Flexibility is key for families during nursing home visits

The resurgence of the coronavirus is not just putting a damper on traditional holiday celebrations, but on visits to loved ones in nursing care facilities as well. Whether you can plan a visit will depend on where the facility is, what policies they have set and, of course, what's in the best interests of your loved one.

Outside is best

We all know by now that outdoor visits are safer than indoor ones for preventing the spread of coronavirus because of the increased space and airflow. The sunny days of early November with temperatures rising into the 70s seemed like spring, but we know it's much colder now. Keep that in mind when planning visits. If you have an outside visit planned and an indoor one is not possible, try keeping plans to yourself to avoid disappointment for your loved one in the facility.

Sometimes inside is OK

Whether indoor visits are permitted will depend on guidelines set forth by the individual facility and the prevalence of coronavirus cases. While health experts agree that outdoor visits are the least risky, indoor visits may be permitted, especially under certain compassionate care guidelines set out by the Centers for Medicare & Medicaid Services. Those circumstances include:

• End-of-life situations.

• When a newly admitted resident is struggling with the change in environment and lack of family support, or when they need encouragement with eating or drinking because they've become dehydrated or are losing weight.

• When a resident is grieving the recent death of a friend or family member.

• When a resident demonstrates a change in mood, such as talking less or crying.

Keep visits small

The CMS recommends people in nursing facilities receive no more than two visitors at a time - even outdoors. Those pairs of visitors should be from the same household and, of course, wear masks and maintain appropriate social distancing. Understand that these guidelines are set to safeguard you loved one's health.

Take care who visits

As much as grandma might want to see her grandchildren, now is probably not the time for visits from college students or young adults who do not live with you. According to a recent Centers for Disease Control and Prevention survey, people age 18 to 29 were far less likely to take steps to avoid contracting COVID-19 than those in older age groups. The study measured six behaviors: wearing a face mask, washing or sanitizing hands, social distancing when out of the house, avoiding crowded places, canceling or postponing social or recreational activities and avoiding some or all restaurants. A total of 53% of those age 60 or older reported following all six of these behaviors, while just 38% in the younger group did. Check with what the individual facility allows, but perhaps a short visit through a window might be a safer alternative for younger adult visitors.

Plan ahead

Taking steps to plan your visit will help ensure its success:

• Check ahead to make sure your visit won't interfere with mealtimes or scheduled appointments.

• Make sure any gifts you bring, like blankets or books, are labeled. And double-check that gifts of food or drinks are both allowed by the facility and won't interfere with your loved one's dietary restrictions.

• Consider how masks might affect your interaction. If your loved one is hard of hearing, you might want to consider a mask that is clear in the front so they can read your lips.

Be flexible

Guidelines may change as coronavirus cases rise. That visit you had planned could get canceled at the last minute. Be flexible and use the disappointment as an opportunity to think of new ways to connect. For example, someone I heard of participated in a socially distanced 80th birthday celebration where a family member assigned friends and family a specific day to reach out. Each person called, texted, sent a card or sent a gift on their assigned day so that the birthday recipient heard from a different person on each of the 80 days leading up to her special day. You don't have to do anything on such a grand scale, but even something small like designating a week for family members to send a short note sharing a favorite holiday memory could do wonders to lift a loved one's spirits - and make them feel a little less alone.

• Teri Dreher is a board-certified patient advocate. A critical care nurse for more than 30 years, she recently founded Seniors Alone Guardianship & Advocacy Services (SeniorsAlone.org), a not-for-profit organization that serves the area's senior orphans. She also is the founder of NShore Patient Advocates, www.northshorern.com.