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Visiting Loved Ones in Long-Term Care Facilities in the Midst of COVID-19

Navigating visitation with residents in long-term care facilities

Reviewed by: Gayle Ayers, DO, and Liam Fry, MD
Written by: Ashley Lawrence

Long-term care facilities provide both medical and personal care to people, usually older adults over the age of 60, who are unable to live independently. In March 2020, long-term care facilities were identified as high-risk settings for outbreaks of SARS-CoV-2, the virus that causes COVID-19. During this time, U.S. health departments put specific guidelines in place to improve infection prevention and control (IPC) practices to help prevent outbreaks and limit the spread of COVID-19 in already affected facilities. Efforts to mitigate outbreaks in long-term care facilities were necessary to reduce overall COVID-19 mortality and associated disparities; however, these efforts greatly impacted the residents of these facilities.

“Visitation restrictions during the COVID-19 outbreak placed physical and emotional tolls on residents, especially those living with moderate to more advanced dementia or other disabilities,” says UT Health Austin geriatric psychiatrist Gayle Ayers, DO, in UT Health Austin’s Comprehensive Memory Center within the Mulva Clinic for the Neurosciences. “Living in social isolation like that is just not healthy in its own way.”

Feeling socially isolated creates an increased risk for depression, anxiety, and other expressions of distress. The prevalence of severe loneliness among residents of long-term care facilities is anywhere between two and four times as likely as the community population, which has been amplified by visitation restrictions in place due to COVID-19.

“While visitation is an important factor when it comes to the wellbeing of residents in a long-term care facility, we still have to be really careful about physical contact,” explains Dr. Ayers. “We try to advise family members of loved ones to redirect, redirect, redirect. While this tactic is mostly used to change the subject matter of a conversation to a more comforting topic, it can also be used to redirect physical contact. I would suggest bringing a wrapped gift or other meaningful objects, such as a hat, photo album, or framed picture, to your next visit. These items can easily be wiped down and passed to your loved one during your visit.”

You can also connect with your loved ones through:

  • Personal devices for video chats, emails, text messages, and phone calls
  • Cards and letters with messages of support and updates on family members
  • Recorded videos and video messages shared through email or text messages
  • Care packages with photos, drawings, favorite snacks, and forms of entertainment (i.e., books, magazines, puzzles)

“Unfortunately, there aren’t many great alternatives to visiting loved ones in long-term care facilities,” shares Dr. Ayers. “Even if you do not trust the precautions facilities have put in place, it’s important to try to find a way to visit that will work for you. You may want to think about visiting through a window or some other transparent barrier while talking to your loved one over a phone. There is also the option of video calling, but that can be very reliant on the facility’s staff, which can put certain limits and restrictions on visitation.”

Ways to prepare for your upcoming visit:

  • Bring tangible props to help minimize physical interactions
  • Prep loved ones by showing photos of or reminiscing about family members who will be visiting so they don’t get overwhelmed
  • Try to keep to a set visiting schedule as routines bring feelings of comfort and safety
  • Be patient and understanding, especially if your loved one is not up for a visit after your arrival
  • In the weeks leading up to your visit, limit your public exposure as much as possible
  • If possible, consider conducting your visit outdoors
  • Check with the long-term facility about specifics regarding visitation and adhere to all local and state health and safety laws, rules, and regulations

“If you’re worried about your loved one’s wellbeing, reach out to the facility’s staff,” encourages Dr. Ayers. “These are the people who interact with your loved one every day. They can validate your concerns or let you know if you’re just picking up on a bad time. Your loved one’s mood can fluctuate depending on the amount of sleep they had the night before, whether or not they’ve eaten yet, or even if their blood sugar is low.”

While not all loved ones in long-term care facilities have access to, or the ability to use, the internet or a smartphone, there are an abundance of internet- and phone-based resources available to those who feel isolated and alone as they continue to navigate the challenges that have emerged since the start of the COVID-19 outbreak. These resources are also available to individuals with disabilities and older adults who do not live in long-term care facilities.

Resources available in the Austin area and beyond:

For more information about UT Health Austin’s Comprehensive Memory Clinic, call 1-833-UT-CARES (1-833-882-2737) or visit here.

About UT Health Austin

UT Health Austin, the group practice designed and managed by the faculty and staff of the Dell Medical School, focuses the expertise of a team of experienced medical professionals to deliver personalized, whole-person care of uncompromising quality. Our experienced healthcare professionals treat each patient as an individual with unique circumstances, priorities, and beliefs. Working with you, your care team creates an individualized care plan to help you reach the goals that matter most to you — in the care room and beyond. For more information, call us at 1-833-UT-CARES or request an appointment here.