IT is the smell of a care home that hits you first: the whiff of disinfectant and mashed potatoes, beneath which lie base notes of things you’d rather not think about. In the best of homes, of course, there are also flowers, uplifting paintings, and floors so well polished you could skate on them. While residents are frail, it is clear that this is not simply a parking bay but a residence where they can make themselves at home.

Most of us have experience of such places, good and bad; and most of us dread the day when we might find ourselves in them, feeling helpless and adrift. Yet for millions they provide a sanctuary in their declining years, offering safety, security and company when they are no longer capable of looking after themselves.

To that extent, you might say that care homes are among the most important institutions in the country. Not that the staff’s salaries begin to reflect the significance of their role. Nor would you have known how valuable they are when the pandemic swept through them like wildfire, taking a terrible toll among the unprotected and vulnerable.

Despite being a potential petri-dish for Covid, care homes were all but overlooked in the government’s initial rush to save the country. Once the dangers the elderly faced in these enclosed communities became apparent, and as the number of deaths rocketed, the restrictions imposed on residents’ liberties were draconian. I don’t need to remind anyone of the days when people waved to their relatives through windows, or faced their final hours without family at their side.

Yet even now, although the aged have been jabbed and boosted, and care homes require staff and visitors to be tested, a remnant of the darkest days of the virus clings on. Despite the threat Covid poses being vastly diminished, those caring for residents with dementia must still don a mask.

Alison Walker, the television sports presenter, describes this policy as “barbaric”, and claims its impact on her parents in the past two years has been “catastrophic”. She says, “My mum has lost the ability to form sentences now as she is deaf. She used to lip-read but how do you lip-read though a mask? …My parents are 89 and 91. They have been through enough.”

Walker is asking Holyrood to change the care home policy as a matter of urgency, to allow her parents and others “to see folk smile again”. In response, a spokesperson for the Scottish government commented: “Care homes look after some of our most vulnerable citizens and with Covid-19 still in circulation, it is right that we are taking a careful approach as more normality is restored to care homes. Face masks are an additional measure to protect those living in care.”

Thanks to a recent change in the rules, in some circumstances family can visit without masks, if they are on their own in a room with their relative; and in certain clinical situations coverings can also be removed if they are making communication difficult.

Yet this is very much the exception. While most of us are enjoying once again seeing the faces of those we meet in shops, cafes or buses, people with seriously impaired cognitive function – who are already struggling to make themselves understood or to make sense of their surroundings – remain trapped in a nightmarish limbo.

Those who are working closely with them, seeing to their most personal and intimate needs, remain inscrutable behind their protective shield. If there was anything designed to remind someone that they were utterly dependent on the help of strangers, it is being treated in this impersonal and distancing way.

Much has been made of the difficulties young children encountered during lockdown because people were masked; when finally they were removed toddlers had trouble interpreting unfamiliar expressions. The problem is even more acute for those with dementia and Alzheimer’s. For them, facial expressions are a way to navigate their increasingly confused and narrowing existence. Even when it is hard for someone to remember the name of their visitor or carer, the sight of a friendly, loving face offers reassurance. Recognition doesn’t matter quite as much when you can see a smile.

Naturally the best of care home workers will be doing everything they can to surmount the barrier a mask creates. Tone of voice, gentleness of touch, and time spent focussed on an individual can all alleviate the distress of isolation and bewilderment. But dedicated care, tailored to each person, requires time, which is often in short supply when many others also require round-the-clock support. And, when deafness is an issue, masks are an additional – intolerable – hurdle. With care home residents already contending with multiple health problems, those with dementia and hearing difficulties are being doubly disadvantaged.

The old have borne the brunt of the pandemic. If they managed not to contract it in its early days, they then were sealed off from the outside world like astronauts. Even now, as the country reopens, their life remains cruelly constrained. Although medics will argue that masks are in the elderly’s best interests, increasingly this policy looks unsustainable.

The question is, at what point do sensible measures turn into an excess of caution? For those in the winter of their lives, quality of life is surely as important as the number of days left to them. What’s the point in being kept alive and virus-free if there is no pleasure left?

Normal interactions involve seeing people’s faces and being able to hug and hold them. Even those with advanced dementia can still find comfort in this. To look out from a care home chair upon a sea of masks is unimaginably hard to cope with. Meaningful contact with the people around them is vastly reduced. And, since many with dementia or Alzheimer’s will not understand what’s going on and why, it will simply deepen the fog in which they are marooned.

With each backward step in comprehension – and there is little hope ever of regaining lost ground – they slide further from the reach of those they love. While the use of masks is tacit recognition of residents’ fragile physical health, it takes no account of their emotional well-being. If not exactly killing with kindness, it is needlessly harsh all the same.