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West Virginia has announced it will be the first state to allow visitors back into nursing homes beginning next week. Across the country, visitors have been banned for three months because of the pandemic. That ban has meant family members have had to make do with window visits and video chats, and some have seen a serious decline in the health of their loved ones. NPR's Ina Jaffe reports.
INA JAFFE, BYLINE: It wasn't candlelight and soft music that made the 40th anniversary of Luann and Jeff Thibodeau so memorable. It was gazing at each other through the window of Jeff's nursing home in Texas, eating carryout from the Olive Garden, just the two of them - and a nursing assistant.
LUANN THIBODEAU: And she fed him, and I ate mine, and that was it. So that was our 40th wedding anniversary.
JAFFE: Luann used to bring dinner for her husband every night except Tuesday, when she goes to Bible study. She says as his multiple sclerosis got worse, he became increasingly disinterested in food.
THIBODEAU: And I bully him into finishing a meal. And I'll say to him, Jeff, you know, this is what an adult man eats, so you need to eat this.
JAFFE: But a staff member can't do that. Nursing home residents have rights, so if Jeff tells a nursing assistant that he's done eating after three bites, she has to abide by his wishes. A family member like Luann can push. The impact of her absence is striking.
THIBODEAU: When I see him at the window, I can tell his clothes are way big on him, and I'm pretty sure he's lost significant weight.
JAFFE: Nursing homes do allow what are called compassionate care visits, but that usually is interpreted narrowly as end-of-life visits. That interpretation needs to be broadened, says Robyn Grant, director of public policy for the National Consumer Voice for Quality Long-Term Care.
ROBYN GRANT: Residents are declining mentally, physically, and we think that those situations are times when family members should be permitted.
JAFFE: If that were the case, Sky Gonzalez might still be able to visit his mother, Eva, at her nursing home in Southern California. Before the visitor ban, either Sky or his brother saw her every day.
SKY GONZALEZ: She probably feels like we've abandoned her.
JAFFE: Eva Gonzalez is 98 and lived on her own until about 18 months ago. Then she started having falls and symptoms of dementia. She needed 24-hour care. But now that Sky can only reach her on the phone, he can't see what kind of care she's getting.
GONZALEZ: When I call, she always seems to be dehydrated. I need some water. So, you know, and they say they keep going in there to check on her. But how do I know what's going on or not going on?
JAFFE: Yet, calling his mom directly just seemed to make things worse.
GONZALEZ: She became more agitated, wondering, well, where are you? Why aren't you here? Come get me out of here. And it would end up with her sobbing and just - it's sort of like my calls were just creating more stress for her.
JAFFE: Banning all nonessential people from nursing homes may have been a wise move at the beginning of the COVID-19 outbreak, but now the policy needs to be reconsidered, says Tony Chicotel, a staff attorney with California Advocates for Nursing Home Reform. For one thing, the ban hasn't kept COVID-19 out of nursing homes.
TONY CHICOTEL: The virus finds its way into the building through whoever's coming in, whether it's staff or visitors.
JAFFE: And it's likely to keep finding its way into nursing homes as long as it's in the community at large. The Centers for Medicare & Medicaid Services have published guidelines for how nursing homes might reopen to visitors, but the agency says it will ultimately be up to state and local leaders to set the rules. Tony Chicotel says his organization has a proposal that could work right now.
CHICOTEL: For those family members who provide support to that person's quality of life in ways that the staff probably just can't, those family members should have access to residents as long as they follow the same safety protocols that the staff are following.
JAFFE: Nancy Snider would've given anything for that. Her husband, Matt, was in a Michigan nursing home for many years with Huntington's disease.
NANCY SNIDER: It's one of the worst diseases someone can have. And he's battled it like a warrior for all these years.
JAFFE: Either she or her daughter saw Matt almost every day.
SNIDER: Like if we'd go in and his shirt needed changed or his bedding wasn't changed or if he still had some food from breakfast on his face, you know, we would do that - just basically anything.
JAFFE: And without that help and human contact, his decline was stunning. His weight dropped to about 90 pounds.
SNIDER: For Matt, unfortunately, it's too late now. He's actively dying.
JAFFE: Nancy Snider says the ban on visitors cheated her of her time with Matt in his final days. Shortly after we spoke, she moved him to a hospice facility that allowed family visitors. He died a few days later with his wife and his daughter holding his hands.
Ina Jaffe, NPR News.
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