Visits to Long-Term Care Must Balance Health Risks with Quality of Life

B.C. Seniors Advocate Releases Results of Province-wide Survey

Today, British Columbia Seniors Advocate Isobel Mackenzie released the results of a province-wide survey on the impact of visit restrictions at long-term care and assisted living homes.

The report, Staying Apart to Stay Safe, reflects the experience of more than 13,000 residents and their family members over the course of the current pandemic.

“This is one of the most challenging issues we face,” Mackenzie said. “Visit restrictions were imposed in long-term care and assisted living homes because we care about the seniors who live there, and we want to keep them safe. But as we enter our ninth month, British Columbia seniors and their families are seeking a better balance between preventing the transmission of COVID-19 and ensuring quality of life.”

Calls, letters and emails on the issue of visit restrictions have dominated the Office of the Seniors Advocate more than any other single issue in its history. Many of the stories detail the negative impact of limited visits or no visits, with some residents and their family members expressing more fear about loneliness than contracting COVID-19.

The report highlights that when COVID-19 first struck care homes, the Province acted swiftly and decisively, bringing in a number of prevention measures that have seen B.C. perform relatively well in managing COVID-19 in long-term care and assisted living.

“The Provincial Health Officer and the Government of B.C. have my profound gratitude for their quick and comprehensive actions at the beginning of this pandemic,” shared Mackenzie.

“Many lives were undoubtedly saved. However, residents and family members now recognize the pandemic will continue for many more months, and the survey makes it clear they are asking for more time with their loved ones.

“When we started visit restrictions, the goal was to ensure residents in long-term care and assisted living were kept safe from COVID-19. Eight months later, we need to ask the question:

What are we keeping them safe for if it is not to enjoy the time they have left with the ones they love?

While COVID-19 has tragically claimed the lives of 151 residents of long-term care and assisted living more than 4,500 other residents have died from something other than COVID-19 during this pandemic and in many cases, they spent their final months, weeks and days in relative isolation, unable to spend time with those they loved most,” continued Mackenzie.

The survey generated over 13,000 valid responses from all parts of the province. In a series of questions covering visits before the pandemic, during the first phase of visit restrictions, and currently, the survey found:

  • Before the pandemic, 55% of families were visiting long-term care and assisted living residents for an hour or more several times per week and even daily;
  • Prior to COVID-19, the majority of visitors were performing essential care for residents, such as personal care, grooming, assistance with feeding and mobilization;
  • Most family members were not aware of the possibility of essential visits during the first four months of visit restrictions, and almost half of the people who did apply for an essential visit were refused;
  • Under the current visitation policy, the majority of visits are only once a week or less, and half the visits in long-term care are 30 minutes or less;
  • 30% of current visits are outside only;
  • Currently, 65% of visits are observed by staff for some or all of the time;
  • Only 21% of visits are in the privacy of the resident’s room (75% of long-term care residents and almost 100% of assisted living residents live in private rooms);
  • 70% of visitors are not allowed to touch their loved one;
  • Most visitors are washing their hands, wearing a mask, having their temperature checked, and answering health questions prior to each visit; and
  • Most family members and residents support some visit restrictions during the pandemic, although they believe visits should be more frequent and that at least one more visitor for each resident should be permitted.

The report also highlights data that points to signs of negative health impacts on residents. Of concern to the Seniors Advocate is the substantial increase in the use of antipsychotic medication during the period of visit restrictions and clinical assessments completed in the first quarter that show an increase in unexplained weight loss and worsening of mood or symptoms of depression.

The report also highlights the need for residents and family members to have a collective voice in the decision-making process and makes three recommendations:

  1. Allow all residents to designate an essential care partner;
  2. Allow social visitors and determine the number allowed by balancing the risk of COVID-19 with the risk to a resident’s health from the long-term family separations;
  3. Create a provincial association of long-term care and assisted living resident and family councils.

The complete report is available at https://www.seniorsadvocatebc.ca/reports