For the first time in four months, famiÂlies will be alÂlowed to visÂit their loved ones inÂside seniÂor care homes, as MinÂneÂsoÂta health authÂoriÂties cauÂtiousÂly lift lockÂdown reÂstricÂtions meant to preÂvent the spread of the novel coÂroÂnaÂviÂrus among vulÂneraÂble oldÂer adults.
The MinÂneÂsoÂta Department of Health is recÂomÂmendÂing that nursÂing homes and asÂsistÂed-livÂing faÂciliÂties alÂlow cerÂtain famÂiÂly memÂbers and outÂside careÂgivÂers inÂside these faÂciliÂties to help monÂiÂtor resiÂdents' care and alÂleÂviÂate the harmful efÂfects of proÂlonged iÂsoÂlaÂtion and loneÂliÂness. These "esÂsenÂtial careÂgivÂers" will be deÂsigÂnatÂed by the faÂciliÂties and will be alÂlowed to make schedÂuled visÂits lastÂing up to three hours a day, or until caregiving tasks are completed, unÂder new guideÂlines isÂsued FriÂday.
The anÂnounceÂment marks the most sigÂnifiÂcant step so far toward the reÂopenÂing of MinÂneÂsoÂta's 1,700 seniÂor care comÂmuÂniÂties, which have come to reÂsemÂble locked fortresses since the panÂdemÂic beÂgan. With virÂtuÂalÂly all visiÂtors barÂred from nursÂing homes since mid-March, seniÂor home resiÂdents have enÂdured months of wrenching iÂsoÂlaÂtion in their rooms.
Across the state, seniÂors have not hugged or kissed their loved ones for months. AÂdult chilÂdren have reÂsortÂed to wavÂing at their parÂents from a disÂtance and talkÂing to them through cracks in winÂdows, like visiÂtors to prisÂons.
"Words cannot express how significant this [guidance] will be for families," said Dustin Lee, chief executive of Prairie Senior Cottages, which operates seven assisted-living and memory care homes statewide. "This has already brought such intense relief that families have been calling us, quite literally, with tears of joy."
Amid enÂcourÂagÂing signs that COVID-19 is aÂbatÂing in MinÂneÂsoÂta's seniÂor homes, state health reguÂlaÂtors are pubÂlicÂly recognizing the critiÂcal role that famÂiÂly memÂbers play in the care of vulÂneraÂble seniÂors as well as the sigÂnifiÂcant risks posed by iÂsoÂlaÂtion and loneliness. It also reÂflects a growÂing recÂogÂniÂtion that while coÂroÂnaÂviÂrus outÂbreaks could stretch on for months or even years, seniÂors in care homes canÂnot be cut off from their supÂport netÂworks indefinitely.
ProÂlonged iÂsoÂlaÂtion has been linked to a wide range of seÂriÂous health probÂlems in oldÂer adults, inÂcludÂing heart disÂease and stroke. As a risk factor for early death, social isolation now eclipses obesity, according to national research. At least two residents of Minnesota nursing homes have died partly due to social isolation related to COVID-19 restrictions, according to a Star Tribune analysis of death records.
"Some of the most heartÂbreakÂing storÂies of the whole epiÂdemÂic, frankÂly, inÂvolve the sepÂaÂraÂtion of loved ones from their famiÂlies and the very real psychoÂlogiÂcal and physÂicÂal harm that iÂsoÂlaÂtion causÂes," Health ComÂmisÂsionÂer Jan MalÂcolm said in an interÂview FriÂday. "I think many of us have famÂiÂly and friends in that very sitÂuÂaÂtion and we have seen the reÂalÂly inÂcredÂiÂble toll that [iÂsoÂlaÂtion] takes."
Some families said they have become so troubled by the prolonged confinement of their aging relatives that they have considered removing them from their senior homes and bringing them home.
"It's been torture," said Karen Schneider of Coon Rapids, whose 91-year-old mother moved into an assisted-living facility in March after she suffered a stroke.
Schneider said her mother, a former factory worker, has recovered physically from the stroke but is starting to show mental and emotional stress from spending months confined to her room with little human interaction. In recent telephone calls with her children, Schneider said her mother has broken down and pleaded to be taken out of the facility. "She will cry and say, 'Get me out of here, get me out of here, I'm going downhill,' " Schneider said. "It's just killing my mother not being able to see her children and friends."
Lee said the severe lockdown measures were necessary at first, but he has become increasingly concerned that they were eroding the health of seniors living at his homes. In recent weeks, staff at his facilities have noticed increased levels of anxiety, depression and insomnia among residents at Prairie Senior Cottages stemming from their sense of isolation. Several of his homes have seen an increased number of falls as residents have become more disoriented without human contact, he said.
"They say social isolation is deadly, and I agree," said Lee, who expects to begin allowing visits early next week. "When you're not connected to others, you lose part of your humanity."
The decision to permit limited indoor visits by relatives and outside caregivers is the third time in the past month that state health authorities have relaxed lockdown restrictions on senior homes. In mid-June, people were allowed to visit their loved ones through the windows of their facilities. Then they were permitted to visit with them outside, provided they wore face masks and avoided touching. It marked the first time in months that many vulnerable residents had seen their loved ones in person, without the use of video conferencing technology.
The state's latest loosening of restrictions comes amid signs that the pandemic is finally ebbing in long-term care settings after ravaging hundreds of facilities this spring. The weekly death toll in long-term care settings has declined significantly since early May, and several nursing homes that had large and deadly clusters of the virus have reported no new cases for several weeks. Overall, however, long-term care facilities continue to account for nearly 80% of the deaths from COVID-19, state health data show.
"We know it has been a long four months for our residents and essential caregivers," said Patti Cullen, president and CEO of Care Providers of Minnesota, a long-term care industry group. "We hope that this designation will provide the needed support as an interim step until it is safe to resume visitations on a broader scale."
Under the new guidÂance, seniÂor care homes are enÂcourÂaged to work with famiÂlies to deÂvelÂop a procÂess for deÂsigÂnatÂing cerÂtain peoÂple as "esÂsenÂtial careÂgivÂers." These careÂgivÂers can be a famÂiÂly memÂber, friend or volÂunÂteer who proÂvidÂed reguÂlar care and supÂport to the resÂiÂdent before the panÂdemÂic. The move is a recognition that a resÂiÂdent's relaÂtives and close friends are ofÂten the most inÂvestÂed in their care, and can be best positioned to deÂtect chanÂges in their condition and adÂvoÂcate on their beÂhalf, ofÂfiÂcials notÂed.
The new guidÂance is volÂunÂtary, which means that some nursÂing homes and asÂsistÂed-livÂing faÂciliÂties may not perÂmit the visÂits. EsÂsenÂtial careÂgivÂers must also comÂply with a numÂber of rules, such as wearÂing face masks and eye proÂtecÂtion while inÂside the faÂciliÂties and mainÂtaining physÂicÂal disÂtancÂing. Visiting careÂgivÂers won't be alÂlowed to take resiÂdents into the comÂmuniÂty exÂcept for esÂsenÂtial medÂiÂcal apÂpointÂments. They should also not visÂit resiÂdents who have COVID-19 or who have exÂperiÂenced sympÂtoms, the guidÂance states.
In some cases, seniÂor home resiÂdents may be able to deÂsigÂnate more than one esÂsenÂtial careÂgivÂer based on their daily needs and past inÂvolveÂment. Long-term care faÂciliÂties have unÂtil July 25 to draft poliÂcies and prepare to implement the new visits.
Chris Serres • 612-673-4308
TwitÂter: @chrisserres