B.C. seniors are showing medical as well as emotional effects from isolation in long-term care homes, including an increased use of anti-psychotic medications.
An extensive survey of care home and assisted living residents by B.C. Seniors Advocate Isobel Mackenzie heard tragic stories of the effects of strict visitor restrictions, where relatives who had helped seniors with meals, hair brushing and other essential personal assistance were told to keep their distance, shorten visits, or not visit at all.
“Many residents are despondent as the only thing they look forward to is receiving a visit from their family,” Mackenzie wrote in her latest report, released Nov. 3. “There are also early warning signs of measurable health impacts. After many recent years of stability, the rate of antipsychotic use for residents in long-term care has increased seven per cent during this pandemic and initial reports from the quarterly assessments show troubling trends of unintended weight loss and worsening of mood among long-term care residents.”
A quarter of long-term care residents die each year, and end-of-life visitation was affected as well as day-to-day help. More than eight out of 10 respondents indicated that before the pandemic, their loved one had additional people such as paid companions, physical therapists or hairdressers to help them. Personal care services are considered essential by provincial health officer Dr. Bonnie Henry, along with assistance in feeding, mobility and communication, such as using a phone.
Visits were restricted to essential only in March after COVID-19 transmission began in care facilities, and on June 28 one “social” visitor was allowed. The report found that most care home operators went beyond the public health orders in restricting visits to a single person. The report included some personal descriptions of the results of separation for up to six months. One resident said her sister became the designated visitor for their 98-year-old mother, meaning she couldn’t visit and her sister had to provide what both had shared.
“I have asked if we could alternate monthly, one month my sister, the next month me; however this was refused,” the respondent wrote. “My mother can’t understand why I don’t visit her. I was not allowed to go in and do her hair or cut her toenails, even though I have done that for the past two decades, yet a stranger was allowed to come and do those services.”
Another wrote: “I feel I am missing out on the limited time my husband has left. He doesn’t speak, so it is all the more important that he sees me. It’s interesting that the assisted living residents have the freedom to come and go, from the same building and door, with no masks. And yet I can’t get within six feet of my husband. I have asked several times to be considered an essential visitor. I need help.”
Mackenzie says the issue of restricted visits has generated more phone calls and letters to her office than any other in its history. Her recommendations include allowing all long-term care residents to designate and essential care partner, and allow social visitors to determine the number allowed to balance the risk to residents’ health from long-term separation from families.