“Whatever you do, don’t bottle it up”

05 May 2020 -

"Whatever you do, don't bottle it up"The Covid-19 crisis has put huge emotional strain on many of us. Few are feeling it more profoundly than managers in the care home sector. In this powerful insight, we discover how they are coping with the stress and mental health challenges

Mark Rowland

For Robin Hall and her team, there is no choice but to take each day as it comes. There is no room for planning: “You’re firefighting pretty much the whole time,” she says.

Robin is the administration manager and bursar of The Home Comfort in Portsmouth, a care home with around 29 residents. It’s part of Hampshire Care Association, for which Hall acts as secretary. She is responsible for much of the day-to-day running of the home, including sourcing PPE and other equipment needed to deliver the correct level of care.

The home has so far had one confirmed case of Covid-19, and a few suspected cases, which means some residents are quarantined. “I don’t think anybody knows if that’s the right thing to do,” she says. “It’s quite normal for residents to have bacterial infections – chest infections, urinary tract infections – all the time. So you just don’t know. And I guess the not knowing is part of the stress of it all.”

PPE supplies have, of course, been a major concern for Robin and her care workers. While the home hasn’t run out of PPE so far thanks to Robin’s efforts, supplies are far from certain. There are seven government-approved suppliers of PPE, plus the local resilience forum, for emergencies. “There was a point for about two weeks where I was having to contact different suppliers every day to confirm that they didn’t have product they could ship to us before I went to the local resilience forum, and they’d give us a day, maybe two days’ worth of PPE. That’s pretty exhausting, and it’s impossible to hide from the staff.”

Here are some ways you can alleviate some of the stress of your current situation.

Admit that you’re struggling

The stress, Robin says, is constant. In addition to just keeping things running, there’s the constant fear – for residents, workers’ families, and the workers themselves. Several carers at the home are in their 70s, and there have been conversations about whether they should self-isolate. But if they do, the care home will be short-staffed – a couple of weekends ago, four or five staff didn’t show up to work, so the home didn’t have enough workers to get residents out of bed. “It’s easy to underestimate how stressful it is for carers if they can’t do what they perceive as a good job.”

So how is Robin and her team coping? “It’s hard because it’s what we deal with all day at work: we’re trying to ingest all of this new guidance that we’re getting and dealing with questions about PPE, and also making sure the business is running, making sure the bills are paid. You end up living and breathing it all the time.”

Simply admitting to yourself that you’re struggling means that you can start to move forward and find ways of alleviating or managing the situation. If you try to bottle it up, you’re just putting the problem off until it becomes too unmanageable.

Build a community, and reach out to others

One thing that has helped Robin is a sense of community, and support from others, whether that’s from family and friends, colleagues or the wider care community. Hampshire Care Association has a WhatsApp group and a manager’s network, which is helping with support.

A company called Mobilise is doing the same for people who are caring for friends and family members. Some people have found themselves as ‘accidental’ carers during the lockdown, moving in with elderly parents or moving vulnerable people in with them. For existing home carers, they are caring in complete isolation, without assistance.

Suzanne Bourne is head of carer support at Mobilise and a carer herself – she looks after her husband, who has Parkinson’s. She says that in times like this, a sense of community can be a lifeline for carers. Mobilise is running online ‘cuppa’ mornings to give carers a place to share experiences.

“It’s somewhere to have a bit of a cry or a bit of a laugh. We take people as they are, and it gives them a real boost. People come back time and time again.”

Share information

New carers often have a lot of questions, and the mornings are a crucial source of information. The biggest anxieties have been around getting enough food. Necessary trips to the GP or the hospital has also been a big source of anxiety. Suzanne shares a story about a woman who needed to take her husband to the hospital, but she was self-isolating due to her own health issues.

“When we talked it through to start with, she was weighing up whether she would die, her husband would die, or they both would both die. Those were really the options that she thought that she had.”

The group encouraged her to seek out more information. Once she had spoken to the hospital and her GP, her anxiety decreased. “Information is really powerful in helping you make a decision about risk. Essentially that’s what they’re doing – managing risk. People jump to the extremes quite quickly.”

Use resources

COVID Calm is offering free therapy services during the lockdown in the form of drop-in Zoom sessions that run several times a day, offering simple, evidence-based stress management techniques for those who need them. This is open to all healthcare professionals, but it’s mostly doctors and nurses that are using it. “I’ve only had a couple of care workers in my calls – I think they’re not sure if it’s for them or not,” says Abbey Robb, a therapist who is volunteering with COVID Calm. “But these people are really stressed, and people that they’ve built relationships with are dying, and they don’t have the equipment to look after them.”

Do something for yourself

“In war zones and at the Nightingale hospitals, they set up buddy systems for the medical staff on shift. That’s been proven to be really psychologically helpful, to have someone that you check in with. There are really quite simple things that people can put in place that will be quite effective at helping people be more resilient. And make sure they are aware of the wider schemes that will support them.”

There is no respite for care workers and care home managers at this time, so it’s vitally important that they work to keep themselves psychologically healthy. A lot of that is down to having a good routine, says Abbey – ensuring they eat three meals a day, that they have time to rest and exercise. A good routine means that stress is easier to manage. But most importantly, they must make sure they realise they’re not alone.

For more help managing through the current crisis, visit our Leading Through Uncertainty hub. You can also browse our fantastic new line-up of digital events.