A study in 26 nursing homes in the Netherlands, which proved that families can visit without causing new Covid infections, encouraged advocates. Perhaps, they say, in areas with a low incidence of infection in the Community, when the facilities have sufficient protective equipment and testing capacity, family care can be carefully reintroduced.
But many long-term care facilities are still unable to meet these conditions. Dr Bergman, whose group expects to publish its recommendations next month, said some of them were still short of protective equipment, in particular N95 masks in appropriate sizes. In many regions, test bottlenecks are so slow that they are useless for screening visitors.
Medicare promised last month to send a rapid test kit to each of the 15,000 nursing home homes, giving priority to those with outbreaks or Covid hotspots; it has released about 2,400 so far. But these antigen tests produce more false negatives than slower but more reliable PCR tests, experts say; facility administrators also worry about the cost of supplies that kits require.
“Providers are eager but wary of welcoming visitors and volunteers back to their buildings,” said the American Health Association / National Center for Life Support in an email. “That’s why we need public health officials to direct resources – testing, PPE and funding – to long-term care for ongoing care.”
There is always a reason for the delay, and facilities where residents and employees have already been injured and died by Covid-19 are understandably afraid of a repeat. But they could exercise judgment, Dr. Karlavish said, and at least allow visitors for residents who are apparently struggling with isolation. “Nursing homes care for a group of people for whom ethical decisions with a high share are a part of life,” he said.
Almost by definition, residents of long-term care have a limited period of life; Residents of a nursing home are especially fragile. Do they value safety so much over quality of life that they want to spend their last months or years separated from their loved ones? Did anyone ask them?
Ms. Baum continues to visit her mother and mother-in-law from a distance, but is haunted by “the idea that one of them can pass without any of us next to them,” she said. “I don’t know what I would do.”
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