Face-to-face visits at the Concord nursing home still too risky 

  •  Well-wishers honk their horns and wave to residents of Presidential Oaks on Sunday. Teddy Rosenbluth 

  •   Teddy Rosenbluth—

  •  Irv Lawler waves down to his family from is room in Presidential Oaks, where he has been quarantined.  Teddy Rosenbluth / Monitor staff

  • Irv Lawler's family hasn't seen him face-to-face in months. The drive-by visitations give them hope. Teddy Rosenbluth—All rights reserved by...

Monitor staff
Published: 6/22/2020 3:33:01 PM

The Father’s Day parade at Presidental Oaks nursing home in Concord could be heard from a distance.

A procession of cars honked and passengers shouted as they angled their home-made signs at the windows above. Cellophane balloons and American flags trailed the cars as passengers circled the building, again and again, in an attempt to spot their loved ones inside.

A family jumped from the back of a pickup truck and ran over to the building, waving flags and holding up Father’s Day posters. Irv Lawler waved with both hands from his second-floor window. Taped to the window was a handwritten orange sign that read “Miss you!”

The New Hampshire Department of Health and Human Services announced a week ago that residents of long-term care facilities, such as Presidential Oaks, could start meeting face-to-face, as long as they were six feet apart and followed various other precautions.

Too soon, said Anne Purington, the CEO of Presidential Oaks. It could be weeks before this type of visitation is available. For now, Zoom calls and drive-bys will have to do, she said.

“The announcement was given with good intentions, but it just isn’t feasible,” Purington said. “It’s going to take a lot of coordinating and time before this can actually happen.”

The guidelines for outside visitations are lengthy and time-consuming. Staff must call each visitor and read out a long list of screening questions to determine if they might spread COVID-19 to their residents: Have you had a fever? Have you traveled internationally in the last 14 days? What about muscle aches?

They repeat this line of questioning again when the visitors arrive in the parking lot.

Then, staff must accompany each resident to their visit, staying close enough to enforce the six-feet minimum while staying far enough to give the families privacy. Anything touched during the visit (including tables and chairs) needs to be promptly sanitized and a detailed visitor log must be kept in case of an outbreak.

Purington said she’d be happy to do all of this. She knows her residents are itching to see their loved ones – she wants them to be reconnected, too. But right now, it just doesn’t seem possible.

Almost everything about her job has changed in the last couple of months.

She’s constantly adapting the facility’s routines for the coronavirus era, when one slip up could put all of her residents at risk. There are new residents she has to figure out how to introduce into the building safely, doctors who need to take blood without touching anything, even something as simple as bringing in mail requires a carefully devised plan that limits exposure to the virus as much as possible.

Now, she has to figure out how to manage outside visitations on top of all of the other responsibilities COVID-19 has introduced.

Patricia Kenny, the director of nursing services at Presidential Oaks, decided to sleep in the facility at the beginning of the pandemic to help in case of an emergency. She also said she wanted to provide emotional support to her staff, who were having a difficult time adjusting to isolation at the beginning of quarantine. She usually spends six hours a day screening the staff for COVID-19, in addition to fulfilling her pre-pandemic responsibilities. Her staff screens the patients three times a day for the virus.

“There’s no balance,” Purington said when asked how she and Kenny balance the coronavirus workload with their other responsibilities. “You just do it.”

Neither Purington nor Kenny has taken time off for months.

Purington is working on a plan to open up the facility for outside visitations but, like all her other plans, it requires time to make sure it meets high safety standards.

Jake Leon, a spokesperson from the Department of Health and Human Services, said state officials understand that many long-term care facilities have seen a higher workload since the beginning of the pandemic.

“The department continues to encourage long-term care providers to reach out to us to find creative solutions to balance residents’ psychosocial needs and the health and safety of their residents and staff,” Leon said.

Many of the families lined up outside the facility on Father’s Day hadn’t seen their loved ones face-to-face since March. Still, they are thankful for Purington’s prudence. In a state where 80% of coronavirus deaths have happened in nursing homes, Presidential Oaks has remained COVID-19 free.

Stephanie Lessard said it has been really difficult being apart from her grandmother, whom she used to see every day when they lived across the street from each other. During the pandemic, she has called her grandmother on the phone but said it’s just not the same.

“As much as we want to see her, we want her to be safe,” Lessard said.

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