March 18, 2020

Nursing Homes Restrict Visitors Amid the Coronavirus Outbreak

By Carole Fleck

By Carole Fleck

Some experts fear that social isolation due to visitor restrictions will harm nursing home residents.

The pdf for the issue in which this article appears is available for download: Bifocal, Vol. 41, Issue 4.)

As the novel coronavirus continues to spread, the Centers for Medicare & Medicaid (CMS) directed the nation’s 15,000 nursing homes to take aggressive measures to control the outbreak among vulnerable seniors. Prohibiting visitors except in critical situations, and cancelling group activities and communal dining, were among the restrictions recently announced.

The decisions about visitation during a compassionate situation such as end of life were to be made on a case-by-case basis. The CMS also called for residents to be screened for fever and respiratory symptoms, and for staff members to be screened at the beginning of their shift. The CMS measures were among the most restrictive ever implemented at nursing homes.

Experts and older adults’ loved ones expressed concern that such precautions could exacerbate the feelings of loneliness and social isolation by many elders, which also pose a health at risk. A recent report by the National Academies of Sciences, Engineering and Medicine examined how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low-income, underserved, and vulnerable populations.

The report, citing a substantial body of evidence, said that social isolation was a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking or obesity. It also found that one in four Americans aged 65 and older were socially isolated, and 43 percent of those 60-plus reported feeling lonely.   

Some advocates called the new CMS actions unduly harsh, adding that nursing homes could have provided sufficient protection by screening all visitors for obvious symptoms and providing them with gloves and masks for visits.

Richard Mollot, executive director of the Long Term Care Community Coalition, said he felt unnerved by the restrictions and alarmed by the well-documented problems of infection control at many facilities -- now an even bigger threat as the coronavirus barrels into communities.

 “We are deeply concerned that residents are cut off from loved ones and vice versa. We know that, in addition to providing company, love, and a friendly face, families provide vital monitoring and often essential care,” he said.

Read the CMS fact sheet: https://www.cms.gov/files/document/covid19-emergency-declaration-health-care-providers-fact-sheet.pdf?eType=EmailBlastContent&eId=23036eb9-2439-42d1-a014-eebc7664544e

Also keep up to date about the restrictions by visiting the Consumer Voice for Quality Long Term Care online: https://theconsumervoice.org/news/detail/latest/cms-issues-more-restrictive-guidance

For the National Academies of Sciences, Engineering and Medicine report, go to https://www.nationalacademies.org/our-work/the-health-and-medical-dimensions-of-social-isolation-and-loneliness-in-older-adults

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