-aired indoor spaces. Construction materials should be less porous so that a virus’ lifespan may be shortened on certain surfaces. This means more steel and less plaster, for example. Special attention must be paid to air ducts and as many services as possible should be individualised.

Scandinavian countries have been using this model for some time and their mortality rate in care homes hasn’t been so bad. Now it is time to adapt it to our setting and use this unfortunate pandemic to re-think a model that would have become dated sooner or later.

Catalonia’s population pyramid is growing top-heavy and, therefore, one thing is clear: caring for the elderly will play an increasingly greater role in our welfare state and service sector. We had better take action, if we wish to avoid another nightmare like we have had these last few months.