Why nursing homes and medical centers will be among the last places to lift COVID-19 rules
This story is part of a larger series, "Rebuilding America," which chronicles the reopening of the Kentucky and US economies after the COVID-19 closures. The Courier Journal is one of more than 260 local newsrooms in the USA TODAY Network tracking our economic reboot this summer.
Louisville, KY— Pat Eckerle needs to see her grandkids.
It's become much more than a strong desire after more than two months without in-person visits at Dominion Senior Living of Louisville.
The 88-year-old understands the precautions the facility has had to take amid the coronavirus pandemic, which has led to the deaths of more than 200 people in nursing homes across Kentucky since March.
But as more people begin to resume activities in the community, such as shopping at stores and eating at restaurants, Ecklere said she doesn't understand why her family can't come by, even if it's just one person at a time.
"I don't have much time anyway," said Eckerle, who moved into the personal care home just a few weeks before the outbreak reached the commonwealth. "Our grandchildren stand outside of windows and wave to us. But it's working on my mind.
"This is ridiculous."
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Health care professionals say they know that extensive restrictions — from visitor bans to required face coverings — have been tough both mentally and emotionally for patients in medical settings, from delivery rooms to nursing homes.
But while Kentucky's businesses and public spaces inch back to normal, they say it's imperative that many restrictions remain at places where people have greater risks for becoming seriously sick.
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"Normal considerations where people were coming in like they used to, I think, is way down the road, maybe even until we get a vaccine or effective therapeutics," said Tim Veno, president of LeadingAge Kentucky, a trade organization that represents nursing homes and assisted living centers.
"We hear from residents every day who want to see their loved ones, and it's very painful, with regard to that. But we also believe we have a paramount duty to protect their health and welfare."
Hospitals only recently began allowing visitors back into their buildings, amid the third phase of Kentucky's plan for reopening health care facilities.
But patients are limited to one visitor at a time, and all visitors are expected to follow certain rules, such as wearing a mask, having their temperature taken and remaining in the patient's room through their entire visit.
Patients who are entering hospitals for elective surgeries are also expected to be tested for the coronavirus ahead of their scheduled date.
“We know that our patients look forward to visits from their loved ones while they are in the hospital, and we want to facilitate that, while still taking appropriate precautions to protect our patients and staff,” Baptist Health Louisville President Larry Gray said by email.
Dr. James Frazier, vice president of medical affairs for Norton Healthcare, said all the extreme measures taken by health care facilities in recent months were meant to prevent a surge of patients from overwhelming the state's systems.
So far, he said, those measures have worked.
"Now as we continue to open back up, we just have to understand that the virus is not going away," Frazier said. "It wasn't a matter of 'We stay sheltered in place for two months, and all of a sudden the virus is gone.' It's still out there. We have to be ready for it, and we are."
Dennis Chaney, executive director of ancillary services for Med Center Health in Bowling Green, said it's important to remind people to seek medical services if they need them.
But it's equally important to continue proper hygiene, mask-wearing and social distancing as restrictions are lifted both in hospital settings and the general community.
"It's really how we behaved 10 to 14 days ago that affects the cases and hospitalization rates we're seeing today," Chaney said. "So how we behave in the coming days ... as we loosen up on restrictions will continue to have an impact on that."
Nursing home and state officials will also be watching the community's actions and virus rates as they consider easing restrictions within senior facilities, where some of Kentucky's most medically vulnerable residents live.
Gov. Andy Beshear has said nursing homes are a priority for his administration, and a long-term care task force created by the Cabinet for Health and Family Services is now testing every resident and staff member at the state's 285 licensed facilities.
That process, which could take several weeks, will have to be completed before the homes can open to visitors. But in the meantime, the task force will begin to discuss phases for getting nursing homes back to normal.
"We know how important visitation is. We also know how deadly that this virus can be," Beshear said. "... Remember, one person affected going into a nursing home can cause some real significant damage we can't undo."
Mary Haynes, president of Nazareth Home, which operates two senior facilities in Louisville, said employees miss visitors, too.
Staff members often rely on residents' family members to help them better understand and care for their patients, Haynes said. And everyone is anxious for their doors to reopen.
"It takes everybody to create that environment of support and affirmation where people thrive," Haynes said.
"But I think we have a while until we can do things differently."
Until visitors are allowed to return, Haynes said employees at Nazareth Home are keeping residents entertained through video chats, televised worship services and more face-to-face interactions.
The homes have even received virtual reality headsets that allow residents to relax and "travel the world," Haynes said.
"We can never take the place of family, and we know that," she said. "But we are doing all that we can to make sure that social engagement is present because it's very important in all of our lives."
Reporter Morgan Watkins contributed to this report. Reach reporter Bailey Loosemore at email@example.com, 502-582-4646 or on Twitter @bloosemore. Support strong local journalism by subscribing today: courier-journal.com/baileyl.
Restrictions for hospitals and nursing continue
Medical settings where patients are more at risk of becoming seriously sick from COVID-19 are moving slower to reopen their doors than other businesses, such as retail and restaurants.
Here's where hospitals and nursing homes stand:
- Inpatient surgeries have resumed at Kentucky hospitals, with just one visitor allowed per patient.
- Patients must be tested for the coronavirus before entering a hospital for an elective procedure. Visitors must wear masks and be screened upon entry.
- Visitors are not allowed to accompany patients for routine appointments, unless their assistance is required.
- Visitors are still prohibited from entering nursing homes and assisted living facilities.
- Residents of senior facilities are not allowed to congregate, though they can leave their rooms if they take precautions, such as social distancing and wearing masks.