Complaints of unfairness end compassionate visits to Manitoba care home during pandemic

Making exceptions to allow some family members to visit residents living in personal care homes during the COVID-19 pandemic has led to some difficult decisions by managers and, in one case, resulted in complaints about risk and unfairness. 

It's a scenario that played out at a personal care home in Powerview-Pine Falls, Man., in recent weeks.

After restrictions on family members entering personal care homes in Manitoba were announced by Manitoba's chief public health officer on March 17, local managers at care homes have had the discretion to allow family visits in certain cases on compassionate grounds.

In one example, the 20-bed Sunnywood Manor personal care home in Powerview-Pine Falls, which is located about 100 kilometres northeast of Winnipeg, made an exception for two of its residents to each have a family member continue visiting in April.

When other families observed that happening, it led to complaints.

Some told CBC News it was unfair to allow certain residents to have visitors while others could not. They said they also feared that allowing people other than staff into the home could increase the risk of the virus getting in.

"There was a lot of people concerned about that, including myself," said Jack Brisco, mayor of the rural municipality of Alexander, one of the communities served by the care home. 

"I thought — they're going in and possibly bringing in the virus, possibly exposing other people," said Brisco. "Others say 'if they're going in, why can't I go in?'"

Powerview-Pine Falls resident Diane Houston, whose mother-in-law lives at the home, said she was "disappointed and shocked" that two other residents continued to have visitors while her family did not.

"We all thought the care home was closed to visitors," Houston said.  

'Tough decision'

"It's a really tough decision," said Jan Legeros, executive director of the Long Term and Continuing Care Association of Manitoba, which represents about 40 homes.

"We have to weigh the risk ... against our assessment of that individual resident and their specific emotional needs," Legeros said.

She said she asked association members whether they had been making exceptions to the no-visitors rule. She received about 10 responses, with all of them indicating they had made exceptions but only in one or two cases.

Legeros emphasized the importance of connecting seniors with their loved ones. 

"We need to combat social isolation. It's a disease. And really we must combat that in any way we can think of," she said, "through technologies, through window visits, through telephone conversations." 

The municipal council for the RM of Alexander got involved in the issue and at its meeting April 15 directed its administration to write to the regional health authority "and ask that they clarify for the community exactly what steps/procedures and policies have been implemented to protect the health and safety of the residents at the facility and the local residents," said RM of Alexander chief administrative officer Don Dowle in an email to CBC News. 

After that, the situation changed abruptly. 

The Interlake-Eastern Regional Health Authority said the visits for the two families would end.

"On April 17, we moved to restrict all family members from entering Sunnywood Manor. We have put in place measures to provide temporary alternative staff care for individuals who were receiving family care," CEO Ron Van Denakker said in a statement to CBC News. 

He left the door open to potentially allowing visits in the future.

"As always, management staff on site can exercise their professional judgement in granting exceptions to restrictions for compassionate reasons," Van Denakker said. 

"These criteria include recognition of the role of some residents' family members in helping us ensure their loved one's health and safety as well as that of other residents. We will continue to grant these exceptions as we deem necessary given our responsibility to ensure residents' care needs in a safe environment," Van Denakker said.

CBC News has not been able to get in touch with the two family members who had to stop visiting their loved ones. A different relative of one of the residents didn't want to comment on the situation.

Concerns for 'personal safety'

After the rural municipality of Alexander raised concerns about the visits by the two families, Van Denakker sent an email to the municipality's administration April 17 alluding to tension in the community.

"Due to staff and visitor concerns for their personal safety based on strong threats from community members, we sadly made the decision to suspend all visitors and will need to bring in two additional staff to look after two residents with significant needs," Van Denakker wrote to the CAO of the RM of Alexander.  

"Should this result in resident care concerns, we will consider activating the compassion clause again," Van Denakker wrote.

He also informed the municipality that Sunnywood Manor was meeting all provincial guidelines for personal care homes, including for infection prevention. 

"These family members are subject to the same screening process for symptoms of illness as staff when they enter a facility and they interact only with the individual resident they care for during their time in a personal care home," Van Denakker said in an email to CBC News.

Suggestions about threats in the community brought a strong reaction from Winnipeg resident Kim Trethart, whose mother lives in Sunnywood Manor, and who had voiced concerns over allowing visitors for the two residents.

He wrote a letter to the editor of a local newspaper criticizing the remarks by Van Denakker as "totally unprofessional, irresponsible and insensitive". 

"These two individuals granted 'special' visitation rights appear to have circumstances no different from the other families with loved ones in the facility," Trethart wrote.  "Allowing two extra people besides staff to come and go could have had disastrous results as proven by the number of deaths in long-care homes from COVID-19."

Van Denakker declined to comment on Trethart's remarks.

Once the visits for the two residents were stopped, Mayor Brisco said he didn't hear any more complaints.

Families play 'essential role'

The role of family in caring for relatives in care homes or hospitals is a familiar one for Julie Drury, who's an advisor on the subject at the Canadian Foundation for Healthcare Improvement, and who also lived the experience of caring for her own child with complex medical needs.

"The fairness one is really hard, right, and it pulls at all of our heart string — 'Why does that person get to see their loved one and I don't?'" Drury said. "I empathise with that and have great compassion for that." 

While Ottawa-based Drury doesn't know the medical history of the two residents whose family members had their visits stopped, she said the decision to end their visits "lacks the recognition that families are allies and partners in care, and that they do play that essential role as an essential partner in care, not just a visitor."

"There are visitors in the health care system, you know extended family who come to visit grandma and grandpa in residence, and that's great," she explained. 

"But there are also family members who have acted as essential partners in care and are doing some of the care for residents which is why this organization had to hire two replacement staff for these two family caregivers." 

"So without knowing the context specifically, it seems to me they were likely doing significant roles in care and caregiving that were essential," Drury said.