CORONAVIRUS (COVID-19) RESOURCE CENTER Read More
Add To Favorites

Families struggle with nursing home visitation restrictions

Leader-Telegram - 8/2/2020

Aug. 2--It has been more than four months since Gloria Hulett has been able to hug her husband.

Hulett's husband, Donald, an 88-year-old resident at the Country Terrace memory care unit in Altoona, is in the late stages of Alzheimer's disease.

Though Hulett understands the visitation restrictions in place at Wisconsin nursing homes to protect residents from possible coronavirus infection, that doesn't make it any easier to abide by them.

"I can see him, but we can't touch," said Hulett, of Altoona. "I'm going crazy about it. Thankfully, he's not because he really doesn't recognize us anymore. If he was, I might try to break down the door."

Hulett's pain is being felt by families across the country as they struggle to balance their desire to maintain close personal contact with loved ones in nursing homes and the need to protect vulnerable residents from falling victim to the COVID-19 pandemic that Kaiser Family Foundation says has killed 63,000 U.S. nursing home residents and resulted in positive tests for more than 336,000.

Families have been forced to rely on phone calls, video chats and window visits since nursing homes started banning almost all visitors in mid-March. At that time, the state Department of Health Services and U.S. Centers for Disease Control and Prevention informed nursing homes and assisted living facilities to allow entrance only to essential employees, those deemed medically necessary and relatives visiting a resident at end-of-life.

Window and video visits happen almost every day at Dove Healthcare's three nursing homes in the Chippewa Valley.

"While we empathize with the very difficult circumstance of not being able to sit right by each other or give a hug, our residents and their families are overwhelmingly appreciative for this form of communication, and the other options available, for the time being," said Jeremy Kiley, Dove's regional director of operations.

Outdoor visits

DHS offered some relief for contact-starved families by issuing new guidance on July 17 permitting in-person outdoor visitation, although the state agency cautioned that the safest approach is still to prohibit indoor and outdoor visitation. Outdoor visits, which are being phased in by Chippewa Valley nursing homes and are believed to present a lower risk of virus transmission, still require masks, extra cleaning and social distancing of 6 feet between residents and guests.

Dove has started offering outdoor visits by appointment at four of its assisted living facilities and is developing procedures to allow safe outdoor visits soon at its six regional nursing homes, Kiley said.

"It has been such a wonderful experience seeing loved ones together again," Kiley said of the outdoor visits at assisted living facilities.

At Country Terrace, Hulett has appreciated the chance to see her husband without looking through glass -- and complete her daily milk shake deliveries to Donald in person -- during recent outdoor visits on the facility's patio.

Donald's sister, Donna Gran of Northfield, also said the visitation restrictions have been tough to live with.

"We want him to be safe and healthy, but it's just a challenge, like it is for everybody," Gran said.

Mandy Heard of Eau Claire worries about the impact of visitation limits on residents.

Heard's 94-year-old mother, Betty Crews, is a resident at Chippewa Manor in Chippewa Falls who Heard fears has struggled with the lack of visitors during the COVID-19 lockdown.

"It's very important that people have interaction, and now my mother says she is depressed," Heard said. "That's hard because there's nothing I can do about it."

While she understands the reasons for the restrictions -- and even acknowledges COVID-19 could be fatal for Crews because of her fragile physical health -- Heard said the mental health of isolated residents, who also are enduring greatly reduced social activities in the facilities, should be taken into account.

"It is a real problem for the nursing homes, the families and the residents," she said. "It's a big deal."

After months of unsatisfactory window visits in which hearing was consistently a hurdle, Heard said she enjoyed her first outdoor visit last week and was particularly appreciative that Chippewa Manor provided a microphone with an amplifier to improve communication through masks.

Nursing home administrators also understand the additional challenges visitation limits present for residents and families, and they have worked with state officials to develop temporary solutions such as the protocol for outdoor visits, said Jim Stoa, government relations director for the Wisconsin Health Care Association and the Wisconsin Center for Assisted Living.

Stoa acknowledged that visits by friends and family play a major role in maintaining the mental and emotional well-being of nursing home residents.

Kiley said Dove caregivers also are aware that visitation changes are difficult and monitor residents' mental health and seek ways to support them.

"Nothing can fully compare to or replace being able to embrace your loved one in a hug, hold their hand or sit next to each other while enjoying a good meal, so this is hard," Kiley said, adding, "We have extremely creative employees dedicated to improvising and adapting. There is still hope, joy, laughs and smiles taking place every day at Dove Healthcare."

Balancing act

In the early days of the pandemic, nursing homes relied heavily on facilitating virtual communication with residents. While that can be helpful, Stoa said, it doesn't work for all residents and can't replace the human connection of in-person visits.

Outdoor visits offer a reasonable band-aid fix for now, he said, adding, "Everybody realizes we're going to need to adapt as the weather changes and if the disease surges."

In the meantime, Stoa said state officials and long-term care administrators will continue the balancing act of trying to meet residents' needs for both physical protection from a highly contagious virus and the mental health boost that comes from interacting with relatives.

"Facilities have been and are continuing to take every precaution to prevent COVID-19 from entering facilities and to prevent its spread," he said. "While we are doing our best to find ways to meet residents' psycho-social needs, it is with the understanding that the top priority right now has to be infection control."

The high-risk nature of many nursing home residents is evident in Kaiser Family Foundation statistics. The 1,432 cases reported in Wisconsin long-term care facilities through Thursday make up just 3% of the state's total caseload. However, the 365 deaths of people living in those facilities account for 42% of the state's coronavirus-related deaths.

DHS reported last week that it has two active and four closed COVID-19 investigations in Eau Claire County nursing homes. Public health investigations are initiated when at least one person tests positive for the virus.

Though they understand the risk, family members said it's difficult to remain apart from loved ones in long-term care.

Heather Betsinger of La Crosse, for instance, said it's frustrating that she hasn't been able to hug her 87-year-old grandmother, Gert Rutherford, for more than four months at Pine View Terrace in Black River Falls even though the facility hasn't had a single COVID-19 case.

"I was able to see her through a window for about two minutes a few weeks ago, and to not touch her or sit down and look her in the eye and spend time with her was heartbreaking," Betsinger said.

She would like to see the residents get more of their quality of life back in the time they have left.

Outlook unclear

Before the pandemic struck, Ginger Harings of Chippewa Falls said she used to go for walks three or four times a week with her sister Kathy Cliff, a resident at River Pines in Altoona. That hasn't happened since March, and they both miss interacting without panes of glass between them.

"It's a bit daunting, but you just have to accept it and understand that it's not about one of us; it's about all of us and hopefully getting through it," Harings said. "Unfortunately, it has lasted much longer than I anticipated."

Nursing home officials pledged to continue following the guidance of regulatory agencies to keep residents safe, but they stopped short of making promises about the duration of restrictions.

"COVID-19 has proven to be anything but predictable," Kiley said, asserting that no one can forecast with any certainty what the next week, month or even year will bring with the pandemic.

"In an ideal world," Stoa said, "we would be able to return to safe and regular visitation sometime soon in a less restrictive way than is now required because of COVID. But given the situation, it's not realistic to expect a quick return to the way things used to be."

___

(c)2020 the Leader-Telegram (Eau Claire, Wis.)

Visit the Leader-Telegram (Eau Claire, Wis.) at www.leadertelegram.com

Distributed by Tribune Content Agency, LLC.

Nationwide News