The devastating impact of coronavirus on the residents of senior citizens' nursing homes in Catalonia and Spain has laid bare an obsolete model and an institutional neglect of these centres. But beyond the model, there is also an issue of crisis management, which was deficient, as has been shown by the data on deaths and infections in nursing homes. Families trying to cope with grief have at the same time begun demanding to know who is responsible, and hundreds of complaints have been laid, so that the Spanish public prosecution service is now investigating criminal accusations in 93 old people's homes in Catalonia, and a total of 349 centres across the Spanish state.
On May 3rd, the rest home action group Coordinadora Residències 5+1 lodged a criminal complaint from 95 families against 11 centres in the Barcelona area. The complaint contemplates four offences: negligence of the duty to provide help, breach of the right to health care, denial of health assistance and homicide through negligence.
The 11 centres referred to in this complaint are in Barcelona city and the nearby municipalities of Santa Coloma de Gramenet and L'Hospitalet de Llobregat. They are of four management types: public residences with public management; public with private management; private with places subsidized publicly; and municipal management. In all of them, therefore, public administrations have responsibility.
But the essence of what happened can be extended to all old people's residences where there have been coronavirus infections and deaths, says María José Carcelén, spokesperson for the Coordinadora Residències group. "Unfortunately, this has happened everywhere," she sums up.
"Someone decided that the elderly were an expendable group. That they could be allowed to die. Who will be the next group? If we let this stand as if nothing has happened, who has the right to decide on life and death? Who has this power to decide which of us will die in the next pandemic? Which group is surplus to requirements in this society? This is tremendously serious. It is not just about suffering and death in despicable situations, it is what lies behind all this, which is very grave," denounces Carcelén.
A death sentence
The complaint that has been laid relates the events from March 23rd, 2020, when Catalonia was already in coronavirus lockdown. Family members have presented the emails they sent to the Catalan government ministry of Labour, Social Affairs and Families and the ministry of Health, insisting on the need for personal protective equipment, for tests on care home workers and residents, as well as for the isolation outside the homes of elderly people with symptoms or positive test diagnoses.
The complaint leaves it clear that there were not enough staff to adequately care for residents, partly due to the high numbers of staff on sick leave as a result of the pandemic itself, but also because in too many cases the care ratios laid down were already being breached. The families complain that the ratios of nursing and health personnel provided for in the Catalan government's 2010 social service plan were already manifestly insufficient, due to the fact that in 2020 residents are more dependent on average, as a result of huge waiting lists to obtain a place in public or subsidized residences.
According to the complaint filed with public prosecutors, there are cases of residents who arrived at hospitals malnourished and dehydrated, clear examples of abuse and neglect.
Family members have complained that - as a constant theme in all the cases reported - information was hidden from them. As well, they assert that there was failure by homes to send some of the patients who had tested positive to hospitals: "This was a death sentence, because the residences do not have qualified health personnel (doctors and nurses) monitoring health problems 24 hours a day, and nor their own health resources and equipment. And this is still happening. "
According to the complaint, there are cases of residents who arrived at hospitals malnourished and dehydrated
The 95 families making the complaint call for an investigation into what care the elderly received inside the residences, the details of the deaths including who was sent to hospital and who wasn't, and to investigate the "chaotic management" that took place. One of the families' complaints is the complete lack of information: "management was absolutely opaque," says the action group spokesperson. For them, the complaint is the only way to find out who was responsible and for those people to be accountable.
"The exact number who died is practically unknown. A civilized society cannot allow this to happen and look the other way," she concludes.
Catalan government turned its back
The Coordinadora Residències group was set up in 2017 to fight against the privatization of five senior citizens' residences in Barcelona. "The reality of the residences was a long way from the equipment and staff they had," explains María José Carcelén.
Last summer, in July 2019, the group entered into talks with all parties in the Catalan Parliament. The result of the meetings was a proposed resolution that included the modification of the social services plan, public management for homes, 24-hour nursing service, and a change so that nursing home residents didn't lose their right to go to the CAP primary health care centres. "Everyone knew what the situation was" inside the residences, explains Carcelén, but she says "there was no will to resolve it."
And the resolution was put to the Catalan Parliament in July 2019, but neither of the government parties, JxCat and ERC, voted in favour. At that time, ERC already had responsibility for Catalonia's residences, in the competencies of minister Chakir el Homrani. However, the party abstained. "They did not dare to vote against it because politically it was incorrect to tell the public what we were asking for was wrong, so what they did was abstain," Carcelén complains. “They didn’t have the courage to vote against it, we said that to them,” the Coordinadora Residències representative explains.
“We started collecting signatures in December because we could see that nothing would be implemented,” Carcelén explains. “Everyone who was able to remedy it, knew perfectly well what the situation was,” she insists.
In December 2019, meetings were once again held with all the parties in order to unblock the motion. "There was no will at any time to take it forward. Part of the problem and the lack of care that the elderly have had comes from here. Don't let them say they didn't know," says María José Carcelén forcefully.