It has been four months since family members were allowed to visit their loved ones in nursing homes and other long-term care facilities. The limitations were implemented in mid-March and neither Governor Greg Abbott nor the Texas Department of Health and Human Services, which regulates these facilities, have released plans to allow visitors.
Thousands of Texas residents and dozens of state legislators are calling for Abbott to open nursing homes for at least limited family visits.
Mary Nichols has organized an online petition through Change.org and gathered over 8,000 signatures. She has printed the petition in book form and mailed it to Abbott in hopes that he takes action.
She hasn’t seen her mom, who is 75 and has end-stage Alzheimer’s disease, since March.
“When it all started, we all assumed it would be a few weeks while they figured it out. By day 60, I started making calls. By mid-June I started the petition. I got mad because I got tired of there not being a plan,” Nichols told The Texan.
She pointed out that it isn’t just people like her mom who are being isolated from their families. There are much younger people with spinal injuries or other disabilities who need 24/7 care, she explained. Young adult children with traumatic brain injuries are being kept from seeing their parents.
Representative Matt Krause (R-Fort Worth) and Senator Charles Perry (R-Lubbock) were joined by eight more state senators and 45 members of the Texas House in a letter to Phil Wilson, Interim Executive Commissioner of the Health and Human Services Commission (HHSC).
The letter calls on Wilson to “immediately move forward and put a plan into action to allow limited family visitations” inside these long-term care facilities with appropriate guidelines to protect this vulnerable population.
The letter also picks up on an idea from Nichols’ petition: the designation of a family member as an “essential caregiver” so that they can be considered essential and enter the facility just like other members of the staff.
Other states, like Minnesota, have established guidelines for designating an essential caregiver “who was previously actively engaged with the resident or is committed to providing companionship and/or assistance with activities of daily living.”
“It’s a win-win for the nursing homes,” Nichols remarked. “These people are an extra set of eyes and hands who can help with tasks and relieve the pressure on the staff. They also help protect the goals of the family and the nursing home by advocating for the needs of the residents.”
Nichols and Krause point out that the virtual visits by FaceTime or window visits are not equally accessible to all. Some residents can’t hear well or understand a virtual visit or be taken to a window because they are bed-bound.
“Many cannot understand a virtual visit, and simply look down the hall for their loved one when they hear their voice on an electronic device,” the legislators state in their letter.
In addition, HHS guidance allows family members to visit hospice patients, but only when death is imminent.
The state’s Long-Term Care Ombudsman Patty Ducayet believes that the “compassionate care” exception to the visitation policy is far too narrow. She made recommendations to HHSC policy makers in early June that the exception be expanded to include when a person is declining and needs a visit and care from family.
She has also challenged the notion that outside visits are prohibited by the rules. However, now that Texas summer heat has arrived with temperatures in the 100 degree range, this option is less feasible.
Fran Rhodes of the True Texas Project began gathering stories and personal accounts from families who are unable to visit family members in nursing homes. She learned about the predicament through a friend.
“This is the very definition of neglect,” Rhodes said. “Isolating residents from their families.”
One couple, who has been married for 46 years, are unable to see each other except through a window. The wife used to visit her husband nearly every day of the week. Now she hasn’t seen him for four months.
“My husband says he would rather die than stay there,” she told Rhodes. “If we could only sit on the porch for a few minutes every now and then I know my husband would be much better.”
Rhodes contacted HHSC in mid-June with the stories she had collected from affected families.
In the reply, HHSC provided no plans for allowing any limited visits, pointing again to the virtual visits that are being encouraged.
“We understand how hard it has been for residents to not be allowed in-person visits from their loved ones. However, these measures continue to be critical to protecting individuals who are proving to be the most vulnerable to COVID-19. Unfortunately, we are seeing steady increases in the number of COVID-positive cases in Texas facilities, even in rural areas,” the letter stated.
According to the Texas Department of State Health Services, there have been 15,497 COVID cases in nursing homes in Texas since March. The data does not show current cases.
Ducayet has also created an online survey for families to share their stories. She has collected 146 stories in less than a week and plans to share them publicly and with elected officials to educate them about the effects this lockdown is having on residents and families.
“I think it is deeply unfair and wrong that we’ve allowed this to continue this long,” Ducayet told The Texan.
Nichols said according to her research 40 out of 50 states have developed plans for some limited visitation to nursing homes.
In mid-May the federal government released guidelines for re-opening long-term care facilities, outlining criteria for states to follow.
Oklahoma announced its plans on June 12. Visits are allowed based on case prevalence in the area, availability of personal protective equipment, and local hospital capacity.
Ducayet encourages family members to speak out and tell their stories, contact Abbott’s office, HHSC, and their local and federal elected officials. She also hosts a weekly Facebook live session on Wednesday at 12:15 p.m. where she attempts to answer questions from families.
Nichols says she has no expectations that the petition with thousands of signatures will spur any action by Abbott. “This has been put on the back burner,” she said.
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Kim Roberts is a reporter for the Texan in the DFW metroplex area where she has lived for over twenty years. She has a Juris Doctor from Baylor University Law School and a Bachelor's in government from Angelo State University. In her free time, Kim home schools her daughter and coaches high school extemporaneous speaking and apologetics. She has been happily married to her husband for 23 years, has three wonderful children, and two dogs.