Arkansas and many other states are preparing or have already started to allow visitation of nursing home residents, albeit outdoors and under strict guidelines. In retrospect, some analysts believe that for thousands of Alzheimer and dementia patients, the severed contact with their families and to some degree their caregivers due to the Coronavirus outbreak, contributed to many residents dying when they contracted COVID-19.
“Isolation and limit of support can lead to depression, which will influence the way a person with Alzheimer’s/dementia eats and drinks because they don’t have the verbal cues that they once were getting,” is how David Cook, the public policy manager for the Arkansas chapter of the Alzheimer’s Association, described the effects of isolation on residents with Alzheimer’s and dementia. He acknowledged that ending the closed visitation in nursing homes is a very important step; however, he expressed that many advocates’ are urging facilities to use caution as visitation is restarted.
Data from the Centers for Disease Control and Prevention (CDC) was recently analyzed by The Wall Street Journal, and the results of that analysis suggested that the COVID-19 outbreak caused disruptions that possibly contributed to the deaths of 15,000 residents. Although the study pointed out that the “excess deaths” did not occur as a direct result of the Coronavirus, the disruption in the consistent routines that residents were accustomed to having resulted in more falls and the weakening of many residents’ already fragile immune systems.
Cook also pointed out more concerns about the reopening, saying, “Alzheimer’s patients often have co-existing chronic conditions, whether it be a heart issue or maybe a respiratory issue. We have increased concerns that the state’s not ready for [reopening] because we don’t believe that the adequate testing is in place.”
Caregivers and family members were reminded about the importance of handwashing, wearing a mask, and practicing social distancing guidelines along with scheduling outdoor visits.
Compliance Perspective
Allowing visitors may provide welcome relief for both families and residents, but failure to follow CDC guidelines requiring a nursing home to have gone 28 days without a positive case of COVID-19, along with failing to ensure that visitors are practicing hand sanitizing protocols, wearing masks, practicing social distancing, and scheduling outdoor visits may result in the re-introducing of the virus into the facility. Placing residents in jeopardy could be considered provision of substandard quality of care, in violation of state and federal regulations.
Discussion Points:
- Review policies and procedures to ensure that plans for reopening and allowing visitors are compliant with all state and federally issued guidelines regarding preventing the spread of COVID-19 in nursing homes.
- Train staff regarding the importance of being present during visitations to ensure that residents are not placed in jeopardy due to a visitor ignoring infection control protocols. Staff should also be trained on ways to provide interaction and consistent routines with residents who have Alzheimer’s and dementia, even in such situations as the Coronavirus outbreak
- Periodically audit to determine if infection control guidelines are being observed by families during visitations.
