Visits to nursing homes resume in half of US states to the relief of families

(From left) Ina Barbosa, of Attleboro, Mass., and Kimberley Vann-Lites, of Norton, Mass., visit with their mother, Mary Vann, age 85, in person for the first time since the coronavirus pandemic shut down visits to Hebrew Rehabilitation Center in Boston's Roslindale, on June 11, 2020.

(Kaiser Health News)States across the country are beginning to roll back heart-wrenching policies instituted when the coronavirus pandemic began and allow in-person visits at nursing homes and assisted living centers, offering relief to frustrated families.

For the most part, visitors are required to stay outside and meet relatives in gardens or on patios where they stay at least 6 feet apart, supervised by a staff member. Appointments are scheduled in advance and masks are mandated. Only one or two visitors are permitted at a time.
Before these get-togethers, visitors get temperature checks and answer screening questions to assess their health. Hugs or other physical contact are not allowed. If residents or staff at a facility develop new cases of Covid-19, visitation is not permitted.
As of July 7, 26 states and the District of Columbia had given the go-ahead to nursing home visits under these circumstances, according to LeadingAge, an association of long-term care providers. Two weeks earlier, the Centers for Medicare & Medicaid Services clarified federal guidance on reopening nursing homes to visitors.
    Eighteen states and the District of Columbia were similarly planning to allow visits at assisted living centers.
    Visitation policies may change, however, if state officials become concerned about a rise in Covid-19 cases. And individual facilities are not obligated to open up to families, even when a state says they can do so.
    Relaxing restrictions is not without risks. Frail older adults in long-term care are exceptionally vulnerable to Covid-19. According to various estimates, 40% to 45% of Covid-related deaths have occurred in these facilities.
    But anguished families say loved ones are suffering too much, mentally and physically, after nearly four months in isolation. Since nursing homes and assisted living centers closed to visitors in mid-March, under guidance from federal health authorities, older adults have been mostly confined to their rooms, with minimal human interaction.
    The goal was to protect residents from the coronavirus as the pandemic began to escalate. But the virus entered facilities nonetheless as staffers came and went. And now, families argue, the harms of isolation exceed potential benefits.
    "My mother stopped eating around the middle of April — now she just picks at her food," said Marlisa Mills of Asheville, North Carolina. "Every week, she becomes more delusional." Mill's mother, 95, has dementia and lives in a nearby nursing home that remains closed to visitors.
    Residents "are dying of broken hearts and neglect," said Lelia Sizemore, whose 84-year-old father's health deteriorated precipitously after her mother stopped her daily visits to his Dayton, Ohio, nursing home in early March.
    Diagnosed with severe dementia, blind and unable to feed himself, Sizemore's father lost more than 10 pounds in two months and succumbed to respiratory failure on May 24. Even at the end, the nursing home refused her mother's requests to see him in person.
    "I didn't even get to say goodbye," sobbed Sizemore, who lives in Oregon and last saw her father in July 2019.
    Ohio began allowing visitors at assisted living centers on June 8 and will permit outdoor get-togethers at nursing homes as of July 20.
    New Jersey has the second-highest number of Covid deaths in the country. On June 19, the state's health commissioner announced that all long-term care facilities could accept visitors outdoors — just in time for Father's Day.
    Broadway House for Continuing Care, a Newark facility, quickly notified families and arranged to pitch a tent with chairs and tables underneath in a garden area.
    "It's time to open things up some more: We've all been operating under a sense of being under house arrest," said James Gonzalez, chief executive officer of Broadway House and chair of the board of the Health Care Association of New Jersey.
    With weekly tests, 10 residents and 26 staffers at Broadway House have learned they had Covid-19. One resident has died since the outbreak began.
    "Are we worried about visitors bringing the virus? Yes, but I think we can manage that," Gonzalez said. "We're going to have to