“Unfortunate episodes oblige me to intervene again on the protection of the elderly in RSA”. Letter from director Piccirillo to Moratti

Below we publish the letter from the director Piccirillo to the Lombard vice president Letizia Moratti on the case of the armored RSA.

Dear Vice President and Councilor for Welfare,

I would like to bring to your kind attention, once again, the reports of indignation received by the family members of the guests of the nursing homes who are still prevented from free access to the facilities without any explanation whatsoever.
As proof, I also read the article recently published by Everyday occurrence and the appeal of some of the signatory associations for which I also presented, some time ago, the request for a hearing in the Health Commission.

As I was able to write to you several times, and to report to you verbally every time you promptly received me, unfortunately some RSAs on the regional territory still do not apply the provisions and indications that the Region has also provided on the subject.
It is by virtue of your sensitivity and the action you have conducted in recent months that I trust in a further intervention by you, aware of the fact that the line followed would certainly be welcomed by those who “only” wish to recover the emotional relationships that have been for too long hindered.

I ask you, even today, that controls be intensified and that action be taken even more effectively to protect guests, people who wish to be close to him and the whole community that deserves to rediscover the deep sense of trust in the institutions in the first place.

I have reported to you on several occasions the specific cases of the structures that – I was told – still do not allow family members to visit their loved ones: sometimes, the Management establishes too limited time slots, of just 1h in the morning and 1h in the afternoon , even on holidays, and for positive guests 1 hour a day dressing included. In other cases, the
visits are not allowed on holidays, as it was not even on Mother’s Day.

Outside, visits are often reserved for a privileged target because guests must be able to walk independently with sufficient safety; for others, access to the outside remains possible if the spaces are suitable but in many cases it is precisely the presence of architectural barriers and other obstacles that do not allow
use movement aids easily.

What’s more: in some structures, face-to-face meetings would decrease from three to two per week. In addition to the material damage that relatives suffer – being able to go to the facility midweek only thanks to a work and professional “sacrifice” or for the precious, significant and important collaboration of colleagues, using work permits and holidays – these restrictions seem really distorted with respect to the framework national and regional and not even supported by a possible and particular epidemiological context persisting in the structure (and in any case unknown to the family members themselves); and that, in any case, it would remain unjustified in light of the fact that even the dGRn 6082/2022 provides for a minimum daily access per guest of no less than forty-five minutes to be guaranteed, even in the presence of guests who are positive for the Sars-CoV- virus. 2.

Recently, for example, it has also happened that the structure has addressed to the family the heartfelt invitation to find another accommodation for the elderly, citing that the relationship of trust between the family and the staff of the residence. This, in the aftermath of an emergency call from the Police Force that the family member made after the structure had, for the umpteenth time, prevented him from visiting the relative also to play the role of caregiver.

These unfortunate episodes oblige me to intervene once again in the Regional Council to ask for my latest motion on the subject to be dealt with urgently. You will remember – we talked about it – that I ask for a concrete commitment on the part of the Region and yours to make the RSAs return to places with free access, allowing family members to be able to visit their loved one daily and for large time slots, and to be able to reach also the wards freely.

I also believe that the time is now more than ripe for the Region to intensify controls and to adopt any new guidelines and guidelines for improving the conditions of assistance and hotel, socio-creative and psychological comfort of the patients, promoting and supporting the recognition the central role of the family
and therefore the establishment of committees for the participation of family members within the residential structures in the area.

The free access of the family member in the structure must be allowed and indeed facilitated with the deep conviction that it does not affect the quality of care and the professionalism of the staff. The presence of family members and their attempt to intervene in the organization and choices of the residential structure is not an interference, but also a help
for operators who may have many difficulties with patients who have cognitive problems, disoriented or with a difficult character.

If I am not mistaken, moreover, over the years it has already been recognized that the presence of family members and their involvement in the life of the elderly residents is an integral part of daily life, at least when family members request it.

Last but not least, I would like to draw your attention to the content of my numerous Questions on the subject – thanking you also on this occasion for the answers you have given me – because the problem of “diversity of treatment” between residents based on the decisions of the Health Directorate remains unsolved. The important reorganization efforts undertaken in the months following the “dark period” of the pandemic, also by the providers, the high level of vaccination coverage and the massive screening activities conducted periodically for the research of SarsCoV-2, have made it possible to achieve adequate levels of security for guests, visitors and operators.

The hygienic-sanitary measures for the prevention and control of viral transmission have been rigorously adopted in the structures for some time, also thanks to the training and information promoted and received. The decreasing trend of the epidemiological trend and the introduction of green certifications allow for derogations
to some prohibitions, as established also by national decrees.

The discretion and “caution” of the health departments of the structures, in this specific area, has no real reason to exist. Inexplicably, national regulations and regional indications continue to remain a dead letter while socio-affective relationships continue to impoverish and this – as the ministerial circulars had already highlighted for months -, in a fragile and largely cognitively unstable population, only favors further psychoemotional decay and the worsening of organic pathologies. The choice to limit contacts and the persistence of distance from family members is contrary to the very principles of care for the elderly.

It almost seems like a position taken by the Health Departments, and which as it is should lead us to reflect on what is the true meaning of accreditation which in fact translates into an outlay for the Region without having any say in the matter.
I trust that more precise determinations and specific notes can be sent to the structures or that the monitoring of the scrupulous observance of the latest adopted is intensified, because families are exasperated while they continue to take on the most substantial part of the fee.

Certain of the fact that you will welcome this mine, as it has been until now, I thank you for your attention and best regards.

The Regional Councilor
Luigi Piccirillo

“Unfortunate episodes oblige me to intervene again on the protection of the elderly in RSA”. Letter from director Piccirillo to Moratti – Il Fatto Quotidiano