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The supervision of the Inspection of Health and Care Services (Ivo) extends mainly during the period from March to June of this year. It has been aimed at people who live in special housing for the elderly.
From April to the end of May, several hundred elderly people died in special housing in the country, every week.
The decisions after the inspection were presented today at a press conference.
All regions receive feedback – Örebro County Region on four out of four points:
► Older people living in special housing have not received care and treatment based on the needs of the individual in case of suspected or established covid-19. 1
►Elderly people living in special dwellings and their relatives have not received information and have not participated in the care and treatment in the event of suspected or established covid-19.
► The positioning and implementation of end-of-life care has not been carried out in accordance with the regulations in force during the covid-19 pandemic for the elderly living in special dwellings.
► It is not possible to follow the care and treatment of the elderly living in special dwellings who have had a suspected or established infection by covid-19 due to deficiencies in the records of primary care patients.
In his reasons, Ivo writes decisions about the Örebro County Region about how, among other things, it was not possible in medical records to track how decisions about end-of-life care were made.
“In several cases, the medical records examined by IVO show very little or no information on how and why a decision on terminal care was made and on what information was provided and what consultation was made with the patient and their families.”
In interviews that have been conducted, however, it has emerged that the inadequate documentation is due to the pressure situation.
“The interviews that IVO has conducted give a consistent picture that decisions about palliative care are always made in consultation between the doctor and the nurse. This is not reflected in the patient’s records.”
Nor have physicians always been available to perform individual assessments of the patient’s care needs.
“Especially during certain times of the day, such as afternoons, nights and weekends,” he says in Ivo’s assessment.
Doctors have also conducted evaluations over the phone and, in some cases, through third-hand information. Several nurses also testify about how the ER doctors did not have time to go out to the accommodation.
Regarding the influence of the elderly and relatives on care, it seems that doctors have not always been able to participate, sometimes for financial reasons.
Instead, most of the contacts have been handled through nurses.
“If the economic conditions were there, the doctors could also be significantly more active, among other things in terms of conversations with relatives,” says one of the nurses interviewed according to Ivo’s decision.
In his supervision, the Örebro County Region Health and Medical Director was interviewed, as well as medically responsible nurses from all county municipalities. Interviews have also been conducted with nurses in special accommodations, as well as with operations managers and physicians in charge of primary care operations. In addition, patient records have also been reviewed.
The Örebro County region now has until January 15, 2021 to present its report and attitude on the shortcomings that Ivo has pointed out.
