As coronavirus cases rise again in nursing homes, some states have begun requiring visitors to present proof that they are not infected before entering the facility, causing frustration and dismay. for family members.
Officials in California, New York and Rhode Island say new COVID-19 testing requirements are needed to protect residents – an extremely vulnerable population – from exposure to the omicron coronavirus variant very contagious. But many family members say they can’t secure tests amid overwhelming demand and tight supplies, leaving them unable to see loved ones. And being shut down from facilities feels unbearable – like a recurring nightmare with no end.
Severe staff shortages are complicating efforts to ensure safety while keeping facilities running; This shortfall also jeopardizes care in long-term care facilities, a concern for many family members.
Andrea DuBrow’s 75-year-old mother, who has severe Alzheimer’s disease, has lived for nearly four years in a nursing home in Danville. When DuBrow couldn’t see her months earlier during the pandemic, her mother forgot who she was, she said.
“This latest restriction is essentially another lockdown,” DuBrow said at a meeting last week about the new California regulations. “The time my mother was gone when she could tell in some locked-in part of her that it was me, her daughter, cleaning her, feeding her, holding her hand, sing her favorite songs – that time is being stolen. we.”
Ozzie Rohm, whose 94-year-old father lives in a nursing home in San Francisco, said the worst part is the lack of a clear vision of the future.
“This is a huge inconvenience,” said Rohm, “but the most frustrating thing is that nobody seems to have any kind of long-term plan for families and people.”
Why should family members be subject to testing requirements that don’t apply to employees, Rohm wondered. If household members are vaccinated and healthy, wear good masks, stay in people’s rooms, and practice strict hand hygiene, do they pose more risk than employees who follow? these processes?
California was the first state to announce new policies for visitors to nursing homes and other long-term care facilities on December 31. These policies go into effect January 7 and will remain in effect. maintained for at least 30 days from that time. To see a resident, one must show proof of a negative COVID-19 rapid test performed within 24 hours or a PCR test performed within 48 hours. A COVID-19 shot is also required.
The California Department of Public Health, in a statement announcing the new policy, cited the “greater transmissibility” of the omicron variant and the need to “protect particularly vulnerable populations.” in long-term care facilities.”
Throughout the pandemic, nursing home residents have suffered disproportionately high rates of morbidity and mortality.
New York followed California with an announcement on January 7 that people visiting nursing homes would need to present proof of a negative rapid test result taken no more than a day earlier. And on January 10, Rhode Island announced a new regulation that requires proof of vaccination or a negative test.
Patient advocates said they were worried other states could adopt similar measures.
“We’re concerned that omicrons will be used as an excuse to shut down clinics again,” said Sam Brooks, program and policy manager for National Consumer Voice for Quality Long-Term Care, an advocacy group. for people living in these facilities, said.
“We don’t want to go back to two years of being locked up in nursing homes, and the isolation and abandonment of residents,” he added.
That’s also a priority for the federal Center for Medicare & Medicaid Services, which has emphasized as of November 12 the right of residents to receive visitors without restriction as long as safety procedures are followed. Nursing homes may encourage but do not require visitors to take pre-tests or provide proof of vaccinations, CMS explained.
Safety procedures include wearing a mask, strict hand hygiene, and maintaining an appropriate distance from other residents.
However, with the rise of the omicron, the facilities have been pushed back.
An organization representing nursing home medical directors and two national long-term care associations sent a letter to CMS administrators in mid-December asking for more flexibility to “protect the safety of of residents” and “instituting temporary visitation restrictions in nursing homes”.
On January 6, CMS affirmed residents’ visitation rights but said states could “take additional measures to make visitation safer.”
When asked to comment on recent states’ actions, the federal agency said in a statement that “a state can require nursing homes to test visitors as long as the facility provides the tests.” rapid antigen testing and adequate testing supplies.
“However, if there are insufficient supplies of rapid testing,” the statement added, “visits should be permitted without testing (while adhering to other practices, such as such as face covering and physical balance).”
The Biden administration’s new plan could help ease the shortage of testing per household. But for family members who visit nursing home residents a few times a week, that supply won’t go very far.
Since the start of the year, tensions have been raised over the balance between safety and resident visitation rights.
In the week ending January 9, 57,243 nursing home workers reported being infected with the coronavirus, nearly 10 times more than three weeks earlier. During the same time period, the number of infections from people rose to 32,061 – almost eight times more than three weeks earlier.
But the outbreaks are occurring in a different context today.
More than 87% of nursing home residents have been fully vaccinated, according to CMS, and 63% have also received a booster shot, reducing the risk of COVID-19. Nursing homes have also had experience dealing with outbreaks. And the numbers of nursing home confinements – loneliness, despair, abandonment and physical breakdown – are now much better understood.
“We’ve all seen the negative effects of limited visits on our health,” said Joseph Gaugler, a research professor of long-term care services at the University of Minnesota School of Public Health. mental health and well-being of residents. “For nursing homes to go back to their bunkers and shut everything down, that’s not a solution.”
Tony Chicotel, a staff attorney at California Advocates for Nutrition Home Reform, said family members often play an important role in caring for family members, especially in the context of staff shortages. .
“We need people in these buildings who can take care of the residents,” he says, “and often it’s visitors who are essentially acting as unpaid certified nursing assistants: combing. groom and clean the inhabitants, rotate and reposition them, feed them, stretch, and exercise them. ”
According to the US Bureau of Labor Statistics, nearly 420,000 employees have left nursing homes since February 2020, exacerbating existing shortages.
When DuBrow learned of California’s new testing requirement for visitors, she arranged to have a PCR test at a site on January 6, with results expected within 48 hours. . Instead, she waited 104 hours before receiving a response. (Her test results came back negative.) Eager to visit her mother, DuBrow called every single CVS, Walgreens, and Target within a 25-mile radius of her home to request a test, but to no avail. result.
The California Department of Public Health, in a statement, said the state has established 6,288 testing sites and sent millions of home tests to counties and local jurisdictions.
In New York, Democratic Governor Kathy Hochul has pledged to make nearly 1 million tests available to nursing homes where visitors can take them on the spot, but that presents its own problems.
“We don’t want to check on customers who are queuing at the door,” said Stephen Hanse, president and CEO of the New York State Medical Facilities Association, an industry group. “We don’t have the medical staff to do that, and we need to focus all of our staff on taking care of the residents.”
Given the current staff shortages, trying to ensure that travelers wear masks, stay away from their bodies, and adhere to infection control measures is “a tax on staff,” said Janine Finck-Boyle, deputy head of staff. Leading Age’s president of legal affairs, said. long-term care providers benefit.
“Really, the challenges are huge,” says Gaugler, of the University of Minnesota, “and I wish there were easy answers.”
https://www.sbsun.com/2022/01/24/senior-living-families-complain-as-states-require-covid-19-testing-for-nursing-home-visits/ Families complain as states require COVID-19 testing while visiting nursing homes – San Bernardino Sun