Routine masking must never return to care homes

We must oppose any future attempt to re-impose this cruel restriction

Photo by Michael Williams II on Unsplash

The women and men who work on the frontline of our care homes perform one of the most crucial, yet undervalued, roles within our society. Entrusted with the responsibility of looking after the elderly and most vulnerable in our communities - the physically fragile, the confused and bewildered, the frightened and obstreperous – the actions of social care workers will determine whether residents’ last years of life are fulfilling or traumatic. It is therefore regrettable that, for extended periods during the Covid event, they were compelled to carry out their pivotal duties with their most important assets – their faces – hidden behind masks.

Five years ago, the requirement for all care home staff and visitors to wear a face covering was imposed by public health experts as a pandemic restriction to reduce viral spread, despite the fact that the most robust scientific evaluations have concluded that surgical masks constitute an ineffective barrier to microscopic pathogens. But even if these strips of plastic did achieve some benefit as an infection control measure, consideration of the raft of harms associated with them would lead to only one rational conclusion: the obligation that all staff and visitors should wear a mask must never return to our care homes.

Care homes are not hospitals; they are places where people live. By the time elderly people with dementia enter these facilities their life spans are, typically, very limited. It is imperative that residents’ experiences during these final years are both rewarding and soothing. In these environments, the most important element of effective social care – the bedrock upon which all other helpful interventions depend – is human connection. Without it, the range of essential care-giving tasks (such as meeting basic needs around hygiene and nutrition) are rendered more difficult to perform effectively, as well as the overall encounter being experienced as less therapeutic by the service user. And masks make it virtually impossible to achieve this crucial one-to-one synergy between two living beings.

A recent comprehensive risks/benefits analysis of mask wearing in care homes powerfully highlights the plethora of negative consequences associated with this infection control measure. The harms of face coverings – physical, social and psychological - are multiple and wide ranging, impacting on residents, carers and visitors alike. Yet it is the ways in which masks impede human connection that are the most deleterious for elderly dementia sufferers approaching the end of their lives. These specific sequelae include:

- Impaired communication: Muffled voices and no opportunity for lip-reading condemning many residents to a communication vacuum.

- Less social stimulation: Discouragement of conversation, thereby increasing the likelihood of mental decline and the neglect of the residents’ nutritional and personal care needs.

- Loss of interpersonal spontaneity: No quips, jokes, banter or smiles; a socially sterile and de-humanising milieu.

- Less opportunity to offer empathic comfort: Faceless carers will be more likely to evoke distress, confusion and feelings of isolation, rather than instil peace and contentment.

Further discussion about how masks impede the development of human connection in care homes is provided in a Smile Free film, titled ‘Masking Humanity’, where healthcare professionals specialising in the care of the elderly offer their damning verdicts on the insidious impacts of this restriction.

The elderly and vulnerable within our care homes deserve to be soothed, understood and nurtured within a warm and homely environment. Faceless carers are unable to deliver such humane surroundings. Therefore, as we reach the five-year anniversary of the first UK mask mandate, I respectfully ask that all those selfless people striving to improve the lives of older, cognitively-impaired residents– social care staff, care home managers, care home owners, and residents’ families and friends – actively oppose any future attempts to impose mask requirements.