Homes for the elderly shun patients with MRSA bacteria

Symptom-free patients kept in expensive hospital beds in Helsinki

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The transfer of elderly people suffering from the rapidly spreading antibiotic-resistant MRSA staphylococcus hospital bacteria from hospitals to old people's homes has caused problems.
      In hospitals run by the City of Helsinki, there are currently around ten elderly patients who would be fit enough to live in a managed care facility, rather than in a hospital.
      However, Jaana Saarenheimo, deputy head physician of the Herttoniemi Hospital, says that they are being kept in the considerably more expensive hospital because of the bacteria. Some have been hospitalised for months, even though symptom-free carriers of the bacteria usually do not need treatment.
     
A special section for MRSA patients was to have been opened at the Kustaankartano service centre in Helsinki, but the launch has been postponed until later in the spring because of delays in repairs.
      "It is quite senseless to keep the old people in hospital. Here on the hospital side we have been constantly waiting for social services to get things into shape", Saarenheimo says.
      "It is wrong if even a single elderly person has to suffer from it."
      It has been decided in Helsinki that MRSA carriers would be placed only in the city-run service centres of Kustaankartano, Roihuvuori, and Riistaviori, and not in any private facilities. Each one is to get his or her own room and toilet, which complicates the matter.
     
MRSA rose to epidemic proportions last summer in the Helsinki region, Pirkanmaa, and around Oulu. According to Arja Peiponen, head of services for the elderly at the Helsinki Department of Social Services, there is uncertainty in the care facilities for the elderly on how the senior citizens infected by MRSA should be treated.
      Dr. Jukka Luomio of the Tampere University Hospital says that there have been prejudices in Pirkanmaa as well. He has heard from different parts of Finland of cases in which carriers of the bacteria have not been accepted into a care facility.
      "It is my interpretation that opposition has been based on misconceptions", he says.
     
Doctors and nurses in Pirkanmaa have been touring facilities for the elderly to explain what MRSA really is, and how carriers should be treated.
      Luomio says that no old people have been left without a place in a facility because of MRSA. Another question is how carriers are treated in the institutions, and what their rights are.
      "If a facility for the elderly is a person's permanent and final home, that person's activities should not be limited in any way. For instance, it must not be a reason to deprive such a person of participating in exercises in a swimming pool, or other activities."
      He also feels that it would be unreasonable to shut such people in a single room for the rest of their lives.
     
The National Public Health Institute has issued instructions according to which having MRSA must not limit a patient's access to treatment or rehabilitation. The National Authority of Medicolegal Affairs and the provincial government of Southern Finland have not received any complaints of cases in which treatment would have been withheld because of the bacteria.
      Luomio emphasises that MRSA will stay under control if hospital personnel wash their hands carefully.
      However, the spread of the bacteria cannot be prevented completely, because the old people are often life-long carriers.
      The epidemic itself has shown signs of abating. In January, 38 new cases were diagnosed in the Helsinki and Uusimaa Hospital District (HUS). According to HUS infection specialist Veli-Jukka Anttila, there are just under 1,000 carriers of MRSA in the entire HUS region.
      A total of 58 new cases were reported in January to the register of communicable diseases kept by the National Institute of Public Health.


Previously in HS International Edition:
  Helsinki hospitals hit by MRSA epidemic (24.8.2004)

Links:
  Q & A on MRSA (BBC Online - the UK has a serious MRSA problem)

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