After three months of isolation, families of nursing home residents push for visits [CT Post]

Kelly: Socially distanced, PPE protected, outdoor meetings “critical for the health of these people who haven’t seen their families in months. That can have just as much of an impact on their well-being.”

Article as it appeared in The Connecticut Post

For more than seven years, Maria has visited her mom at a long-term care facility in Trumbull. Her mom has dementia, and even as her memories have faded, Maria was there every day at lunch time, usually with goodies like flowers or sweet treats for her mother.

Maria hasn’t seen her mother since early March, except through video chats facilitated by her mother’s nurses. Her mom, who at 91 actually contracted COVID and recovered, lives on the fifth floor of the building, so window visits aren’t an option.

“I don’t know how long they’re going to keep us out for,” said Maria, who asked not to use her last name for fear of retaliation against her mom. “We do the video chat but that’s not the same as being there. When my mom is doing the video chat she’s staring up at the ceiling. Does she hear me? She doesn’t respond. The video chats are more for us to see her because she is my mom, you know exactly when there’s something wrong.”

Now, with the state opening up, family members of nursing home residents are calling on Gov. Ned Lamont to consider opening up visitation, even if it’s only in limited capacities.

Lamont says it’s too early. He has worried since the first signs of coronavirus about the state’s population living in long-term care facilities. As he watched the virus rage through nursing homes in Washington State, became one of the first governors to end visitation to nursing homes and assisted living facilities.

At the time, in early March, many assumed that would last a few weeks at most. It’s been three months with no visitors except for rare exceptions.

Even so, the virus found its way into these settings. More than 2,300 people have died with the virus in nursing homes, which is 11 percent of all licensed beds; and more than 8,300 have tested positive for the virus.

Family members say their loved ones are suffering other health consequences as a result of not being allowed outside or to have visitors.

Maria’s family others have watched the state begin to reopen. They’ve watched staff go in and out of the facilities where their family members live — many work in several facilities — and wondered why they can’t do the same. They understand the virus and its disproportionate impact on the elderly, so they’re willing to take all of the necessary precautions: to isolate before visiting, maintain an appropriate distance, dress head-to-toe in personal protective equipment, whatever is needed.

Lamont has offered no clarification on when family members might gain even limited access, saying only that he doesn’t foresee opening up visitation at long term care facilities anytime soon. There is no mention of expanded visitation in any of the reopening phases that have been presented to the public thus far. His executive order is in effect through September.

“I hear the anguish. You can’t see your grandmother, you can’t see your father there, it’s been now a matter of months,” Lamont said Friday in an interview with Hearst Connecticut Media. “The social isolation is just so, so, so hard. But there’s nothing more dangerous than walking into a nursing home and the potential of bringing COVID in with you so we’re trying to get that balance … I’d like to see the infection rate in the nursing homes go down a little more along the lines of what we’ve seen outside the nursing homes. We are making progress there but not enough.”

Maria, like so many others, has no idea when, or whether, she might next see her mom.

“I just hope that we do get to get up there at some point before she does die. I know that sounds awful, but that’s reality,” Maria said. “She’s 91 years old and has dementia. I just want to see her. To me it’s heartbreaking. You love your mom. You’ve only got one. She’s 91 years old, she’s not going to last much longer. Those people deserve to have dignity. It’s very frustrating.”

Mental and Physical Consequences

Lucille Dernago didn’t know when her husband went to the hospital for health problems unrelated to COVID, that it could be the last time she’d see him for two months.

William Dernago, her husband of 60 years, is 84 so he was transferred to Whispering Pines Rehabilitation and Nursing Center in East Haven to recover. He’s been kept on a non-COVID floor and has never tested positive for the virus, but he hasn’t been allowed out.

Lucille Dernago said he’s developed a bed sore from not being allowed or helped out of bed enough. His muscles have atrophied, making it harder for him to get up anyway, and he’s lonely, she said.

“We don’t know what’s going on in there,” Dernago said. “I don’t understand why we can’t go see him. I’m taking him out of there and I’m going to take him home. I think we can take care of him better here. He’s got to get back on his feet.”

The couple lives in a 55-and-older complex in Branford, and she’s working to get all of the supplies her husband needs, and plans to pay nurses to help out in their home.

Their story is not unique. Mairead Painter, the state’s long term care ombudsman, said 100 percent of the complaints she’s received in recent weeks are related to visitation, and the subsequent health consequences for residents of long term care facilities.

“Residents want access, they want time out of their rooms, they want to see their loved ones even if it’s at a distance,” Painter said. “We have been advocating very strongly for that consideration. I totally understand the infection control concern but we need to find a way to make residents feel less socially isolated. We’ve got to start to reengage them because social and emotional needs are as important as some of the medical components of this.”

State Sen. Kevin Kelly, R-Stratford, a ranking Republican on the General Assembly’s aging committee and a lawyer specializing in elder services, and said many people have reached out to him with concerns about not being able to see their loved ones. They worry about how residents are treated without family members as an outside check.

“Looking at the experience of Italy and the state of Washington, it was known that nursing homes needed extra protection because the virus is particularly lethal to the senior population,” Kelly said. “ But now we’re protecting from COVID and we’re also setting up situations where they’re going to become more exposed to other issues and other health problems that are equally as lethal. It’s critical that these families who are the eyes and ears get back in.”

Kelly said expanded testing for all long-term care residents is critical, and that a blanket reopening without safety precautions is unwise; no one is arguing for that anyway.

“Especially when we get into July and August I don’t understand why we couldn’t have socially distanced, PPE protected, outdoor meetings,” Kelly said. “It’s critical for the health of these people who haven’t seen their families in months. That can have just as much of an impact on their well-being.”

Balancing Act

Matthew Barrett, president of the Connecticut Association of Health Care Facilities, said it’s reasonable for families to watch the outside world reopen and wonder why they still can’t gain more access to their loved ones. The risk is simply still to high, he said.

“While the hospital capacity numbers are improving, we still have a large presence of COVID in assisted living facilities,” he said. “With that knowledge I don’t believe we’re near a decision to reopen nursing facilities and loosen up the strict visitor ban.”

But, he said, there could be a sign of loosening. He said families should pay close attention to how reopening is going outside of nursing homes for an indication of when they might see restrictions start to ease in elder care facilities.

“No one is really sure that we won’t see a resurgence of COVID,” Barrett said. “If we fail at reopening and we slip, then it will elongate the opportunity to revisit the visitor restrictions. If we were a state that didn’t have COVID in the community outside the nursing homes, it might be different. But that is not Connecticut. The risk is too high right now.”

‘Doesn’t make sense’

For people like Joan Law’s grandmother-in-law, Mary Law, a spry 102-year-old who’d put many people half her age to shame, that’s not the news they’re hoping for.

Mary Law lives mostly independently in a congregate setting in Manchester, and a family friend has visited her every day for the past several years to help her with small tasks. Joan Law and her husband live in Stratford, and used to visit Mary frequently.

Under Lamont’s executive order, that person, who has isolated at home, isn’t allowed into the Mary Law’s apartment. But the family could hire a certified nurse for $60 a day to do those same tasks. There have been no cases of COVID in the facility where Mary lives.

“But those people are going into multiple homes,” Joan Law said. “We could dedicate somebody to keep her safe — that would only go to her apartment — because she’s our loved one. It doesn’t make any sense that a nurse could go in that is going to multiple homes, but we can’t. There’s a fear that we could bring the virus in, but I think family members are going to take better care and do everything to not bring it to our loved ones.”

Because Mary lives in a mostly independent facility, she is allowed outside and her family has seen her that way. But no one is able to help her with small tasks like putting eye drops in her eyes every day or helping with her hair because those tasks happen inside where visitors are banned.

“It just doesn’t make any sense,” Joan Law repeated.