For the first time in months, Minnesotans who live in senior care facilities can meet face to face with their loved ones, provided their visits are outdoors.

The Minnesota Department of Health released new guidance late Wednesday that allows outdoor visits at nursing homes and assisted-living facilities under a strict set of guidelines.

The reaction was swift at Oak Meadows Senior Living, a community in Oakdale with about 130 residents. Nearly two dozen family members of residents immediately called or e-mailed to schedule visits. Under sunny skies Thursday, residents could be seen talking and laughing with relatives while sitting on park benches or walking amid the flower gardens on the community's 26-acre campus.

Deborah Veit, executive director of Oak Meadows, said several people broke down and cried from relief as they scheduled visits with relatives they had not seen in person since March.

"Emotionally, this is a huge deal," Veit said. "People have been cooped up for so long that it's so nice to see people make that connection they missed."

Visits had been all but barred at these facilities when they closed their doors in mid-March in an effort to protect vulnerable residents from COVID-19, the respiratory illness caused by the virus.

But after a three-month lockdown, nursing homes and assisted-living facilities across the state began notifying families early Thursday that visitor restrictions were finally being eased and they could arrange outdoor visits.

The change marks the second easing of lockdown restrictions at Minnesota's senior care facilities this week and comes as public health officials work to balance the safety of residents with growing concerns about social isolation and loneliness.

Thousands of Minnesota seniors have spent much of the past three months holed up in their rooms, with minimal contact with friends and family members. Across the state, adult children have been forced to interact with their parents through cracks in windows or by pressing their hands against the glass, like visitors at a prison.

Prolonged social isolation and loneliness have been linked to a wide range of health problems and increased mortality rates for older adults. At least two residents of Minnesota nursing homes have died this month partly due to social isolation related to COVID-19 restrictions, according to a Star Tribune analysis of death records.

However, public health experts say those numbers understate the true count because other factors, such as "failure to thrive," often are listed on official death certificates instead of isolation.

"We absolutely know that social isolation and emotional disconnectedness is a major health concern, and the separation that has happened for residents of long-term care facilities and their loved ones is one of the most heartbreaking things about this epidemic," Health Commissioner Jan Malcolm said Wednesday.

Tamera Roberg, of Rice Lake, Wis., said she is still struggling with the revelation that isolation may have been a factor behind her 98-year-old father's death at a nursing home in Robbinsdale. His death certificate identified Alzheimer's disease as the primary cause of his death, but it also listed "social isolation/failure to thrive related to COVID-19 restrictions" as another cause.

Roberg said she received an emergency call from the nursing home on June 2, urging her to visit because her father was dying. The call surprised Roberg: For weeks, staff at the home had maintained that her father, Chester Peske, a World War II veteran, was healthy and thriving. However, by the time she arrived at her father's bedside, he had already died.

Roberg had not been allowed to see her father since March, and she was immediately shocked by her father's gaunt appearance.

"It took my breath away," Roberg said of seeing her father's body. "He was a healthy man who had suddenly been reduced to skin and bones." She added, "I'm looking for answers, but I think the outcome likely would have been different had my father been allowed to have more visitors and have more eyes on him."

Gary Fadden of Elk River said he has "no doubt" that social isolation played a role in the recent death of his mother, Stella Fadden. Before the pandemic, she was a healthy and feisty 99-year-old, who would move around the facility with her walker and chat with other residents. But after the lockdown began in March, Fadden said, he noticed his mother became less responsive; on FaceTime calls, she would just stare blankly at the screen.

On her death certificate, "social isolation as a result of COVID-19 restrictions" was listed as a cause.

"I am confident that Mom would have made it to 100 [years] had it not been for the lockdown," Fadden said. "My mom was a social person, and not having visitors was really hard on her."

Minnesota's senior care communities continue to be hit hard by the coronavirus, but there are encouraging signs that the official number of new cases and deaths is waning in those facilities. So far, 1,064 residents of long-term care facilities have died from COVID-19, accounting for nearly 80% of all reported deaths from the virus since the pandemic began. But the weekly tally of new coronavirus cases in long-term care facilities has fallen dramatically over the past month, from a high of 1,049 cases in mid-May to 169 cases last week, state health records show.

The Department of Health began to relax rules around visits to long-term care communities early this week, when it allowed people to visit their loved ones through the windows of their facilities. But the new guidance goes much further.

Now residents not infected with the coronavirus can visit with their relatives outside the homes, provided they wear masks and maintain social distancing. Physical contact, including hugging, kissing and holding hands, will not be allowed during the visits, according to the state guidance.

Facilities must establish a schedule for visitation hours, the state says, and have a system to ensure that visitors are screened for signs and symptoms of COVID-19.

Star Tribune data editor MaryJo Webster and staff writer Glenn Howatt contributed.