State nursing homes hunker down

Visitation restrictions, resident isolation part of new normal

Outside visits to nursing homes have all but ceased, one of several measures long-term care facilities are taking to protect vulnerable residents from exposure to covid-19.

Family members are generally allowed to enter the sites only for end-of-life calls, nursing home officials reported.

The restrictions came after guidance from the federal Centers for Disease Control and Prevention as well as the Centers for Medicare and Medicaid Services. The Arkansas Health Care Association has been in contact with both groups and officials are regularly updating its website to reflect changes, Executive Director Rachel Bunch said.

“Our priority right now is to prevent covid-19 from getting into any long-term care facilities in the state, and, if it does, to keep it from spreading,” Bunch said Tuesday.

The group is the main trade association representing nursing homes in the state and has worked with the state Health and Human Services departments on rules related to such facilities.

Nursing-home officials from around the state say they are limiting the size of social gatherings within their facilities, implementing more rigorous cleaning routines, isolating residents as necessary, finding alternate ways for residents to communicate with family members and screening employees for

covid-19 symptoms.

They are anxious to keep the virus out of long-term care centers given its high estimated fatality rate in elderly people, which some early research has pegged at around 15%.

“Evaluations from prior viral epidemics that spread like COVID-19 found that actions taken early in outbreaks (such as social distancing, restricting interaction with others, washing hands) can significantly reduce the spread of the virus,” Bunch wrote in an email last week.

“Waiting until the virus is spreading in the community is often too late.”

The Arkansas Health Department’s directives on nursing-home visitation in the outbreak tightened noticeably over the course of past week, evolving from recommended screenings and barring of symptomatic visitors to prohibiting all visitors unless “medically necessary or by law enforcement or other emergency personnel” or state or federal regulators.

“While we understand these visitor restrictions may be difficult for residents and families, it is a critical and temporary measure for their protection,” Bunch said in a statement Saturday.

In neighboring Louisiana, 13 cases of covid-19 have been identified at the assisted-living and retirement home Lambeth House in New Orleans.

Four of those residents — a 98-year-old, a 92-yearold, an 84-year-old and an 80-year-old who was a retired U.S. district judge — had died as of Wednesday, reports said.

In an interview, Bunch also pointed to an example in the state of Washington where a covid-19 outbreak caused 29 deaths.

“We’re trying to prevent anything like that from happening in Arkansas,” she said.

At Highlands of North Little Rock Therapy and Living, residents who have respiratory and cognitive issues are quarantined in their unit because of increased risk, said Raymond Holmes, a social worker at the facility.

Workers are cleaning rails, common areas and rooms more often than normal.

The facility, which has 91 residents, is providing phones for residents who don’t have cellphones to call their families, Holmes said.

“We are extremely concerned about a lot of our residents because we do operate with residents over 65, so they are totally at risk,” Holmes said.

Bunch said she’s heard from other facilities that are using video chat programs or having residents write letters and cards to family members.

Other providers have taken to social media to facilitate communication. Greenhurst Nursing Center in Charleston used Facebook to share pictures of residents holding white boards, on which they’d written messages to their families.

“I am OK I wish I could see you and I love you very much. Love Mom,” one woman wrote.

At Hudson Heights Memorial Nursing Home in El Dorado, some residents’ family members are visiting but staying outside the facility, opting to call their family and wave at them through a window or the panels of a sun porch, said Kara Yutzy, director of nursing for the facility.

The El Dorado facility, which has 81 residents, is quarantining two residents after they had to go to the hospital for health problems unrelated to covid-19. They don’t have symptoms but are staying in quarantine for 14 days just in case, Yutzy said.

Social activities are limit

ed to groups fewer than 10, residents are eating in their rooms and are being screened daily for symptoms, she added.

“It’s not fun,” she said. “They’re not enjoying it. They understand the need for it, but it’s very isolating.”

Relatives have been understanding of the precautions for the most part, Holmes and Yutzy said.

Bunch said her group is fielding calls from concerned family members.

“This is a big change, and it’s hard to adjust to,” she said.

But, she added, facilities are working hard to stay informed on what to do. Hundreds are participating in phone calls in which the group gives out updates.

Further information on covid-19 for long-term care facilities can be found at arhealth.com/coronavirus-disease-covid-19.