Until the pandemic hit and the state halted visits to nursing homes, Sharon Echtman would arrive daily to bring her husband Joseph lunch and dinner at Chesterfields Health Care Center in Chester.
For her husband, who suffers from dementia and is legally blind, it was a chance for a home-cooked meal and to enjoy time with his wife. Nearly six months into the pandemic — and as COVID-19 infections have been largely eliminated in nursing homes — Sharon and Joseph Echtman remain unable to resume this precious daily ritual.
Now, families are pleading with the state to set uniform guidelines to expand visiting in Connecticut’s nursing homes.
Under pressure from families of residents in long-term care facilities, some of whom haven’t seen family members in nearly six months because of strict visitation rules to combat the coronavirus, the state Department of Public Health is considering easing the guidelines to allow more access to their loved ones.
As the virus spread through nursing homes, killing more than 2,800 residents and infecting thousands more, DPH officials said the guidelines, which allowed window visits and Zoom calls, was all that they could offer. But every nursing home hasn’t been following the policies. Some have allowed families inside their facilities, while others have had to be prodded to set up computer access for their residents.
The families are asking for indoor visits at all nursing homes where there have been no COVID-19 cases for at least 14 days and the community transmission rate is low. They are asking that nursing homes provide PPE, and they are willing to be tested or provide negative COVID test results in order to enter.
“It is apparent that, for many if not most nursing home residents, visits from close family members are the critical, and irreplaceable, component to meeting their physical, mental and psychosocial well-being,” family members wrote in a letter to interim DPH Commissioner Deidre Gifford asking to ease the visitation guidelines.
“Life in a nursing home is isolating,’’ the families said. “When residents are further isolated by losing contact with those they love and depend on for their social and emotional needs, the results can be fatal.”
A vulnerable population
DPH spokesman Av Harris said the department is considering the request from families.
“Together with our partners at the office of the long-term care ombudsman, DPH is looking into ways we can help nursing homes better facilitate visitation that is safe for the residents, staff and their families,” Harris said.
Harris pointed out that the state purchased 800 iPads and distributed them to all 214 nursing homes with the intent of increasing access to loved ones.
He said the department has convened a group to study the issue, and they will soon make recommendations, although he cautioned the state won’t be going back to pre-pandemic indoor visitation yet.
“Nursing home residents with co-morbidities are perhaps the most vulnerable population during this pandemic,” Harris said. “With the exception of compassionate care (end of life) visits, indoor visitation is not being considered at this time, however, the Department has convened a working group that is evaluating potentially expanding the definition of compassionate care visits.”
Sharon Echtman, who signed the letter, said when visitations were halted, her husband’s condition rapidly deteriorated. She said he lost weight because he hates the food there, and she always brought him something to eat from home.
“They would call me and I’d hear him screaming in the background, ‘Sharon, where are you?’ It was awful,” Sharon Echtman said last week. “I’d go for an hour at lunch and then maybe two hours at dinner, and to go from that to nothing is very scary.”
Sharon said she tried a window visit, but the staff would only open the window about 5 inches and it was difficult to communicate with her husband.
The staff at Chesterfield recently has started allowing her to come every Monday and actually feed him in the cafeteria, which hasn’t been in use during the pandemic. Echtman said she wears full PPE.
Echtman said she wanted her husband’s case mentioned in the letter to the DPH commissioner because she can barely recognize her 70-yer-old husband anymore and feels the state has an obligation to do better.
“He was 70 going on 55, but he’s lost a lot of weight. We used to walk together all over the building, and now he can’t walk anymore,” she said.
In their letter, the families don’t ask for things to go back to the way they were last winter. They understand there will be restrictions as long as the coronavirus lingers.
The tenuous situation with nursing homes surfaced again last week in Norwich, where an employee who went out of state brought the the virus back to the Three Rivers Health Care Center. Since then, a total of 15 people, including at least three employees, have tested positive and one resident has died. DPH is investigating the outbreak.
“We understand the 2,800 Connecticut residents of nursing homes died due to the COVID-19 infection, and the paramount need to prevent further deaths,” the letter from families to DPH said. “We recognize the legitimate public health reasons for the restrictions … in light of this tragedy.”
But the advocates say the emotional well-being of the residents and the stress of not seeing their loved ones face-to-face is important as well.
For Laurie McCrewell, isolation has been difficult on her 91-year-old mother Eleanor Schreiber, a longtime resident of the Crestfield Nursing Home in Manchester.
The facility made Schreiber’s wing into the COVID-only area so she was moved from her longtime bed near a window where she’d “watch the birds and the other critters” to a different area with no window view.
McCrewell said she visited her mother several times a week until the shutdown. She has tried outdoor visits that the nursing home set up.
McCrewell said she had one visit early on where they wheeled her mother outside and she sat on a bench and visited with her with an employee present and everyone wearing a mask. A second visit was scheduled but it poured rain that day and it was canceled.
For the third visit, McCrewell took her daughter who has a new baby girl that she named after her grandmother. But it was 90 degrees and humid that day and her mother had to be taken back inside.
“As they were wheeling her away, she asked the nurse, ‘Why can’t she just come inside to see me?‘” McCrewell said.
Many families say part of the problem is there are no standards across nursing homes. Everyone does something different, which also has caught the attention of DPH officials.
“What is clear is that nursing homes should be doing everything they can to help the residents stay connected to their loved ones on the outside on a regular basis,” the DPH’s Harris said. “Ultimately, we need to balance the need of residents and families to see each other with the need for infection control and slowing or preventing the spread of COVID-19 for our most vulnerable residents.”
McCrewell said she reached out to the state’s long-term care ombudsman for help, and they have talked with the nursing home. Her mother is known at Crestfield as the ‘lady with nine lives’ because several times they have called her and said she was in bad shape only to see her recover in a day or two.
But now her mother’s condition has worsened.
“I don’t understand how nursing homes are all doing different things,” McCrewell said. “My mother is done, and I want to make sure she’s comfortable. If I am agreeing to follow some protocols, why am I prohibited from seeing my dying mother?”
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