Family, nurses working together ‘is essential for this plan to work’

To get a better sense of the impacts and concerns of visits at long-term care facilities, we spoke with Tracie Culp Harrison, professor and director at the Center for Excellence in Aging Services and Long-Term Care at the School of Nursing at the University of Texas at Austin. This excerpt of our interview has been edited for length and clarity.

Are you in favor of the changes?

I believe that the state Health and Human Services Commission must follow the overall directive of Centers for Medicare & Medicaid Services. However, I wish the facilities had more of a gradual shift into these rules so the facilities could then see what worked and did not work.

Some facilities have had a very difficult loss during this time. Some (staff members) lost residents to COVID-19 whom they had cared for for nearly two decades. They are grieving. Many loved these residents, and they are a little shy to restart their visitation at full speed. That said, some are also fearful that the families will not return — that we pushed them out, and they will continue in this new lifestyle without caregiving and visitation.

All said, families are essential to long-term care. We need to always remember that no one can enter into a facility, whether it be for a short- or long-term stay, and not have someone who

knows their history and cares about their outcomes. Family tends to be the best connection to identity and hope for the future.

Subtle changes in condition are evident when the resident’s history is known to registered nurses. Without family available to communicate the resident’s history, RNs are left at a disadvantage. Again, family is essential.

How has the loss of connection/visits affected residents in long-term facilities?

The loss of visitation has been difficult for families, residents and their loved ones. The need to remember your connections despite institutional living is important — essential. Feelings of loneliness and symptoms of depression are present. There are also those who do not react well

to isolation, with changes in mentation that may not have occurred as quickly with family present.

How safe do you think the residents will be with the changes?

I believe most will be relieved; however, some will fear the changes. It is now up to professional registered nurses who understand infection control, interpersonal communication and behavior change theory to do their job.

In my opinion, having professional RNs on-site caring for the residents and family to assist and direct is essential for this plan to work. There are studies to support this assertion that when it comes to outcomes for residents, RNs must be available to assist with infection control.

Kristian Thacker / New York Times An aging expert at at the University of Texas recommends gradual changes in nursing home visitations to see what works.