'Open the doors again': One advocate urges nursing home visitation to resume

Washington D.C., Mar 4, 2021 / 15:00 pm

The U.S. must consider increasing nursing home visitation during the pandemic, one advocate for elder care told CNA.

"It's necessary to open the doors again, and end the isolation of the elderly," said Jim Towey, founder and CEO of the group Aging with Dignity, which advocates for care of the elderly. Towey was formerly legal counsel to Mother Teresa, director of the White House Office of Faith-based and Community Initiatives, and president of St. Vincent's College and of Ave Maria University.

Nursing homes and long-term care facilities have seen high death rates from the coronavirus pandemic, and thus have had strict visitation policies. Towey said that as a result, many elderly persons have been cut off from human contact and from the physical presence of their loved ones for nearly a year-with devastating consequences.

"I think what's going to emerge in the next six months is the awareness that COVID was as much a mental health crisis as an infectious disease crisis," Towey told CNA in a Feb. 17 interview. "And this is going to be true at every level of society, from school kids that are failing to thrive to seniors who have been traumatized by their isolation."

While many might see mass vaccination as heralding a return to normal life in the coming months, he said, hospitals and long-term care facilities have not yet changed their "lockdown practices" despite COVID vaccinations beginning in December.

Kaiser Health News has reported that weekly new deaths among nursing home residents had sharply declined by 66% since COVID-19 vaccinations began in December. Yet many facilities, Kaiser reported on Thursday, are still not open to visitation, or have strict visitation policies.

Federal guidance acknowledges the difficulties faced by residents without visitors, and lists precautions that facilities could take to accommodate visitors safely. After Towey spoke with CNA on Feb. 17, multiple states announced a relaxation of their nursing home visitation policies.  

Yet public health regulations have prized physical safety over mental health without full regard to the consequences, Towey said. 

"I feel like the public health concerns failed to weigh the destructive effect these lockdown practices of nursing homes and hospitals have had on human beings and their emotional needs," Towey said of the isolation felt by many nursing home residents during the pandemic.

Furthermore, he added, reports of widespread isolation "will have a chilling effect on individuals and their decisions to go into assisted living or a nursing home. They don't want to be imprisoned. They don't want to be cut off from the human race."

Towey has argued that other local, state, and federal public health policies have reflected society's disdain for the elderly. He told CNA back in May that nursing homes had been "ground zero" for the worst suffering from the pandemic, due to reports of neglect and state orders that nursing homes accept COVID-positive patients discharged from hospitals.

Then, he had warned of a "utilitarian" mindset that the lives of the elderly mattered less.

Now, Towey said, society cannot ignore the mental anguish of residents who have no one to visit them. "The isolation has been punishing. The loneliness that's resulted has been cancerous," he said.

Making matters worse, he argued, is that the U.S. has no plan or national initiative to deal with the problem.

"You can't lock down the elderly forever and isolate them forever, and I don't think our country has thought through humane approaches that give the elderly not simply protection, but also company and love and accompaniment," Towey said.

He juxtaposed the care for the elderly in the U.S. with the situation in Italy. While the country saw high death rates among the elderly during the pandemic, there has also been a campaign by young people to send supportive calls and video messages to elderly residents in isolation. The Catholic "Youth for Peace" movement has organized the campaign, also collecting supplies for elderly residents.

Towey called for a national initiative in the U.S. to rethink elder care during the pandemic-including "how we can change practices immediately" to remedy the "starvation that the elderly are experiencing in the way of human contact."

"I think the United States is lagging behind," he said, noting that the isolation faced by elderly residents-along with anecdotes of them being denied access to ventilators at intensive care units- reflects a societal utilitarian view of human beings, that you're valuable if you're useful. And many feel that our elderly aren't useful."

At the outset of the pandemic, ethicists warned against state and local triage plans that would discriminate against the elderly and the disabled. Care should be rationed on an ethical basis and must not be denied those who are deemed to have a lesser "quality of life" on a utilitarian basis, ethicists told CNA.

The Office for Civil Rights at the Department of Health and Human Services (HHS) warned that it would be watching for any age or disability-based discrimination during the pandemic. The office successfully prodded Alabama to update its controversial triage plan and exclude problematic provisions.

Some public officials, such as Gov. Andrew Cuomo (D-N.Y.), have been criticized for state policies that allowed COVID-positive patients to be discharged from hospitals into nursing homes.

Although New York reversed that policy last spring, Cuomo's administration is under federal investigation for its handling of nursing homes during the pandemic. An aide admitted that the administration tried to hide the nursing home death count from the federal government.

The general isolation or neglect of the elderly, Towey said, is all part of the "throwaway culture" condemned by Pope Francis

"I think Pope Francis has properly focused on the disproportionate impact that COVID has had on the elderly, far beyond the fatality count," he said.

"It's damaging to the social fabric that ties us all together," he said.

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