After a year of isolation, hope on the horizon for nursing home residents
Jeanette Sullivan-Martinez said last April, "You can do anything for two weeks, so at the end of two weeks, you say you can do anything for two more weeks."
Nearly a year later, the Pendleton Health and Rehabilitation Center resident still holds this attitude, though she wishes there were breaks between two-week periods.
"I'm sad to say that it has become 52 weeks and not just two weeks," she said Thursday, the day after the one-year anniversary of the Connecticut Department of Public Health directive for nursing homes to restrict visitors due to the COVID-19 pandemic. Also on Thursday, the Centers for Medicare & Medicaid Services — known as CMS — released updated guidance on visitation.
With most Pendleton residents vaccinated, Sullivan-Martinez is hopeful that soon "we'll be able to move about the community a little bit more. I'd love to be able to sit outside or go and have a coffee with my children, a nice dinner, just to get together and see them, even if we can't hug."
Over the past year, Sullivan-Martinez became a grandmother, and she said the "very, very hard part of" lockdown is not getting to see her two grandchildren. She's seen her 10-month-old granddaughter once or twice but hasn't seen her 6-week-old granddaughter in person yet.
Last April, Sullivan-Martinez hadn't seen her mother in more than a month, but she was able to have outdoor visits over the summer. But in December, Pendleton had an outbreak: According to reports from DPH, between late November and early January, 65 Pendleton residents tested positive for COVID-19 and nine residents died.
Sullivan-Martinez said residents were confined to their rooms with doors shut for nearly two months, and she was one of only a few people on her wing who didn't get the coronavirus. But she said staff members have "been superheroes" and stayed positive.
She said Pendleton resumed visitation two weeks ago, meaning a resident can get a 30-minute visit from two people in the conference room, still 6 feet apart and with masks.
Beechwood in New London is also doing half-hour visits, and resident Cathy Corey said she has gotten visits from church friends. But she hasn't seen her two sons in a year.
"It's rough being in the same room all day long," she said. "You can't imagine what it's like until you do it, eat in the same room, sleep in the same room and all that. I mean, you're just sick of looking at the same wallpaper."
She said the one thing that's made it palatable is support from the staff. Some activities at Beechwood over the past year have included hallway bingo and watercolors, and Corey did chair yoga Wednesday. She also said the dining room reopened Wednesday.
Bill White, president and administrator of Beechwood, said that facility now offers limited indoor visitation seven days a week, and families have to wear full personal protective equipment, or PPE. Beechwood, which has up to 60 residents when full, has not had any COVID-related deaths. And with vaccines, White said "it's just starting to feel a little bit like the sun's coming up."
About a month ago, Fairview in Groton began offering visitation in a conference room near the main entrance, Executive Director Billy Nelson said.
He said 82% of employees have been vaccinated, and Fairview has spent more than $600,000 on COVID-related incentive pay to employees during the pandemic.
One of Nelson's takeaways from the past year: "It's very difficult for the government and the public to have an expectation on a nursing home industry that is horribly underfunded at the state level and expect them to be prepared for a pandemic of this proportion."
CMS issues guidelines for expanded indoor visitation
In light of millions of COVID-19 vaccines being administered to nursing home residents and staff, CMS on Thursday updated its visitation guidance from Sept. 17.
The new guidance states that facilities "should allow indoor visitation at all times and for all residents (regardless of vaccination status)," unless the resident: has confirmed COVID-19 infection; is in quarantine; or is unvaccinated in a facility where less than 70% of residents are fully vaccinated and the county positivity rate is more than 10%.
A fully vaccinated resident can have close contact, including touch, with a visitor while wearing a mask, but visitors should physically distance from other residents and staff, CMS says. Visitors should not be required to be tested or vaccinated, or show proof thereof.
"It truly represents hope," said Mairead Painter, Connecticut's long-term care ombudsman. But implementation is still being worked out, and she said nursing homes are waiting for DPH to give them guidance about the federal guidance.
"It's a start; it's a conversation. It certainly makes concessions that are long overdue," said Stonington resident Liz Stern, who was a member of the state's Nursing Home and Assisted Living Oversight Working Group. But she is concerned it plays more to the facilities than to residents' rights.
Her mother was a resident at a local nursing home but died in November at age 91, not related to COVID-19. Prior to her mother's death, Stern said she was doing weekly 30-minute visits, the last one on either side of a window while talking on the phone.
Stern said visits 6 feet apart with masks left her mother disoriented and unable to hear her, but with a window visit, her mother forgot the glass was there.
"We are now mourning deeply the fact that we could not provide for our loved ones, through no fault of our own, that we were victims also of this isolation," Stern said.
In recognition of the one-year anniversary of visitation bans and emotional and health impacts of isolation, Stern and Painter have been among a group of advocates participating in events around the state this week, such as rallies in Greenwich on Monday and Hamden on Wednesday. There will be a rally at the state Capitol on Friday, with speakers at noon, and a memorial Saturday at 1 p.m. at Hammonasset Beach State Park.
From last March until March 2 of this year, 3,862 nursing home residents have died from COVID-19, half of total coronavirus-related deaths in Connecticut.
Worrying for family members in nursing homes
Carol McCarthy of Pawcatuck and Tracy Tremblay of New London each have a mother in a nursing home; they shared their perspectives last April and provided an update this past week.
"She's actually doing pretty well," McCarthy said of her mother. "She's fully vaccinated, so that's good, and throughout this whole thing, I've been FaceTiming with her weekly."
She went about four and a half months without seeing her mother at the beginning of the pandemic but had outside visits in August and September. An uptick in cases last fall shut down visitation again, and McCarthy opened Christmas presents with her mother over Zoom, but she was able to visit again last month and last week.
McCarthy's mother has dementia, and McCarthy said at the height of the pandemic, she noticed more of a blank stare from her mother and lack of response to questions, "just really like a deadening of her personality." But she said her mother has been better since in-person visits resumed, and her mother still knows who family members are.
Tremblay's mother lives in a long-term care facility while her father lives at home, and last April, she said she was amazed at their spirit. Last week, she remained amazed, even though her parents hadn't seen each other until three weeks ago.
Her mother is blind so video calls didn't make sense, "but my parents chose to just talk on the phone nightly for about 45 minutes, like high school sweethearts."
Now, she said her father is able to visit her mother for an hour twice a week.
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