It’s no secret that personal care homes have been severely affected by the COVID-19 pandemic. News stories from across the country highlighted significant flaws in the care and management of nursing homes in the early stages of the pandemic. This resulted in numerous outbreaks in several homes throughout the country with tragic outcomes.

Since the news first broke about the inadequate care in PCHs that led to the widespread outbreaks in many homes in 2020, there has been a very guarded and cautious approach at almost all long-term care centres to make sure these tragedies don’t happen again.

As the world opens and society goes back to pre-pandemic normalcy, long term care facilities keep many restrictions in place in an attempt to protect the residents.

For-Profit Care Home COVID-19 Restrictions

In the first, for profit care centre Mom was admitted to, the administrator proudly boasted their facility had the strictest COVID-19 protocols in the province. When mom first arrived at the centre, she was quarantined for 14 days, a standard practice with nursing homes. After the quarantine period, Mom was only allowed two designated visitors, my brother and I, to visit her. We had to take the home’s mandatory COVID-19 training session to see her. If we didn’t attend this session, we were not allowed in the building. Visitation was only allowed every second day Monday to Friday between the hours of 11:30 am to 1pm and 4:30 to 6:30 pm. We were screened upon entrance and forced to wear masks and face shields during our visit. If we didn’t follow the protocols, we were not allowed into the building. Her stay at this for-profit place was not during a public outbreak. In fact, public case counts were on the decline and society had already eased almost all of the public restrictions.

After the first month, she was allowed to see other friends and family. Visitors had to book an appointment and were restricted to visiting Mom in a room on the main floor. Staff monitored closely, often walking into the room during the 30-minute visit to ensure all visitors kept their face shields and masks on. Visitors who didn’t follow the rules were not allowed back into the building.

Despite the overly strict protocols in place at the profitable PCH, they had two separate COVID-19 outbreaks among patients and staff during the six weeks Mom stayed there. Sadly, one patient died during the second outbreak.

Government Run Centre’s COVID-19 Protocols

The government run facility my mom and sister are currently residing in now also has strict policies in place. Two people are allowed to visit at a time between 11 am to 7 pm weekdays and 9 am to 5 pm weekends. Visitors can only visit with their loved ones in their rooms or outside in the home’s enclosed garden. Visitors are screened upon entering the facility to make sure they are not symptomatic, exposed to COVID, travelled recently out of country or told to isolate. Masks are mandatory.

Three weeks ago, two residents on one of the three units started to display COVID symptoms.  The PCH went into immediate lockdown while they tested the residents. Family, friends, and outsiders were not allowed to visit the facility and residents were isolated to their units and rooms only.  It was soon confirmed that the two individuals had COVID and the facility has been under lockdown ever since.

Despite the strict lockdown policies put in place immediately, the virus spread. So far, eight people have contracted the virus from two different units.

Mom has COVID

Mom is one of the eight. She started displaying symptoms a week ago and was tested immediately. The second test confirmed she was COVID positive.

We worried about her having the virus because she is older and has comorbidities. COVID is one of those viruses that is unpredictable. We’ve had COVID in my house and know friends, family, and coworkers who have had COVID. While there are standard symptoms of the virus, everyone reacts differently so you don’t know from one person to the next how the virus is going to affect them in the short and long term.

Mom received excellent care and after a few days of severe symptoms, started feeling better. It’s been a week now since her first symptoms and while she’s still weak and has minimal appetite, the worst of the symptoms have passed. 

Closure and Spread of the Virus

Despite the closure of the government run PCH to the public, the virus has spread to two separate units. It has gone from two possible cases to eight confirmed and two possible cases. The PCH has less than 80 people residing there so, while the case counts seem low, the population is also lower than most facilities.

COVID and My Sister

My sister, who resides in the same home on a different unit, has not contracted COVID-19 thankfully. It has not made its way to her ward to date. With her severe health issues, we worry about how the virus would affect her.

A Few Observations About COVID-19 Protocols

Despite the strict COVID-19 protocols that personal care homes have, both facilities have experienced outbreaks. While my mom and sister were not in a nursing home during the height of the pandemic, my sister was in and out of hospitals since March 2020. The difference in restrictions between hospitals and nursing homes is noticeable.  While personal protective equipment and screening were still in place, visitation rules were not as strict.

While I agree that residents in personal care homes must be protected, I wonder how effective the strict restrictions are in actually keeping the virus out. In both facilities, it was not family and friends that spread the virus. The public was banned from visiting the nursing home three weeks ago as soon as the first two residents showed symptoms of COVID. Yet, despite the lockdown, the virus has spread to two out of three units. Eight residents out of 80 have contracted the virus and two were symptomatic as of three days ago.

It’s hard not to question the effectiveness of the policies since the virus is still getting into the facility and spreading despite strict restrictions and lockdown policies. If personal care homes want to protect their residents from this and other viruses, I would like the care centre to re-evaluate their policies and create guidelines that protect those residing in the homes without isolating and segregating them from their loved ones.

When Mom first contracted COVID, she commented how, even once she’s better, she won’t be going home. That was heartbreaking to hear. Like many residents, she mourns the life and home she has lost. For those of us who have never been forced from our homes, it’s hard to understand the grief that comes with moving into a healthcare facility. We take our life for granted without truly realizing how easily and quickly we can lose it.

After Mom’s test confirmed she had COVID, her roommate was moved to another room almost immediately to protect her from the virus. While understandable, I question why the nursing home staff reacted so quickly to protect a resident from the virus but did not take the same response to protect my mom from abuse.

As I wrote in my last blog, my mom was verbally and physically abused by a roommate in both care homes she stayed at. In both situations, staff heard and saw the abuse but did not do anything until my brother and I threatened to call the police. Despite zero tolerance policies in place at personal care homes, staff did not respond in either situation to protect Mom until we threatened police involvement. Yet they quickly and strategically protect residents from the COVID-19 virus. I find the difference in their response between a virus and abuse shocking and inexcusable. I’ve tried contacting the home’s social worker to further discuss this but so far have not spoken to her.

Closing Thoughts

I have observed firsthand how personal care homes respond to COVID-19 through my family’s own personal experiences and those experiences shared by friends and colleagues who have loved ones in care homes throughout the city and country. I appreciate and respect the attempts to protect adults residing in personal care homes from the COVID-19 virus, but, after seeing how easily and quickly the virus gets into care homes and spreads, despite the rigid policies, I question how effective those restrictions really are.

Not only has the virus spread despite the lockdown, but the restrictions also affect the mental, emotional, and physical health of the residents. Aside from being separated from their loved ones, residents are not allowed to leave their rooms so they can’t visit with each other. Because they can’t leave their room, they are not allowed a weekly bath or shower nor do not get their physiotherapy or reactional activities. They just sit alone in their room. Mom has a TV and phone, and my sister has her phone. That helps break the monotony of the day. However, many residents don’t have devices, so they just sit.  I don’t need a degree to recognize how unhealthy that is.

I’ve also noticed the stark difference in the type of care residents receive in homes. I’m grateful for the immediate and aggressive medical care Mom received when she was first diagnosed. It made a significant difference in how she felt during the worst days and her recovery. I have seen this not only when my mom got COVID, but also in my sister’s ongoing care since she has moved into this personal care centre. Without question, the medical care is fantastic. But the same cannot be said for their rehabilitative care response to their own policies around abuse. As both places have stated, they do anything unless family get involved and say something. That’s not acceptable.

Mom never contracted COVID living in her own home. She had control over where and when she went out, so she could control her own level of risk and exposure. She has no control over the risk factors in the nursing home.

As someone who believes that not all senior’s should be automatically panelled into a personal care home when they lose their ability to live independently, I believe that this is yet another reason why we as a society need to develop strategies of care so senior’s can remain in their homes and communities for as long as possible.

Getting older should not be a life sentence into an institution. Other countries have implemented changes in housing and home care so seniors can stay in their home and community for as long as possible. There are proven benefits to keeping people in their homes and out of care centres.

My province is working on implementing change. I will continue to do my part to advocate for change in our current system for our aging population.