The Management of COVID-19 in Nursing Homes in Ireland and England: Ethical and Legal Issues in a Time of Pandemic

This paper provides an overview of the key issues that arose in relation to the management of COVID-19 in care homes in Ireland and England between February 2020 and December 2021, with reference to relevant policies, processes, and practices. There is a particular focus on the first wave of the pandemic between February and June 2020, where the risk of contracting and dying from COVID-19 was highest for residents in care homes. The paper examines a number of key issues impacting management of the risk posed by COVID-19 in care homes including the availability of testing; the use of personal protective equipment; staffing; safe discharge from hospitals; the use of Do Not Attempt Cardiopulmonary Resuscitation Orders (DNACPR); visiting and access restrictions; and the recording of care home deaths. A critical analysis is also provided of broader themes impacting the management of COVID-19 in care homes during 2020-21, including ethical issues,
human rights, regulatory governance and accountability.