On March 13, one year ago, Abbott ordered the closure of nursing homes and other long-term care facilities to general visitation. His order last week did not open nursing homes to general visitation.
Even the federal government is recognizing it is time to allow families to visit the approximate 120,000 residents in long-term care facilities. This week, the federal Centers for Medicare and Medicaid Services revised its guidelines for nursing home visitation. “Facilities should allow indoor visitation at all times and for all residents (regardless of vaccination status), except for a few circumstances when visitation should be limited due to a high risk of COVID-19 transmission.”
In Texas, for approximately 200 days last year, no in-person visitation was allowed unless for an end-of-life visit. The median stay in a nursing home is 354 days, less than the year in which visitation has been generally foreclosed. The number of families who lost access to their loved ones during their last remaining days on earth skyrocketed.
A window of hope opened in September when a provision was made for patients to have two family members, designated as essential caregivers, visit. These caregivers receive special training regarding COVID-19 protocols and are allowed to visit for up to two hours at a time and require an appointment.
But even that designation doesn’t work consistently for Stephanie Kirby and her profoundly disabled 28-year-old son, Petre, who lives in the Denton State-Supported Living Center.
Kirby related her story to the Texas House Human Services Committee earlier this week. She told them that she visited several times a week before the COVID-19 shutdown. She said her son, who is not medically fragile or at high-risk for the virus, screamed and cried, lost weight, and is now prone to self-injury.
“I was forbidden by the state from comforting my son,” whom she said is similar in function to a three-year-old.
Even now, as an essential caregiver, she is dependent on the availability of staff volunteers who are willing to escort her into the facility to see her son. If no one is available, she can’t see Petre.
“Keeping families out did not keep [COVID-19] out,” Kirby emphasized, urging provision to be made by the legislators for families to visit regularly again. “No one has more of a vested interest in protecting the residents and staff than the families.”
Mary Nichols organized Texas Caregivers for Compromise in July 2020 after several months of not seeing her mother who suffers from dementia and Alzheimer’s Disease. Over 3,000 families are involved in the group that advocated for the essential caregiver designation.
“On March 13, 2020, I thought it would take two or three weeks to figure this out. I never imagined it would be a year,” Nichols told The Texan.
Her group has taken many steps to draw attention to the plight of isolated elderly and their loved ones by organizing rallies, posting large groups of signs with the names of those who are isolated, and printing and shipping petitions with thousands of signatures to Abbott and members of the legislature.
On Friday, they hired a plane to fly a banner that “Isolation Kills Too” over the capitol.
Nichols believes the group has made progress, but more is needed.
“I’d like to see visitation restored. We need to get on the road to normalcy,” she urged. “Outdoor visitation has a very low transmission risk and so it should not require approval. Essential caregivers sign a contract to abide by the protocols so escorts should not be required.”
She also pointed out that with the state open and the statewide mask mandate removed, she is concerned that cases could increase again. However, if the positivity rate in a county goes up above 10 percent, nursing homes and other facilities can close even the limited visitation that is allowed.
“It is grossly unfair to base visitation rights on everyone else,” she added.
Nichols works to help the families in Texas Caregivers for Compromise because of her mom. “She’s a shell of herself. I feel like I was robbed of the last little bit of time I could have been reassuring her that she mattered.”
Several bills have been proposed in the state legislature to ensure that long-term care facility residents have the right to have at least a designated essential caregiver visit them, even during a public health emergency.
Hearings have been held for House Bill 892 by Rep. James Frank (R-Wichita Falls) and Senate Bill (SB) 25 by Sen. Lois Kolkhorst (R-Brenham). SB 25 was passed out of committee. Rep. Scott Sanford (R-McKinney) has authored “The Linda Nevil Act,” a similar bill meant to protect visitation rights.
Lt. Gov. Dan Patrick listed nursing home visitation rights among his top 31 priorities for the legislative session.