One hundred thirty-six days. That’s how long residents of nursing homes and assisted living communities have been separated from their family and friends. On March 13, Texas Gov. Abbott ordered long-term care facilities to restrict visitation following a similar announcement by the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees nursing facilities.
What began as a well-intentioned policy in an effort to protect Texas’ most vulnerable against COVID-19 is now proving to cause more harm than good.
Family members and loved ones are part of residents’ daily routines and can play a critical role in care by assisting with daily tasks, offering familiar social connections and serving as patient advocates. Nursing homes and assisted living communities are doing all they can to address social isolation, but short-term solutions such as virtual and closed-window visits are no substitution. Studies detailed in the Journal of Post-Acute and Long-Term Care Medicine highlighted the health risks of prolonged isolation and loneliness in long-term care including higher rates of depression, cardiovascular disease, worsening dementia and Alzheimer’s and shorter lives.
So how do we protect older Texans from the virus as well as the health risks associated with our attempt to keep them safe by keeping them isolated from the outside world? We can do both.
Texas can take immediate steps to move beyond a one-size-fits-all approach and reunite residents and families safely. On May 18, CMS released recommendations to state and local officials to reopen nursing homes. Since then, all but 14 states have loosened restrictions on visitation or developed a comprehensive plan to permit visitation when certain criteria are met. Texas is one of the 14 states standing firm on blanket restrictions.
Visitation while strictly adhering to CDC guidelines to prevent transmission of COVID-19 is possible. CMS outlines acceptable forms of controlled visitation prior to full reopening. To start, communities could offer outside visits in courtyards or on patios. Visitation stations or booths could be built to provide additional layers of protection. Compassionate care visits are not exclusive to end-of-life and should be extended to other resident situations.
States are getting innovative. Minnesota implemented essential caregiver guidance allowing residents to designate one person permitted to visit in-person. Recently, Texas legislators provided recommendations to the Texas Health and Human Services Commission to move forward on a similar model. We also have the opportunity to lead the nation by developing a visitor testing model.
We agree Texas needs a thoughtful and comprehensive plan to address visitation long-term. Unfortunately, the virus has become a permanent fixture in our daily lives and these policies are not sustainable.
In May, our organizations, LeadingAge Texas, Texas Health Care Association, and Texas Assisted Living Association, submitted joint recommendations to the Texas Health and Human Services Commission to reopen nursing homes and assisted living communities. We will continue to advocate for senior adults because ending social isolation is critical in winning the fight against COVID-19. By taking immediate action, we can improve resident physical and mental health through innovation.
George Linial is president and CEO of LeadingAge Texas. Diana Martinez is president and CEO of Texas Assisted Living Association. Kevin Warren is president and CEO of Texas Health Care Association.
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