Right now, Arne Liseth is his brother Keith’s only remaining connection to the outside world.

Liseth is his brother’s sole designated visitor at the long-term care home in Campbell River, B.C., where Keith lives.

And as the number of COVID-19 cases spike in the province, Liseth worries what little social contact his brother enjoys will be cut off again.

“Absolutely, his quality of life is worse,” said Liseth. “A once-a-week visit, that is what’s allowed.”

His brother, who has limited mobility and some speech problems due to a stroke, used to enjoy regular visits and outings. Now, he only exits the care home for medical appointments.

“He’s used to getting driven around, going for lunch, visiting friends … and coming over to Quadra once a month, but that’s all gone by the wayside,” Liseth said.

His brother is limited to a 30-minute weekly visit with Liseth in a common room. And that’s following no face-to-face social contact other than window visits for the first fourth months of the pandemic, he added.

It has been hard on his brother’s spirits, who is also getting less necessary exercise, said Liseth.

But his brother is lucid, Liseth said, and unlike folks who have dementia at the home, he’s able to understand why contact with his loved ones is so limited.

The #COVID19 guidelines for long-term care facilities vary from province to province, but the anguish families and residents are experiencing due to visitor restrictions is nationwide, says one #seniors advocate.

“But a lot of (people with dementia) have really regressed, or died and stuff,” Liseth said.

Laura Tamblyn Watts, CEO of CanAge, said visitors' restrictions are akin to locking people up. Photo courtesy of CanAge

The guidelines for long-term care (LTC) facilities vary from province to province, said Laura Tamblyn Watts, CEO of CanAge, a national seniors' advocacy group.

But the anguish families and the residents of long-term care homes are experiencing due to visitor restrictions is nationwide, Tamblyn Watts said.

The restrictions are an attempt to keep COVID-19 in check, but the preventive measures also pose dangers to LTC residents, she added.

“What we’re seeing across Canada is the hugely detrimental impacts of visitor restrictions,” Tamblyn Watts said.

“There’s increased depression, despondency and increased loneliness. In some cases, a willingness to stop treatments, or a lack of interest in many aspects of life.

“But (the impacts) are also physical and measurable,” Tamblyn Watts said, noting physiological effects include decreased physical mobility and cognitive declines.

In terms of visitor restrictions, distinctions need to be made between occasional social visitors and essential family caregivers whose involvement is critical to the well-being of the residents, she added.

There has been an evolution of understanding on how to stem transmission of the virus since the initial stages of the pandemic when thousands of seniors died in residential care due to COVID-19, she said.

“What we know is we can safely have people — even in the cases of outbreaks — visit and spend time in long-term care facilities as long as the proper protocols are observed,” said Tamblyn Watts.

Continued and increased investments in personal protective equipment (PPE), staffing and funding — particularly for non-profit facilities — along with prioritized rapid testing for people who work or visit vulnerable populations are immediate measures that can mitigate the risk of COVID-19 without slamming the door shut at care homes, she said.

But isolating seniors living in long-term care is not a solution, she said.

“By cutting seniors off, you are, in fact, institutionally abusing people. You cannot lock people up and prevent them basic freedoms and rights in Canada,” she said, adding no facility or authority restricts visits with nefarious intent.

“These actions are done with the best of intentions, but with the worst consequences,” Tamblyn Watts said.

Provincial response to visitor restrictions

B.C.’s seniors advocate Isobel Mackenzie is calling on provincial health authorities to loosen visitor restrictions to long-term care homes. Photo by Don Craig

As the pandemic’s second wave advances across Canada, some provinces have stated they won’t lock down long-term care homes completely.

In September, Ontario announced a designated family caregiver could access residential care facilities, regardless of an outbreak.

On Tuesday, B.C.’s seniors advocate called for the easing of visitor restrictions at assisted-living facilities, saying they are harming residents and their families.

Isobel Mackenzie called on provincial health authorities to allow an essential care partner who can visit regularly for longer periods, as well as an additional social visitor.

Currently, seniors in residential care are limited to one social visitor, often for short periods of time in a common space.

It’s a sharp contrast to the past, which allowed regular visits by a family caregiver who also preformed essential tasks, such as feeding or bathing a loved one.

Mackenzie based the recommendations on a survey of 13,000 long-term care residents and their families across the province.

The results were profound, Mackenzie said.

“They were talking about how despondent they are feeling,” she said.

“How confused some residents are as to why they can't see their wife as much as they used to. Or why they can't touch her. Or why can't they see their daughter, who they haven't seen in nine months.”

According to the survey, most respondents supported some restrictive measures — including hand washing, temperature checks and mask protocols — but they want more frequent visits and another designated visitor.

Health authorities in B.C. did a good job at curbing the numbers of deaths in care homes associated with COVID-19 in the first nine months of the pandemic, Mackenzie said.

But a better balance is needed between stemming the transmission of the disease and ensuring care home residents’ quality of life, she said.

Many residents in the homes are in the last stages of life and want to spend that time with their families, Mackenzie said.

At the time of the report, 151 residents of long-term care had died from the virus, but more than 4,500 died from other causes and were unable to spend any quality time with loved ones, she added.

Additionally, most family members weren’t aware of the possibility of essential visits during the first four months of the pandemic, and of those who did apply for an essential visit, almost half were refused, the survey found.

Mackenzie noted that no COVID-19 outbreaks in long-term care homes in B.C. have been reported as being linked to visitors.

Allowing for longer visits is something care homes can do immediately with minimal increases in risk, Mackenzie said.

However, allowing an additional visitor is something that will require the approval of B.C.’s provincial health officer, Dr. Bonnie Henry.

On Friday, Henry announced B.C. had reached another daily record with 589 new cases of COVID-19 and two additional deaths.

Six new health-care facilities reported outbreaks, for a total of 31 long-term care or assisted-living facilities and four acute-care facilities experiencing active outbreaks.

Changes to visitor restrictions were being considered, Henry said Thursday. But, she added, she could not say exactly when they might occur.

Health authorities are working to ensure the appropriate measures, including PPE and adequate staffing, are in place to support increased visitation, she said.

“Those (measures) are coming along, so that’s the good news,” Henry said.

However, the past week showed COVID-19 and its spread posed a great risk to residents in long-term care, she said.

“So, finding that balance has been the most challenging thing that we have been faced with knowing that this virus can be so devastating on our elders and seniors.”

Rochelle Baker / Local Journalism Initiative / Canada's National Observer

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