Long-term care residents should be allowed more visits, B.C. seniors advocate says

B.C.'s visitor restrictions on long-term care homes are harming residents' health and should be eased, says a new report from the province's seniors advocate.

The report by Isobel Mackenzie, released Tuesday, recommends designating an "essential care" partner who can visit more frequently and for longer periods, and allowing at least one additional social visitor. 

It also calls on shifting visits away from common areas and into residents' rooms, saying the move would reduce the burden on care home staff to monitor visits and reduce the need to keep visits short.

The report, which surveyed 13,000 long-term care residents and their families across B.C., said most respondents indicated current restrictions are not working for them, with some calling the rules "inhumane." 

Residents are using more anti-psychotic medications during the restrictions, the report said. They have also suffered spikes in unexplained weight loss, worsening moods and symptoms of depression. 

"The urgency is now," Mackenzie said.

"The residents have told us very clearly in this survey they are more concerned about being separated from their family members than they are about COVID."

Approval needed from Dr. Bonnie Henry

Long-term care homes were among the hardest hit by COVID-19 outbreaks in the spring. At the time, the province restricted visits entirely, a move that Mackenzie said saved lives.

The province then eased restrictions over the summer, allowing residents to see one person at a time — a "designated" visitor — in a common area. 

The visits have to be booked in advance and can happen indoors, outdoors or, in some cases, in a single room.

Visitors must follow several health and safety rules, like wearing a mask, sanitizing their hands and talking to their loved one from at least two metres away.

The report found most family members and residents support some restrictions — including handwashing, getting temperature checks and wearing masks — but want more visitors and more frequent visitors. 

Mackenzie said long-term care homes can already allow for longer visits, but allowing more visitors would require the approval of Provincial Health Officer Dr. Bonnie Henry.

B.C.'s Health Ministry responded to the report by saying the early actions saved lives, noting that in Quebec, per capita COVID-19 deaths are about 15 times the rate of British Columbia, and in Ontario they are four times higher, attributable to deaths in resident care homes. 

"Protecting residents, while balancing the desire for connection, is an incredibly difficult balance that our health leaders wrestle with everyday," the statement continued.

"The seniors' advocate recommendations help inform these ongoing deliberations ... Thanks to each of you for taking the time to remind us of the challenges this pandemic has created for our most vulnerable."

Short, infrequent visits

The survey found most family members weren't aware of essential visits during the first four months of visit restrictions. Almost half of the people who did apply for an essential visit were refused.

Most visits are once a week or less, and half the visits in long-term care homes are less than 30 minutes, according to the report.

Only 21 per cent of residents were allowed visits in the privacy of their room. About 70 per cent of visitors weren't allowed to touch their loved ones.

Mackenzie said health officials may need to consider easing restrictions regionally, amid a surge of cases in the Fraser Health Authority area, the B.C. region hardest hit by COVID-19.

Officials must also take into account the residents' quality of life, Mackenzie said, noting her recommendations would be a "very modest" expansion of restrictions. 

Brenda Brophy, who moved her mother out of long-term care during the pandemic because of the visitation restrictions, called the report a sensible approach. 

"Very little needs to change in Dr. Bonnie Henry's orders," Brophy said. "But you had the facilities deciding to deny visitation."

Brophy said it would also be good to have some sort of mechanism in place that families could go to if families had disputes with the facilities.