Frustrated that many nursing home operators appear to be ignoring a state memo in August permitting limited indoor visits, dozens of family members pleaded with the state Long-Term Care Ombudsman Wednesday night to help them end their loved ones’ isolation that began when the pandemic struck seven months ago.
Ombudsman Laurie Brewer, the state-appointed advocate for people in long-term care facilities, said she anticipates the state Department of Health will make an announcement soon that will broaden the terms of the plan it issued in August. She just doesn’t know when.
In the meantime, she encouraged families to continue appealing to state leaders, especially with the Thanksgiving, Christmas and Hanukkah holidays approaching and the threat of a second wave nearing with the colder weather driving everyone inside.
“I think it’s important that your voices be heard, with the regulators, the legislators, the executive branch. We can’t go back to a situation where we are on total lockdown again and there’s no way for family members to have access to their loved ones,” Brewer said.
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During a virtual meeting with FACE for Seniors, a Facebook group channeling families’ concerns as the coronavirus has kept some of them from making indoor visits or even hugging their parents, Brewer and her staff are challenging nursing home administrators’ decisions over denied visits.
The “executive directive” Health Commissioner Judy Persichilli issued on Aug. 10 lists the requirements long-term care facilities must meet in order to permit visitors, and under what circumstances visits must be allowed.
But some families say — and the Ombudsman’s Office agrees — that some facility operators are dragging their feet in developing a policy. Or they are looking for reasons to deny access.
“There is uneven enforcement for the implementation of the executive directives,” Brewer said. Her office is investigating more than 50 complaints.
Under state guidelines, a relative can be a designated “essential caregiver” and visit a resident’s room once or twice a week, depending upon the status of the outbreak. But some administrators are interpreting the definition as narrowly as possible, keeping sons and daughters away if they do not specify what will go on during these visits. Family members said their loved ones are regressing medically and mentally without loving interactions and in cases, their will to live is waning.
The state’s definition of an “essential caregiver” is “so rigid” that it does not acknowledge the emotional benefits of these family visits, noted Bill Borrelle, the founder of FACE for Seniors and who has been deemed an essential caregiver for his mother, living in a south Jersey facility.
“I know my mother’s emotional well being has significantly improved. I didn’t even have to hold her hand,” Borrelle said.
Some nursing homes are wrongly denying visits from essential caregivers after a facility reports a single positive case of COVID-19, Brewer acknowledged.
There’s no doubt facility operators are acting out of fear, Jennifer McMahon, a field investigator and advocate from the Ombudsman’s Office said.
“We are pushing them to say, ‘Hey, it’s going to be okay, let these people in. But they are scared because of what they went though in March, April, May and June. It was terrifying for them,” McMahon said. “These administrators and directors of nursing saw things we didn’t see. I am not defending them but at the same time I understand where they are coming from.”
New Jersey has suffered more deaths in long-term care facilities per capita than any other state. There have been 6,804 lab-confirmed and suspected resident deaths, according to the state.
One woman at the meeting named Lidia said she was incensed that delivery people and employees can come and go but she can’t be with her 96-year-old mother.
“I am begging and pleading with you Laurie, please help us whatever way you can. Give me the chance to hug my mom. It’s been a long seven months for all of our loved ones in New Jersey,” Lidia said. “Many of them died alone. Many were unattended. They did not get fed. They did not receive the care that they need.”
Back in March, no one understood how long it would take to contain the virus, and how the prolonged isolation would take its own toll on the mental health and resilience of the roughly 48,000 New Jerseyans in long-term care. Outdoor visits began June 21, but they typically last about 15 minutes to 30 minutes, weather permitting. They are by appointment only. And soon outdoor visits will be moot because the winter is coming, Brewer said.
Last month, the U.S. Centers for Medicare and Medicaid Services issued guidelines for long-term care visits that were less stringent than those issued by New Jersey,
One woman described after months of fighting with her mother’s nursing home about visits, she took her mother home for 48 hours. It meant that her mother would be confined to her room for two weeks of quarantine, but it was worth it, she said.
This may be an option other families who can medically handle their loved ones needs may want to explore for the holidays, Brewer said.
“Maybe take them out for a while and then they have to go on quarantine. Honestly, as somebody else said, when you go on quarantine, it’s not that different from how it is now. You are stuck in your room,” Brewer said.
Gov. Phil Murphy and Persichilli, asked on Thursday about the different standards the state and federal government use to allow nursing home visits, defended New Jersey cautious approach.
“We know we are stricter than the federal guidelines,” Murphy said during the routine coronavirus briefing. “That’s not necessarily a bad thing.”
There are active outbreaks inside 150 long-term care facilities, Persichilli noted. “Although they are smaller and we are catching them more quickly. we still believe we have to be very vigilant,” she said.
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Susan K. Livio may be reached at [email protected]. Follow her on Twitter @SusanKLivio.