COVID-19: MSF launches emergency appeal for medical personnel to help care for the elderly in nursing homes (EHPADs)

An MSF doctor checks over a patient with COVID-19 at a COVID care centre in Chatenay-Malabry, in the Paris suburbs. France, April 2020.©AGNES VARRAINE-LECA/MSF
Médecins Sans Frontières (MSF) is launching an emergency appeal for medical and paramedical professionals to help care for dependent seniors in residential homes (EHPADs), particularly in the Paris region. MSF aims to set up teams of doctors, nurses and psychologists to reduce the burden on the most vulnerable facilities and strengthen the provision of medical care.
Since the spring, significant headway has been made to help nursing homes cope with COVID-19, such as with ensuring access to testing and personal protective equipment. Local health authorities and management and staff of nursing homes are geared up to respond to the emergency, while the government, in a show of support, has announced plans to recruit 12,000 health workers for hospitals and EHPADs. However, in many homes there is a glaring shortage of staff—particularly medical. More personnel are essential to ensure residents receive dignified care adapted to their specific needs (whether they have Covid-19 or not), compliance with health protocols, liaise with hospitals and, when necessary, provide end-of-life support.
MSF is launching an appeal to recruit doctors, nurses and psychologists. The organisation will coordinate a pool of emergency personnel to be made available to residential care homes reporting the most urgent needs. 
“In some cases this will involve increasing the provision of medical and nursing care, and in others, giving technical advice, for example, on how to contain the spread of infection or organise visits from families. We will continue to offer staff and residents psychological support, and when necessary, provide medical equipment so that patients with breathing difficulties can have access to oxygen therapy for instance. Although our programme will focus initially on the EHPADs we’re in contact with in the Paris area, we’re already exploring how we can extend our support to other regions,” says Jean-Hervé Bradol, medical doctor for MSF’s programme in nursing homes.  
Applications to join MSF’s medical teams deployed in residential care homes for the elderly are to be submitted without delay to: 
MSF has been working in 56 EHPADs since April 2020. In July, the organisation began offering training and discussion groups to prevent mental health and social issues for care home workers who had lived through the first wave of Covid-19. We also provide support with improving the management of wellness and mental health care for residents.
During its work, MSF has seen the sometimes dire situations endured by residents and staff, often left to fend for themselves. "The distress and exhaustion felt by some EHPAD staff exacerbate the structural difficulties facing the care home sector. As hospitals become increasingly overstretched, it is both vital and urgent that homes be given the personnel they need to be able to give their residents the appropriate care," adds Olivia Gayraud, coordinator for MSF’s programme in nursing homes.  
Due to the shortage of medical staff, and frequently confronted during the first wave of the pandemic with the impossibility of getting sick residents admitted to hospital, some personnel experienced traumatic events they fear will be repeated. Some care assistants have told our teams that they were left alone at night with just a telephone for support to manage complex medical cases they have no training for, sometimes even witnessing, powerless, the agony of residents suffering from lack of oxygen, doing the best they can, without appropriate equipment, to alleviate their pain.
"Manifestations of psychological trauma, anxiety, visual and auditory flashbacks as well as somatic pain, such as weight loss and sleep disorders, are examples of the after-effects we frequently hear of from care home workers we meet in the course of our work", explains Marie Thomas, psychologist for MSF’s programme in nursing homes.
More than 40,000 people have died as a result of Covid-19 in France since March 2020, including more than 12,500 in EHPADs. As the epidemic spreads across the country, it is urgent to support the care home workers already weakened by the first wave and enable them to provide the best possible support to the residents.
From April to June 2020, MSF supported 30 EHPADs housing more than 2,000 elderly people in Ile de France, by providing medical care to residents, protective equipment and technical support, mainly in terms of infection control and prevention. In July 2020, a mental health support programme was launched in 34 EHPADs, including training and psychological support for care home workers - to date, 188 staff have benefited from it. MSF also assisted the elderly and staff working in nursing homes and long term care facilities in other countries such as Belgium, Italy, the United States and Spain.