‘Dying from failure to thrive’
State task force debates allowing some visitation at nursing homes
After five months of physical separation from their loved ones, Florida’s nursing home residents are dying of loneliness and isolation, the wife of an Alzheimer’s patient said Friday as she pleaded with a state task force to speed up the process of allowing at least one visitor per resident.
“There are people dying today, right now … from failure to thrive,” said Mary Daniel, who took a job washing dishes at a Jacksonville memory-care center so she could see her 66-year-old husband there. “I am begging for urgency. … Why am I allowed to touch my husband as a dishwasher, but I am not allowed to touch him as his wife?”
Daniel’s comments came during an initial meeting of the task force, created last week by Florida Gov. Ron DeSantis to map out a “safe and limited reopening” of the state’s long-term care facilities to visitors. DeSantis ordered them closed in mid-March to prevent the spread of COVID-19, which has killed at least 68,000 residents and workers at facilities across the country.
In Florida, nearly 3,900 people have died of the virus in nursing homes, assisted-living centers and group homes as of Thursday night. But in recent weeks the number of infections among residents has begun to
flatten, and it is now declining for workers.
Daniel’s claim that residents are dying from the despair of separation, she said, comes from anecdotal evidence. Members of her Facebook group, Caregivers for Compromise, now over 8,000 strong, describe distraught loved ones who stopped eating and seemed to lose the will to live after months of isolation — a scenario also recounted by gerontologists and long-term care ombudsmen in other states. While some states have allowed outdoor visits or limited indoor visits, Florida’s facilities have remained largely shuttered — although state officials said confusion over the governor’s order has kept out some visitors who should have been allowed in.
“We have certainly allowed facilities to consider it as optional” to allow visitors who previously served as regular caregivers for their loved ones, said Mary Mayhew, secretary of Florida’s Agency for Health Care Administration, which oversees the industry. “It’s either confusion or a decision” by the facility not to continue that.
Daniel also said that “compassionate” visits — for nursing home residents who are nearing death, grieving or recovering from surgery — are also being blocked.
“That [visitation] is not happening,” Daniel said. “A lot of what I’m asking are little things [including] clarification of what the rules are.”
Mayhew said she agreed with the need to act urgently and planned a second meeting for Tuesday, when the group will debate specific requirements to help facilities prepare for visitation.
Dr. Scott Rivkees, Florida’s surgeon general and a
task force member, said federal guidelines spell out such requirements already, including that the facility be free of new COVID cases for 28 days. They also recommend outdoor visits when possible, the use of masks and other personal protection equipment for visitors and residents, maintaining a 6-foot buffer between visitors and loved ones, and having a designated employee “monitor” the visits to ensure compliance.
The Florida Health Care Association, which represents most of the state’s nursing home owners and operators, has its own task force that has recommended all facilities allow outdoor visits for residents who are COVID-negative.
“Preference No. 1 [is] outside areas protected from weather elements, such as porches, patios and other covered areas — or tented areas,” said Emmett Reed, the association’s executive director. “In-facility visits should be limited to the compassionate care situations … and also facilities that have no new-onset cases for 28 days.”
Facilities also should have no staffing shortages; adequate supplies of masks, gowns and gloves; sufficient testing supplies and room in local hospitals to transfer residents if they become ill, Reed said.
But he also called for the resumption of beauty salon and barber shop services within nursing homes for COVID-negative residents, provided they follow certain safety protocols.
“This is a little outside the purview,” he admitted. “We think beauty salons and barbers help quality of life and make residents feel good about themselves.”
Other task force members did not comment on his suggestion.