Domiciliary Care During a Pandemic

During the pandemic, and particularly as lockdown continues, the Care Opticians Team has noticed a significant change in the mental health of many of our patients who we see in a domiciliary care setting. Patients are quicker to be critical of our service and to verbalise this. As a practitioner who prides himself on delivering outstanding customer care this can be very challenging. As an employer sending my colleagues into people’s homes this is an increasing concern.

Paul attending a home visit during lockdown.

As an example from December, I arrived at an appointment 25 minutes early. This was for a couple in their late eighties living in their own home, who we have visited on several occasions over the last 6 years. As the door opened, the husband advised me how totally unacceptable it was to arrive so early. I politely suggested I wait in the car until the correct time. However, this suggestion exacerbated his bad mood further.

As I entered his home, I made the decision not to set up my testing kit, but just to listen to him. We chatted about the new world we found ourselves in, as his wife with advancing dementia came in and out of the lounge, on one occasion presenting with jacket and woolly hat on announcing that she was off, out to the shops. He calmly went through, what was quite clearly a regular routine of removing her jacket and hat, whilst gently telling her that she did not need to go out at this time. Prior to March, he explained to me, he used to have regular respite care several times a week, but this had all stopped during the pandemic.

I completed the eye tests on both of them and prescribed him with some intermediate glasses so that he could see his computer screen more clearly, which had been his lifeline with family over the last 8 months.

As I went to leave, I turned to say goodbye and the atmosphere at his door could have not been more different to my arrival. He looked at me and said “Do you know, you are the first person I have had a chat to, outside of my family, in eight months.”

The price the elderly and more vulnerable members of our society have paid during this pandemic has been huge, especially with their mental health. As a domiciliary optometrist, the ability to listen has become an even more important part of our role to our patients.

Our housebound and vulnerable patients deserve our empathy and kindness more than ever before.

We should be mindful that when we encounter this hostility, it is not really about us or the service we provide. Hard as it is, we should not take these outbursts personally.

I am experienced enough to process what happened in this anecdote; but my reason for sharing is that I hope this serves as a source of encouragement to my peers who may be less experienced and less resilient when faced with this scenario. It is likely to be a factor in domiciliary care for some time.

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