Ethical care during COVID-19 for care home residents with dementia

The COVID-19 pandemic has had a devastating impact on care homes in the UK, particularly for those residents living with dementia. The impetus for this paper comes from a recent review conducted by the authors. That review, a qualitative media analysis of news and academic articles published during the first few months of the outbreak, identified ethical care as a key theme warranting further investigation within the context of the crisis.

To explore ethical care further, a set of salient ethical values for delivering care to care home residents living with dementia during the pandemic were derived from a synthesis of relevant ethical standards, codes and philosophical approaches. The ethical values identified were: caring, non-maleficence, beneficence, procedural justice, dignity in death and dying, wellbeing, safety and personhood. Using these ethical values as a framework, alongside examples from contemporaneous media and academic sources, this paper discusses the delivery of ethical care to care home residents with dementia within the context of COVID-19.

The analysis identifies positive examples of ethical values displayed by care home staff, care sector organisations, healthcare professionals and third sector advocacy organisations. However, concerns relating to the death rates, dignity, safety, wellbeing and personhood – of residents and staff – are also evident. These shortcomings are attributable to negligent government strategy, which resulted in delayed guidance, lack of resources and PPE, unclear data and inconsistent testing. Consequently, this review demonstrates the ways in which care homes are underfunded, under resourced and undervalued.