For Edith Street, being confined to her long-term care facility without regular visits from her daughter for the past 100 days is akin to being in solitary confinement.
Ms. Street, who is 95 and has dementia, has started saying that she feels “like a prisoner,” her daughter Marg Smith says.
“She deserves to be surrounded by her family,” Ms. Smith said. “I’m not a visitor. I am her caregiver. I’m her power of attorney, I make all her decisions for her and I should be allowed to be with her.”
Family members and seniors’ advocates are urging the Ontario government to open up nursing homes to essential caregivers, saying the prolonged social isolation from visitor restrictions to prevent the spread of COVID-19 is causing enormous harm to their mental and physical health.
“The collateral damages are extreme,” said Nathan Stall, a geriatrician at Mount Sinai Hospital in Toronto. “Many people are going to spend their final days, their final months living in lockdown – isolated, lonely, with no direct contact with their loved ones.”
Ontario relaxed its long-term care visitor ban last week by allowing outdoor, physically distanced visits.
However, family members who regularly helped feed, change and bathe their loved ones before the lockdown are upset that the Ontario government has not recognized their key role. Other provinces, including Quebec and British Columbia, allow essential visitors inside facilities.
“It’s vital. This will save lives. There is no question about that,” said Vivian Stamatopoulos, a professor at Ontario Tech University who specializes in family caregiving. “We absolutely need family because they are known to be a vital safeguard for residents … against abuse and neglect.”
Since the COVID-19 pandemic began, nursing home residents have died of dehydration and malnutrition amid allegations of neglect owing to severe staff shortages. As well, some homes have been rocked by claims of elder abuse.
Jane Meadus, a lawyer at the Advocacy Centre for the Elderly, said Ontario’s initial restrictions on visitors left room for family caregivers to help their loved ones. However, she said homes have interpreted the directive as banning all visits inside homes, except in cases involving dying residents.
“It’s been somewhat of a tragedy,” she said. “There were many people who were reliant on family members.”
Gillian Sloggett, a spokeswoman for Ontario Long-Term Care Minister Merrilee Fullerton, said the government’s direction to homes “has been that accommodation should be considered – but is not mandatory – for individuals performing essential support care services for residents,” including family caregivers.
Asked when family caregivers would be allowed back into facilities, Premier Doug Ford said last week that his No. 1 priority is protecting long-term care residents.
“We just don’t want another outbreak. We’re finally getting our arms around this, and they’re doing a good job, but we just can’t have a flare-up of people coming in and coming out so we’re being cautious,” he said.
A recent paper on the experience of 26 nursing homes in the Netherlands that allowed residents to have a designated visitor wearing personal protective equipment found no new COVID-19 infections in the three weeks after visits resumed. In response, the Dutch government allowed all facilities to reopen to visitors.
In Ontario, families have welcomed outdoor visits but say they do not address all residents’ needs and ignore the role of essential caregivers. Under the province’s rules, long-term care homes that are free of COVID-19 are to allow residents at least one 30-minute weekly visit outside as long as the visitor stays two metres away, wears a face mask and has tested negative for the virus within the previous two weeks. Retirement homes are permitted to resume indoor visits at a distance.
When Anil Reddi had an outdoor visit this month with his 92-year-old mother, Vimal Kotak, who has dementia, she didn’t recognize him behind his mask. Mr. Reddi, who used to visit his mother every day, said she seemed depressed and had lost weight.
“It was really painful,” he said. “She looked really sad and almost like she had given up. She didn’t know who she was talking to.”
Ms. Kotak finally recognized her son at the end of the visit when an aide took her back inside her Toronto long-term care home and he stood on the other side of the glass door without his mask.
“For the first time, I saw her smile. She lifted her head up and she pointed at me and said, ‘That’s Anil, that’s my son,‘ ” Mr. Reddi said. “That was just like a few seconds and then she was gone.”
During Ms. Smith’s first outdoor visit with her mother last Thursday, her face appeared haggard and it was clear her dementia had worsened. Before the lockdown, Ms. Smith used to visit her once or even twice a day and would encourage her to eat, take her to activities and engage her in conversation.
At the end of last week’s visit, Ms. Street wanted her daughter to come inside her London, Ont., facility to make her a cup of tea. Despite constant reminders, she doesn’t grasp why the coronavirus has led to a ban on regular visits.
“She has said to me that, ‘I’m getting old and what time I have left, I don’t really care about that. I care more about spending time with family,‘ ” Ms. Smith said. “I agree 100 per cent with her.”
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