Early signs are emerging showing the health consequences forced isolation is having on seniors living in institutionalized settings during the pandemic – and further damage must be prevented by relaxing visiting restrictions, says B.C.’s seniors advocate.
Isobel Mackenzie based her remarks on research and survey results gathered for her Staying Apart to Stay Safe report released Nov. 3, which showed seniors living in long-term care and assisted living facilities and their families are overwhelmingly in favour of increasing the number of visitors allowed, frequency and duration of visits.
“The urgency is now,” said Mackenzie during a Tuesday media briefing. “Residents have told us very clearly in this survey they are more concerned about being separated from their family members than they are about COVID.”
Phone calls, emails and letters to the office of the seniors advocate have been “dominated” by the issue, with “heartbreaking” stories of separation, according to the report.
Of the 13,000 survey responses submitted between Aug. 26 and Sept. 30, only 16 per cent favoured the current policy.
During the briefing, Mackenzie said patterns in data are emerging to show “significant deleterious health impacts on residents of long-term care through this pandemic,” “arguably” due to prolonged isolation.
That includes a seven per cent increase in the rate of antipsychotic medication used at care homes, a three per cent increase in the use of antidepressants and initial reports from quarterly interRAI assessments that show “troubling” increases in unintended weight loss and worsening mood among long-term care residents.
The report offered three recommendations based on survey results:
• Residents should be allowed to identify an “essential care partner” who is allowed frequent visits.
• Residents should be allowed to have “social visitors,” the number of which should be determined by balancing the risk of contracting COVID-19 with the consequences of social separation.
• “A provincial association of long-term care and assisted living resident and family councils” should be established to give families a voice in policy decisions.
Mackenzie said she plans to meet with the Ministry of Health next week and will also advocate “sooner rather than later” for the council.
After the pandemic was declared in March, only “essential visits” were allowed at facilities to assist with feeding, mobility, compassionate care and other needs, but decisions about who qualified were left to individual care homes.
The survey found nearly half of essential visit applications were denied.
Since the end of June that policy has relaxed to also include one “social” visitor, but again it was up to individual care homes to establish rules around frequency, length of visits and location of visits. According to the survey, about 30 per cent of visits are only allowed outdoors, 65 per cent are observed by staff, and almost 20 per cent occur with a physical barrier separating residents from their loved ones.
Currently, 77 per cent of visitors reported they weren’t allowed to touch their loved one.
The report also noted “the reported visit frequency and duration of visits for the designated visitor are, on average, significantly shorter and less frequent than visits prior to the pandemic.”
The lack of universally applied rules has led to frustration among families, said Mackenzie. “We need to communicate with absolute clarity to care homes that visits need to happen in the residents’ private room,” she said, adding it will be harder to achieve clear rules for those who share rooms.
Mackenzie also acknowledged the surge in COVID-19 cases, especially in the Fraser Health Authority, but said for context over the past nine months there have been fewer outbreaks relative to the average number of daily cases than when the pandemic started.
“In long-term care, the goal is not immortality, it is quality of life in our final years,” she said.
There are 349 long-term care sites and 212 assisted living sites in B.C. Since the first outbreak in March, 20 per cent of long-term care sites and seven per cent of assisted living sites have experienced outbreaks, 97 per cent of which have occurred in the Fraser Health and Vancouver Coastal Health regions.
About one per cent of resident and less than one per cent of staff in long-term care facilities have been infected. To date, 151 long-term care residents have died of COVID-19, compared with 4,500 who have died during the same period of other causes.