Families say nursing home residents need physical contact after months of restrictions

David Alexander's wife is in the final stages of dementia.

They've been married for 38 years and some days, he says, it's difficult to know if she recognizes him.

"But I think she recognizes me as someone she likes to see," said Alexander.

Doris Alexander has been living at a nursing home in Sussex for 5 years and her husband has visited her every day.

"It's just the two of us," he said. "We don't have any family around here, so I used to spend a lot of time there."

Most days, he would spend six to eight hours at the nursing home and help feed his wife lunch and supper.

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Then COVID-19 hit and for months, the couple had to make do with window visits.

Every day, with the help of his walker, he would visit with his wife through a pane of glass he outside, and she sitting in her room in a wheelchair.

Now, with the restrictions eased, he can make an appointment in advance for a 45-minute visit every five days.

There have been no hugs, no held hands. No physical contact at all.

"I get very upset sometimes after I've left her. And I think about, you know this is my wife she's gradually getting into the final stages of dementia and I can't touch her."

He has nothing but praise for the nursing home workers who have cared for his wife.

"They give her wonderful care and attention all of the time," said Alexander,

And he doesn't blame them for having to enforce the strict regulations meant to keep nursing home residents safe from COVID-19.

In fact, he agrees with the precautions, pointing out that, for the most part, nursing homes in the province have been able to keep the virus out.

But he worries about the toll on residents and loved ones.

"She could pass away, and I've never been able to touch her. Never been able to be near her, and hold her hand and tell her I love her."

Current restrictions

With the easing of restrictions, face-to-face visits are now allowed as long as they're scheduled in advance and physical distancing is maintained.

That means no contact still.

The government's recovery plan for nursing homes, called COVID-19 Visitation Recovery, says, "It is assumed that every resident may have 2 visitors every 5 days."

But the frequency of visits can depend on the capacity of a centre to allow physical distancing. The length of the visits is also determined by individual homes "based on their operational capacity," explained Bruce Macfarlane, communications director for the Department of Health.

Emotion toll

Bonnie Aigner is worried about the emotional toll the isolation has had on her mother.

Aigner said she completely understood the protective measures that were taken during the initial lockdown of nursing homes. She said the health of vulnerable residents was foremost and banning visitors was the right call.

But then she looks around at the Atlantic bubble and the contemplation of extending that bubble; school starting in September and an election not long after.

"To not even be able to give the poor woman a hug, which she needs, is having an effect on her," said Aigner.

She said her mother struggles to understand why family members don't visit anymore.

"I think the government has forgotten about these people," said Aigner.

"I plead with this government to have some compassion and humanity."

She said she doesn't expect a return to the old rules, but she thinks it would really help residents like her mother to have one designated family member allowed more access one person who could provide badly needed physical contact.

With proper hand-sanitizing, and while wearing a mask, that person should be allowed to give hugs and hold hands, said Aigner, "and fill their dying souls with the love and compassion they need."

After all, she said,nursing home workers have direct contact with residents and then go out into the community after their shifts end.

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"How is me going in and giving her a two-second hug worse than them being in contact with kids that are in school all day long and then go and look after my mom?"

Aigner believes the Atlantic bubble should remain closed at least until nursing home residents are allowed hugs from loved ones.

"Keep our bubble and keep COVID out, so residents living out their last days in [long-term care] can have some quality of life return," said Aigner.

Greg Loosley agreed.

He said he can't believe the government would contemplate opening the borders before opening nursing homes to one designated loved one.

"It's just not right," said the Sussex resident, whose wife of 53 years lives in a nursing home.

He hasn't held his wife's hand since March.

"People need human contact," said Loosley.

He said he would gladly do whatever Public Health officials ask to be able to give his wife a hug wear a mask, give his temperature, use hand sanitizer.

Loosley said the last few months have taken a toll on his wife's mental health. Even the debilitating effects of multiple sclerosis rarely got her down, but the COVID-19 restrictions that have kept her family away, have brought on depression.

Loosley is limited to one 45-minute visit every five days arranged in advance. He obeys all the rules and still has to be supervised by a staff member.

"That's what really bothers me," he said. "I don't need to have someone supervise us."

Re-evaluating restrictions

Government officials were asked on Wednesday what conditions would have to be met before physical contact would be allowed between nursing home residents and their loved ones.

Macfarlane wrote in an email: "The Department of Social Development is presently working with Public Health to re-evaluate current restrictions in long-term care facilities in a balanced approach."

He did not respond to an email repeating the question. Nor did he answer what would come first hugs or opening the border to other parts of Canada.

'Hugs are safe'

One Ottawa epidemiologist said it's time to allow hugs in nursing homes.

Raywat Deonandan, a global-health epidemiologist and an associate professor at the University of Ottawa,said hugs from family members are a lot safer than opening up the Atlantic bubble to outside visitors.

"I would say keeping the borders closed is more important than preventing loved ones from being hugged," he said.

"Hugs are safe."

Especially if the loved one is following all of the protocols for visiting a nursing home, which include masks, hand sanitizer and self-screening.

Following all of those protocols, Deonandan said, "the probability of transmission then is vanishingly small."

"Physical contact is fine. Holding hands is fine. Touching the body is recommended.

"In my mind, the way we get through this disease is together so mutual support augmenting our need for mental health support. All these things are important."

And because nursing home residents work with many patients in a day and some may work at more than one facility Deonandan said workers likelyrepresent"a marginally higher probability of risk" to the resident than a family member.

Visits can be stopped

According to the government's COVID-19 Visitation Recovery document, if one case of COVID-19 is confirmed in a nursing home, all visits to that facility will stop. And if a resident is awaiting results for COVID-19 testing, that person cannot have visitors.

By June 5, residents could have two visitors at a time, but they had to be outside. By June 10, visits were allowed inside with "strict controls."

As of July 3, 2020, visitors from Nova Scotia, Prince Edward Island and Newfoundland and Labrador were allowed to visit without a 14-day self-isolation period.

The visitationdocument also outlines what is expected of volunteers and non-essential visitors such as hairdressers.

For family and friends, it lists the following:

1. Screening: Active screening

2. Masks: Community mask worn at all times. If visitor does not have a community mask, amedical mask must be provided, as well as education for donning and doffing.

3. Hand and respiratory hygiene: Informational signage on hand and respiratory hygienevisible, access to alcohol-based hand rub, tissues and garbage.

4. Physical Distancing: maintained as much as possible while travelling through facility andduring visits. Please note some facilities infrastructure may not allow for physical

distancing while traveling through the building, therefore masks are to be worn at alltimes.

5. Documentation: Roster of permitted visitors (name and contact information), log of entryand exit (including date and time), kept on file for 21 days.

6. Controlled facility access: Single entry point, access restricted to resident's room ordesignated visitation area (if resident lives in semi-private room), length of visit to be determined by facility based on operational abilities and visits must be scheduled inadvance.

7. Cleaning and disinfecting: Gifts or other items brought to facility must be cleaned anddisinfected by staff prior to being delivered to resident's room. All high touch surfaceareas and chairs must be cleaned and disinfected following visits