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During the pandemic, several cases in which the elderly have been prioritized out of care have attracted attention, including from DN. DN has also described how physicians who were not present made decisions about palliative care in nursing homes.
The procedure has drawn criticism, the Stockholm Region is now appointing investigations and the National Board of Health and Welfare states that the guidelines have been misinterpreted.
During Friday morning called Lena Hallengren to the two supervisory authorities. Now she is considering stricter regulations.
– There are many indications that it is necessary to strengthen the regulated supply of doctors in the care of the elderly. We have emphasized that personalized attention, which should be as needed, also applies during a pandemic. It is clear that you must have access to a doctor, and we need to take a closer look.
She describes how the question followed, among other things through DN’s reports.
– It is clear that it is very worrying if it is the case that individual evaluations have not been made and the guidelines applied in the care and care of the elderly have been taken seriously. Those who are cared for there are elderly, sick and really need medical skills.
DN has also revealed how the number of physical doctor visits to nursing homes decreased by a quarter in the Stockholm region during the pandemic, and that the number of infected and dead differed significantly between homes where different medical companies were responsible for care.
– We have been able to read and participate in the information that visits to the doctor have decreased quite significantly in nursing homes in Stockholm, despite the fact that this is where we have had the greatest spread of infection and the highest number of deaths while it actually turns out that there has been an increase in the number. doctor visits to nursing homes in other parts of the country, which is interesting. The statistics here stand out.
Hallengren elevators that the organization of care and care for the elderly in Stockholm is different compared to the rest of the country.
– It is important to find out what conclusions can be drawn from it. Here you have many options for care, a rather fragmented care with many actors and you have not switched to home care, which means that both the municipality and the region are involved in health care for the elderly. In the rest of the country, health centers are to a greater extent responsible for medical interventions in the home, which is likely to affect continuity. There, the results of Ivo’s final inspection will be of great importance.
Health and Care Inspection, Ivo, began a review of the country’s 1,700 nursing homes in July to ensure that the elderly received the necessary care during the pandemic. In 91 households, Ivo has found serious deficiencies and continues to review magazines.
Ivo will also analyze the access of the elderly to oxygen. CEO Sofia Wallström leaves a written comment on the ministerial meeting:
“As Ivo has not completed an ongoing review regarding health care interventions in special housing for the elderly, there was no information to provide on any outcomes.”
– This is a very important review that will arouse great interest. But it’s important that they have time to review the quality of what they came up with, says Hallengren.
DN has requested Thomas Lindén in the National Board of Health and Welfare, which refers to the ministry. Hallengren:
– The National Board of Health and Welfare is reviewing what guidelines may need to be updated. When Ivo’s report comes in, there will probably be a reason for us to review what the government, municipality, region and authorities can do.
Ella Bohlin (KD), The Regional Council for Care Development informs DN that there are nine providers that focus on this type of care.
“It is not a division, but it provides better understanding of the patient and greater freedom of choice for the individual. It is too early to draw conclusions before the region as a whole evaluates its efforts on the impact it has had. It is always the doctors and health personnel who do the medical assessment, ”he wrote in an email.
According to Bohlin, the continuity between doctor and patient is important, and if it has been broken, it should be reviewed, so an investigation has been appointed. She assumes that the doctors in special accommodations know the patients well.
“The doctor also tends to have personal contact with family members earlier and making a decision about the transition to end-of-life care is thus a natural part of a longer process. Caregivers work closely with the municipality’s medically responsible nurse, ”writes Bohlin.
The region has given The palliative knowledge center was tasked with assessing this and Ella Bohlin says she wants to wait for the assessment to be completed before any conclusions can be drawn.
“The Minister must respect municipal and regional self-government. The fact that a different party constellation governs cannot take the liberty of criticizing anyway. The reason why the Stockholm Region has not municipalized home care was that it was not possible to involve all municipalities in this decision. A process was underway to carry out such a reorganization. Stockholm has 26 municipalities with different conditions, it is clear that it may have been registered “
