As the coronavirus spreads, many nursing homes and assisted living facilities are discouraging family members from visiting loved ones, and they are screening those who do come. President Trump created additional confusion last night when he urged facilities to “suspend all non-essential visits.” What should you do?
There is good reason for concern. While there is no evidence that older adults are more likely to contract COVID-19, the disease caused by the coronavirus, they often suffer more severe effects. And they are much more likely to die from the disease than younger people. In one nursing home in the Seattle suburb of Kirkland, 19 people have died from the disease, and COVID-19 has been reported in nine other facilities in the area.
But not visiting loved ones living in a nursing home, skilled nursing facility, or assisted living facility is hard. And it creates some difficult challenges.
Keep in mind that, with some exceptions, facilities are discouraging family visits, not prohibiting them.
Nursing homes may be barring nearly all visitors if they are located in communities where the virus has become widespread, such as King County, WA or Westchester County, NY.
Screening visitors
Otherwise, facilities likely will only urge you to stay home. And most will actively screen visitors. They may ask you questions, such as whether you have been coughing or sneezing, have a fever, or have visited a foreign country recently. If the answer is yes, they may ask you to leave. Some facilities may routinely take the temperature of all visitors (including vendors and even visiting health professionals) to determine if they have fever.
All this could change if government turns Trump’s idea into a flat prohibition. But for now, facilities and families still have some flexibility, based on guidelines issued last week by the Centers for Medicare and Medicaid Services. States have issued their own similar guidelines (for example, here is Maryland’s) I asked the American Health Care Assn. whether Trump’s remarks would change its guidance to members, but it did not reply. For now, assume you will be discouraged from visiting, but not barred. What should you do?
First bit of advice: Let the facility staff do their job. They are asking about your health and travel history for good reason. Cooperate with them. And, for the sake of everyone involved, tell the truth. Even if you’ve just had the “sniffles,” let them know.
And if you are not feeling great, stay home. Don’t visit.
Even if you are OK, and not in a community with a large number of cases, you still should think about what to do. If you are a young adult, you could be a coronavirus carrier without knowing it. Many young people may have COVID-19 yet show no symptoms.
Risks of not visiting
But not visiting raises issues. Without company, residents will be lonely and bored. Some may not understand why you have stopped visiting, and that can make them upset and agitated.
Even worse, many facilities also have barred volunteers. That means no friendly visitors, no pets, no one to help support staff with resident activities.
And staff, already overworked in many facilities, now has even more to do. They have to meet tougher infection control standards, both for themselves and their facilities. And, I suspect, many are worried about their personal health. As a result, they may be less attentive to individual residents.
Even in the best of times, it is critical that family and friends are a presence for their loved ones who are in facility care. Not only to provide support, but also to act as advocates. A family member can prevent problems, and make sure that issues are addressed quickly when they do arise.
What will happen when those family members are not there? Phone calls or video chats through Skype or Zoom can help, but they are not the same as a personal visit.
Coronavirus is forcing many hard choices on us all. Whether or not to visit a loved one in a residential care facility is an especially tough one. But, at least for now, when in doubt, don’t.
There is a need for the true cost of these new coronovirus restrictions for visitors at SNF on our older loved ones. These family members perform tasks with family members that include therapy, eating, hygiene and movement which otherwise would be required of staff. It is simple reasoning that if these visitors are not permitted to visit more staff must be added to complete these duties as well as additional cleaning staff to protect the elder residents. With that said not a single government requirement has been issued to the facility for staffing when implementing visitor bans. The Coronavirus Relief $$ is exactly what should be funding these temporary increases. Also the facilities need to be transparent on visitors if any allowed, restricted times, screening processes. These visitors actually may have a reduced exposure on their family member compared to a nurse with their 20 patients, assisting with other patients, fellow staff members and family outside of the facility which is brought to facility each shift multiplied by 2 shifts per day. A family visitors will likely be more disciplined about sanitation of themselves and resident room as less demands are o. Them during their stay than an overworked staff member. Therefore, a visitor ban may actually be counterproductive on patient quality of life, viral exposure and compassion. Even limited access and same screening as employees will prevent secondary deaths of the coronavirus which should more properly be termed neglect. I am writing today because only a few hrs ago we watched my father pass following a visitor ban at a SNF on the first day of the ban with no exceptions, likely caused by overworked, under staffed and poorly implemented procedures and facilities. As you mention our elderly are the most vulnerable to Coronovirus as well as neglect and weakness requiring rehab in the first place.
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