In May 2020, the Centers for Medicare and Medicaid Services issued a memorandum for state and local officials to outline nursing homes reopening. The recommendations provide guidance on evaluating what steps to take to prevent COVID-19 transmission in nursing homes. In looking back to May 2020 and now, what, if anything, has changed? How are nursing homes balancing resident safety and resident needs with the COVID-19 restrictions in mind?
Lifting restrictions varies by state and communities in each state, as noted here in this AARP map. For example, New Jersey and Indiana are now allowing outdoor visits, with infection control measures in place. On the other hand, the state of Oklahoma is encouraging family members to visit their loved ones in long term care, while requiring masks and following protocols.
It is difficult to connect with loved ones on a limited basis. In some cases, a five-minute outdoor visit is the only way families are allowed to visit. It is painful to see the effects of isolation on loved ones, while unable to do anything about it. According to the American Psychological Association, the COVID-19 restrictions that require social distancing affect older adults and create additional loneliness. As a result, the combination of reduced family caregiver support and social isolation takes its toll. The number of reports of residents dying due to the effects of the COVID-19 quarantine continue to grow.
It is difficult to balance the need for safety with the need for companionship. Exchanging safety and protection for social isolation is not a fair deal. On the other hand, families want and need to see their loved ones. In one case, Mary Daniel went so far as to take a job as a dishwasher in the community where her husband lives. Mary has also started a Facebook group called Caregivers for Compromise as a way to influence the process of reopening communities in Florida and other states. It is a positive response and a way to support change in the visitation procedures while maintaining safety.
It should not take a family member taking on a job in a community to see a loved one. Family members are essential to every resident’s wellbeing, and there must be a way to enable safe visits that mitigate the effects of the COVID-19 quarantine.
Kathy Dreyer, Ph.D., is an Advisor at AGE-u-cate® Training Institute, which develops and delivers innovative research-based aging and dementia training programs such as Dementia Live® and Compassionate Touch®, for professional and family caregivers; kathy.dreyer@ageucate.com