Elder-care COVID rules under fire

Barbara and Christine Colucci long to take off their masks and kiss their 102-year-old mother, who has dementia and lives in a nursing home in Rochester, New York. You would like to have more than two people in your room at the same time so that relatives can be there too.

“We don’t know how long she will be alive,” said Christine Colucci, “so please give us the last chance to have this interaction in your final months on this earth.”

The pandemic restrictions are falling almost everywhere – except in many American nursing homes. Rules to protect the country’s most vulnerable from COVID-19 are still enforced, although 75% of nursing home residents are now vaccinated and infections and deaths have fallen.

Frustration has started as families across the country visit their mothers and, this Father’s Day weekend, their fathers. Hugs and kisses are still discouraged or forbidden in some nursing homes. The residents eat in relative isolation and play bingo and do handicrafts from a distance. Visits are limited and must be kept short and cut off entirely if someone tests positive for the coronavirus.

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Family members and lawyers question the need for such restrictions at this stage of the pandemic, when the risk is comparatively low. They say the measures now only prolong the isolation of the elderly and accelerate their mental and physical decline.

“You protected her to death,” said Denise Gracely, whose 80-year-old mother Marian Rauenzahn lives in a nursing home in Topton, Pennsylvania.

Rough tooth had COVID-19 and then lost part of a leg to gangrene, but Graceley said what she struggled with the most was forced loneliness, from visiting six days a week to none at all.

Rauenzahn’s daughters finally got the right to see them once a week, and the nursing home is now planning to relax the visiting rules for all residents at the end of June. But it wasn’t enough as far as Graceley is concerned.

“I think it drove her dementia,” Graceley said. “She is very lonely. She wants to get out of there so badly. “

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The Pennsylvania Long-Term Care Ombudsman has received hundreds of complaints this year about visiting rules. Kim Shetler, a data specialist in the Ombudsman’s office, said some nursing homes COVID-19 restrictions go beyond what state and federal guidelines require. Administrators have done what they believe is necessary to keep people safe, she said, but families are understandably upset.

“We have done our best to ensure that people get this visit,” she said. “It’s her home. They should have the right to come and go and have the visitors they choose. “

A recent survey by National Consumer Voice for Quality Long-Term Care, an advocacy group, found that visit times between 15 minutes and two hours are still common. Some facilities limit visiting hours to weekdays, making it difficult for people who work during the day, or limit visits to once or twice a week.

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The Rauenzahn nursing home in Pennsylvania limits most residents to a single 30-minute visit every two weeks.

Lawyers also object to the federal guidelines on how nursing homes deal with new COVID-19 cases. The guidance states that most visits should be suspended for at least 14 days. Some family members, administrators, and lawyers complain that the recommendation resulted in frequent bans due to one or two cases.

“We have never had a really long time to receive visitors,” said Jason Santiago, chief operating officer at The Manor at Seneca Hill in Oswego, New York. He said the continued isolation is taking a heavy toll. “We have to do things that are more meaningful for these residents, more meaningful for these families.”

While the federal government recently eased restrictions on vaccinated nursing home residents, New York State did not go along with it. For example, those who eat together in common rooms must remain socially distant and must be masked regardless of their vaccination status and be 2 meters away during activities.

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That makes crafting, bingo, music – “a lot of what nursing home life is about” – harder, said Elizabeth Weingast, vice president of clinical excellence at The New Jewish Home, which operates geriatric care facilities in and around New York City.

“We’ve prioritized vaccinating nursing home residents and that’s wonderful, but they’re not getting the same freedoms that you or I have now,” said Weingast, who recently did one Opinion piece call for the restrictions to be relaxed.

Her co-author Karen Lipson of LeadingAge New York, who represents nonprofit nursing homes, said the rules “enforce this kind of love surveillance that is really, really challenging.”

With the virus infecting more than 650,000 people in need of care and killing more than 130,000 people in the U.S., nursing homes had to take precautions if COVID-19 got out of hand, said Nancy Kass, public health expert at Johns Hopkins University. But she said she was stunned by the continued strong emphasis on safety at the expense of residents’ quality of life as “we are no longer in that state”.

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In Ohio, Bob Greve was desperate for a change of scenery after being locked up in his Cincinnati area nursing home for most of last year. But the steward would not allow a visit to his son’s house because of COVID-19 concerns – despite both men being fully vaccinated.

Politics led Greve to a “breaking point,” according to his son Mike Greve, who said his 89-year-old father called six, eight, even ten times a day out of boredom and frustration, constantly talking about getting off the bus.

Mike Greve said he pushed the nursing home’s administrator to go for outside forays only to learn, “If I let you out with your father, I’ll have to let everyone else out.” Greve said the administrator was concerned that residents would be COVID-19 bring.

The administrator has not returned phone and email messages from The Associated Press. A day after AP asked for comment, Greve said the administrator called him into the office, offered to allow his father to visit, and said the policy would be changed for everyone else too.

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Father and son spent a lovely afternoon in the sun at Greve’s house, where his father spotted a deer.

“He said ‘Hallelujah’, I don’t know how many times,” Greve said. “He said, ‘I don’t know how you got me out, but I’m so happy that I could cry.'”

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Rubinkam reported from northeast Pennsylvania. Associated Press reporter Marina Villeneuve in Albany, New York contributed to this story.

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