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Challenges Remain with Nursing Home Visitation in Tennessee

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Gene Brown's son stands outside the window of his father's nursing home to say goodbye last December.
Photo courtesy of Rachel Brown.

After Gene Brown, 92, of Gallatin, broke his hip and went to the hospital last November, he tested positive for COVID-19. Then he was released to a nursing home coronavirus unit with limited visitation. 

Unfortunately, no one could see him, even under the strictest guidelines. He could communicate on a landline, so nurses would make sure he had the phone in bed with him while the family would talk from outside his window.

Soon, his wife, Kathryn, 88, and other family members tested
positive, while Brown’s health continued to decline. He died in December, just days before his and Kathryn’s 67th wedding anniversary. She was sick with COVID-related pneumonia and was unable to say goodbye.

“These moments are happening all over the world,” their daughter-in-law, Rachel Brown, said. “It’s just very sad.”

Risk versus loneliness

Dying alone is a worst-case scenario, but experiences like the Browns have suffered underscore the tension of long-term care facilities trying to weigh safety concerns against the personal costs of isolation. 

Studies show that loneliness can increase the risk of cognitive decline, obesity, elevated blood pressure and even death.

With vaccine distribution continuing, the state lifted restrictions on nursing home visits on Feb. 28. Individual facilities, however, still have latitude on visitation rules. 

 “As more nursing home residents and caregivers receive the vaccination, we hope that individual facilities will encourage and facilitate increased visitation, depending on local positivity rates,” said Rebecca Kelly, AARP state director, who serves on the recently formed Tennessee COVID-19 Long-Term Care Task Force. 

Where visitation is allowed, following guidance by the Centers for Medicare & Medicaid Services, residents and visitors must wear masks and maintain physical distancing. Outdoor visits are encouraged when possible. They may take place indoors if the visitor
documents having had a negative coronavirus test result within the previous 72 hours and passes a temperature check upon entry.  

Some long-term care facilities have added virtual options, helping residents to Zoom with loved ones. Others have created outdoor visitation areas or indoor spaces with plexiglass barriers. 

Ramping up visitation can be costly because of staffing, personal protective equipment (PPE) supplies and testing. AARP Tennessee is advocating for facilities to use federal CARES Act funding to improve communication and visitation procedures.

If you have a loved one in a nursing home, AARP suggests asking the facility: 

  • How far along are COVID-19 vaccinations? 
  • Does the staff have sufficient levels of PPE?
  • What is the nursing home doing to help residents stay connected with their families or other loved ones during this time?
  • How is the facility communicating important information to residents and their loved ones on a regular basis?

“Socialization is critical for mental health,” Kelly said. Balancing human contact along with physical health “saves lives.”

“We know that people are happier when they are with the people they love and who love them.” 

Hollie Deese is a writer living in Gallatin, TN.

More on Long-Term Care

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