NO RISK-FREE OPTIONS FOR CARE HOME VISITS

Province’s health officials say relaxing restrictions a complex consideration

Despite mounting calls for B.C. to lift restrictions on family visits at long-term care facilities, provincial health officer Dr. Bonnie Henry says the time is still not ripe.

“Health authorities and the care homes themselves are trying to work this out as quickly as possible,” she told reporters this week when asked about relaxing the rules against non-essential visits. “That is something we are doing provincewide.”

But she balked at calls for the province to set a deadline for lifting the three-monthold restrictions, as is scheduled to happen starting next week in Ontario.

“I can’t give you a specific date,” said Henry. “But it is something we have been actively working on for some time and each home needs to make arrangements for it to be done safely within their environment and that’s part of the complexity.”

Health Minister Adrian Dix echoed the need for caution, citing the recent outbreak at the Langley Lodge longterm care facility, where COVID-19 has cost the lives of two dozen residents. Evidence of the “vulnerability of people in care,” as he puts it.

“From the beginning, this has been a real sacrifice for a lot of individuals, but of importance, nonetheless,” said the health minister, who has acknowledged that a member of his family is isolated in long-term care. “It’s absolutely necessary to continue to ensure that people in long-term care are safe.”

Still, the calls continue. I regularly receive emails asking me to prompt Dix and Henry with another question on the need to restore visitation rights.

“Why can’t a family member be designated an essential person who can visit their loved one?” said one such missive this week.

“At my husband’s facility (no virus) close to 100 staff enter the building daily. They get (their) temperature taken and get a mask. Why not the same for a family member?

“The family should be an essential part of the care team rather than be treated as an enemy who will do harm.”

While acknowledging the need to keep seniors safe, she went on to argue that “the consequences have been terrible — physical, mental, emotional decline and depression.

“I assert this three-month isolation is now bordering on elder abuse,” she continued. “When the post-mortems are done and the pundits weigh in, many will agree.”

Henry and Dix have both acknowledged receiving many such pleas, some angry, others more heart-rending.

“I don’t want to leave the impression we aren’t thinking of this,” Henry said recently.

“Facilities across the province are looking at how they can do this. We’re coming up with guidance for them. The health authorities are working on this and have been for some time.

“So please don’t think because we couldn’t put a specific date on what we are talking about that there’s no timeline on the horizon.”

The challenges, as I understand them, include the wide variations among facilities. Some can readily make provisions for a separate, secure outside space for visits, while others cannot. Some have sufficient staff to manage what could be dozens of weekly visits, others do not.

Then there are the wide variations among residents, some of them readily mobile, others more fragile.

There is also the question of how to proceed if the relatives of some residents want to have more visits and others want to maintain the restrictions out of an abundance of caution.

“This is a huge balancing act,” as B.C. seniors advocate Isobel Mackenzie described the challenge during an interview with host Gregor Craigie on CBC’S On the Island this week.

“There’s no right or wrong answer here. There’s no riskfree decision here. It’s easy to say, ‘oh, it’s obvious.’ Well, actually, no: It’s not obvious.

“We know that if this virus gets into a care home, it can be, frankly, very deadly. And the more people that come into a care home, the more opportunity there is for that virus to be introduced.”

Indeed, all it would take is a visit from one person with undetected COVID-19. But at the same time, the seniors advocate acknowledged that the current restrictions have to be partly relaxed.

“Nobody anticipates that there’s no visits from now until the pandemic is over, which is a year or so from now,” said Mackenzie.

“I don’t think anybody thinks we’re going to go back to the way it was before COVID-19, when people basically came and went very freely when they wanted,” she continued.

“We can’t return to that for now. But all of the discussions are indicating that we’re looking at a way of allowing some form of greater visitation than we have now.”

For example, starting Thursday, care homes in Ontario that are free of COVID-19 will be allowing one visit per resident per week. All visitors will have to wear masks, respect physical distancing and produce evidence of having tested negative for COVID-19 within the standard incubation period of the last two weeks.

Henry has dropped no hints about what the visitation rules might be. As to when the relaxation could take effect, she has said only “we expect that will be in place in the coming weeks.”

Most likely, the province will wait to see how things play out in Ontario, then begin implementing its own new rules closer to the end of June.

Henry and Dix have both acknowledged receiving many such pleas, some angry, others more heart-rending.