The UK’s residential care homes inevitably came under the spotlight earlier this year, as the grim toll of Covid-19 on residents (more than 19,000 related fatalities as of June) became ever clearer. In the past week, they have become the focus of renewed concern following a government alert to providers and local authorities that coronavirus was spreading again. Care homes are reported to be stopping visits only a few months after they resumed following the March lockdown.
That there is a knock-on effect on physical and mental well-being from the stringent protective protocols is becoming more widely recognised. In August, the Relatives and Residents Association warned “the current situation in care homes is very much like a prison”. This week, This Morning on ITV highlighted the case of 75-year-old Marion Searle, an Alzheimer’s sufferer who – according to her daughter Karen Rogers – suffered visible deterioration and weight loss as a result of being unable to have sufficient contact with her family during lockdown.
One aspect of the crisis that has had little attention, however, is the huge drop-off in visits to care homes by those specialising in keeping residents entertained and engaged. There are no official data to confirm the number of those working in this field, or the number of visits per annum. But there’s much anecdotal evidence to suggest that a once-thriving offshoot of the theatre sector, providing work for hundreds of performers, has been decimated by Covid-19 restrictions, with adverse consequences for residents.
A trawl through the directory of acts maintained by the HousingCare.org charity elicits tales of cliff-edge woe, defiance against the odds and chronic uncertainty. For Daisy Alexandra, who runs Daisy-Chain Productions in Bristol, zero bookings rather than a teeming diary have become the norm for a company built up over eight years.
“Usually we’d visit around 35 care homes a month, performing up to three shows a day – from Fifties swing shows to Abba tributes. But everything has been cancelled – there has been no work since March and I’m now thinking of putting the company into a dormant state until at least the end of the year,” she says.
That means disappointment and financial distress for the 20 actors and musicians she relies on for the tours, and sadness for residents with whom her troupes have built up a friendly rapport. “Even in normal times, some don’t see any relatives – they might be on the other side of the country. For some people, we’re like family, popping in for a visit.”
Alexandra believes there should be a better weighing up of “the balance between the need for safety measures and the value of us going in”, adding: “I can’t blame care providers for saying ‘no’ – they’re scared, it’s still the unknown. But from what I’ve heard, the residents miss us and I fear there’s a detrimental effect on their well-being.” She cites some “miracle” examples of the upside to their work. “One lady had had a stroke, and lost the use of her voice box. I sang Doris Day’s Que Sera Sera and when I held the final note she joined in – the staff were completely amazed.”
The medical boon of participatory performance, music in particular, in jogging memories and enhancing mood has long been attested. On Tuesday, I see it in action. At St David’s House, on the outskirts of Redditch, Carole Laine, a Scottish actress based near Leeds who runs Cats Pyjamas Productions (focusing on entertainment for the elderly and disabled) has secured a rare date after months of almost no work (“Now it’s about two shows a month, normally there would be 10 a week”). With no more kit than a mic, amplifier and bags of enthusiasm, this radiant Fifties-dressed apparition cavorts (and even cancans) on the lawn outside the main building before a captivated crowd of more than 20 elderly residents.
As she rewinds through the decades, here Lulu’s Shout, there a Beatles medley, with West End show-stoppers from Oliver! and Chitty too, arms start to wave, heads to bob, feet to tap, lips to move in singalong mode. Nurses in PPE hand out drinks and lollies, even blow-up guitars, though several male residents are improvising with their crutches. “You’ve been absolute stars,” Laine says, as she takes her bow after a non-stop hour. “I hope it’s not long till I see you again and maybe one day we’ll get back indoors and I can give you all hugs – but for now [she gestures] here’s virtual kisses!”
“I don’t think you can put into words what a difference it can make for residents, especially in these times when they’ve had long periods where they haven’t been able to leave their rooms,” says Gill Talbot, the home’s activities coordinator. The onlookers concur: “It has been a lonely time,” says one female resident, “but this has lifted me up.” One man, in his 80s, feels rejuvenated: “When you’re listening to that music, it’s as if you are 18 again. You forget about the virus.” Many in the medical profession believe that tackling loneliness and raising spirits also protects people.
“Especially now with Covid-19, people going into care homes can be socially isolated, and that isolation is a risk factor for a drop in immunity,” says retired GP David Beales, co-author of Community Care of Older People. “If you’re chronically stressed your body shifts from an antibody rich to an antibody poor type of response. We have a human need for contact and kindness. Live performance that resonates with the audience’s experiences and memories is hugely important.
“In the case of dementia, the worst thing is to be shoved away. Performance not only brings you into contact with people coming in from the outside world, but the staff can talk about the event. Reminiscence therapy is well known as a help in care homes.”
One such practitioner is Southport-based Paul Wilkinson, who specialises in “gentle drama” workshops for groups between 10 and 20. Owing to the participatory nature of the work, he has had no bookings since March.
“I go in with a beautiful box filled with props, prompts and musical instruments and we take them out, unwrap them, and see if it sparks a memory. At one session I took out a newspaper from 1969 about the Moon landing, and suddenly this elderly guy piped up, ‘I remember that!’ and started talking. His carer said: ‘He never normally speaks.’
“It sounds daft,” he continues, “but I do a bunting workshop and it’s amazing what bunting can inspire – memories of VE Day, the Silver Jubilee, even weddings.”
Scaled against the crisis facing the West End, and the regional theatre sector, this sort of activity might seem unglamorous and little worth fighting to restore. But for those benefiting from and bestowing its feel-good factor, it’s just as important. Laine is battling on with the same vigour as Andrew Lloyd Webber: “People might not think it’s glamorous, but when you’re wearing a pretty dress and you see the ladies’ eyes lighting up – and the gentlemen loving it too – that’s a kind of glamour. It’s worrying because we’re getting tighter rules again,” she adds.
She’s prepared to bring a brolly and a cardie to serenade residents outside as the weather worsens but hopes a way can be found to let her brand of showbiz sunshine in through the door. “Every week, I hope things will change. I’m determined to keep on trying.”