B.C. seniors advocate says long-term care residents should have more access to visitors amid pandemic

B.C. seniors advocate says long-term care residents should have more access to visitors amid pandemic
CHEK/File photo
People talk to a relative through a window at a long-term care home in Nanaimo in June 2020.

British Columbia Seniors Advocate Isobel Mackenzie says access to people in long-term care should be improved amid the ongoing COVID-19 pandemic.

On Tuesday, British Columbia Seniors Advocate Isobel Mackenzie released the results of a
province-wide survey on the impact of visit restrictions at long-term care and assisted living homes.

Mackenzie is making three recommendations to the province:

  1. Allow all residents to designate an essential care partner;
  2. Allow social visitors and determine the number allowed by balancing the risk of COVID-19 with
    the risk to a resident’s health from the long-term family separations;
  3. Create a provincial association of long-term care and assisted living resident and family councils.

Mackenzie says while there have been 151 COVID-19 deaths in B.C. care facilities during the pandemic, 4,500 residents have died of other causes, with many spending their final days in isolation from their families.

More on the survey

The report on the survey, Staying Apart to Stay Safe, looked at the experience of more than 13,000 residents and their family members over the course of the pandemic.

The report highlights data that points to signs of negative health impacts of visiting restriction on residents. Of concern to the seniors advocate is the substantial increase in the use of antipsychotic medication during the period of visit restrictions and clinical assessments completed in the first quarter of the pandemic that show an increase in unexplained weight loss and worsening of mood or symptoms of depression. The report also highlights the need for residents and family members to have a collective voice in the decision-making process.

In a series of questions covering visits before the pandemic, during the first phase of visit restrictions, and currently, the survey found:

  • Before the pandemic, 55 per cent of families were visiting long-term care and assisted living residents for an hour or more several times per week and even daily;
  • Prior to COVID-19, the majority of visitors were performing essential care for residents, such as
    personal care, grooming, assistance with feeding and mobilization;
  • Most family members were not aware of the possibility of essential visits during the first four
    months of visit restrictions, and almost half of the people who did apply for an essential visit
    were refused;
  • Under the current visitation policy: the majority of visits are only once a week or less, and half
    the visits in long-term care are 30 minutes or less; 30 per cent of current visits are outside only; currently, 65 per cent of visits are observed by staff for some or all of the time; only 21 per cent of visits are in the privacy of the resident’s room (75 per cent of long-term care residents and almost 100 per cent of assisted living residents live in private rooms); 70 per cent of visitors are not allowed to touch their loved one; most visitors are washing their hands, wearing a mask, having their temperature checked, and answering health questions prior to each visit; and
    • Most family members and residents support some visit restrictions during the pandemic,
    although they believe visits should be more frequent and that at least one more visitor for each
    resident should be permitted.

The report also highlights data that points to signs of negative health impacts on residents. Of concern
to the Seniors Advocate is the substantial increase in the use of antipsychotic medication during the
period of visit restrictions and clinical assessments completed in the first quarter that show an increase
in unexplained weight loss and worsening of mood or symptoms of depression.

“This is one of the most challenging issues we face,” Mackenzie said in a statement.

“Visit restrictions were imposed in long-term care and assisted living homes because we care about the seniors who live there, and we want to keep them safe. But as we enter our ninth month, British Columbia seniors and their families are seeking a better balance between preventing the transmission of COVID-19 and ensuring quality of life.”

According to the report, calls, letters and emails about visit restrictions have “dominated” the Office of the Seniors Advocate more than any other single issue in its history.

“The stories from families that have been separated, some for over six months, are nothing short of heartbreaking. Initially, when visit restrictions were implemented, families and residents supported the need for such measures as they realized they needed to stay apart to stay safe while the health care system learned how to manage this virus in LTC [long term care]/AL [assisted living]; however, as weeks became months, concerns began to rise,” the report says.

The report says that when COVID-19 first struck care homes, the province acted swiftly and decisively, bringing in a number of prevention measures that have seen B.C. perform relatively well in managing COVID-19 in long-term care and assisted living.

“The Provincial Health Officer and the Government of B.C. have my profound gratitude for their quick and comprehensive actions at the beginning of this pandemic,” Mackenzie said.

“Many lives were undoubtedly saved. However, residents and family members now recognize the pandemic will continue for many more months, and the survey makes it clear they are asking for more time with their loved ones.

“When we started visit restrictions, the goal was to ensure residents in long-term care and assisted living were kept safe from COVID-19. Eight months later, we need to ask the question: What are we keeping them safe for if it is not to enjoy the time they have left with the ones they love? While COVID19 has tragically claimed the lives of 151 residents of long-term care and assisted living more than 4,500 other residents have died from something other than COVID-19 during this pandemic and in many cases, they spent their final months, weeks and days in relative isolation, unable to spend time with those they loved most.”

The complete report is available at https://www.seniorsadvocatebc.ca/reports/

In a statement, the Health Ministry said it is spending $160 million to hire 2,400 more staff to increase safe visits, among other things.

With files from The Canadian Press

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