Last June, I attended the funeral and military honors of my 95-year-old grandfather. In the nursing home where he had moved to within the last year, he tested positive for COVID-19 and, although asymptomatic, was moved to isolation. Soon after he stopped eating and drinking and passed away as a result. I was able to talk to him once (on Facetime) the last week of his life, but no one was allowed to visit him. This forced isolation was a mistake not backed up by science. In June of 2020, a case study in the Netherlands found no resurgence of COVID infections when nursing homes increased visitation by allowing one visitor per resident, spacing out guests, enforcing social distancing and mask wearing .
A bill pending in the Colorado legislature seeks to reasonably restrict such cruel forced isolation moving forward.
Brandee Gillham, from Peetz, Colorado provides insight into her own experience when her father-in-law was locked away from his loved ones for the last 19 days of his life. “Not once did a single medical professional say it was in my father-in-law’s best interest to separate him from his family and not one person within the medical facility would actually move the stonewall in front of us that allowed us to be family. All of them disagreed with the system and yet willingly obeyed. All semblance of logical, rational, or independent thought seems obliterated.”
Gillham isn’t the only Coloradan to have issues with their loved ones being isolated. From March 2020 to March 2021 the Colorado Department of Public Health and Environment (CDPHE) received 52 complaints about visitation policies. Considering that list only includes those who were able to figure out the how, what, when and where to go to file a complaint, the number of families that objected to their visitation rights being taken away is probably much higher. Just look at the protests in October that happened outside of a Greeley nursing home. While I understand the desire to prevent the spread of a virus that is especially dangerous to the elderly, there are valid policies that can be implemented to prevent other families from having to see their loved ones treated like prisoners.
State Representative Tim Geitner and Senators Jim Smallwood and Joann Ginal are trying to address these problems with House Bill 21-1172, the “No Patient or Resident Left Alone Act”.
This bill would require any hospital, nursing care facility or assisted living residence to have written policies and procedures regarding the visitation rights of patients and residents. The summary of the bill states that it “prohibits a health-care facility from adopting policies or procedures that prohibit visitation of a patient or resident if the sole reason for the prohibition is to reduce the risk of transmission of a pandemic disease.”
Personally, I struggle with additional government regulation that imposes more restrictions on private enterprises. However, considering the CDPHE licenses and regulates 3,620 health care facilities in the state, it looks like we need to set boundaries to protect the few civil liberties we still now enjoy. Under Governor Jared Polis, the CDPHE has expanded their power beyond what should be allowed. Here’s how this happened.
The Federal Nursing Home Reform Act of 1987 guaranteed that nursing home residents have a right to “visitors of his or her choosing, at any time, and the right to refuse visitors.” However, in certain circumstances, Section 1135 of the Federal Social Security Act allows the Secretary of the Department of Health and Human Services (HHS) to temporarily modify or waive certain Medicare and Medicaid requirements. Under the HHS is the Centers for Medicare & Medicaid Services (CMS). When the HHS Section 1135 waiver went into effect last year it allowed states the ability to restrict all visitation to all facilities whether CMS funded or private paid. Even though CMS is a federal agency, states are actually the only enforcers of CMS guidance. In September 2020, CMS provided guidance that allows family and friends to visit their loved ones under certain rules. CMS even offered funds to purchase tents for outdoor visitation and/or clear dividers. But even after this guidance was released, states like Colorado decided to ignore it.
Thankfully, there have been people all over the United States who have been fighting back against these government policies. Lori Smetanka, Executive director of the National Consumer Voice for Quality Long-Term Care, has been advocating for policies that return rights to the over 2 million people living in nursing homes. She argues that we must create and require “family visitation policies to be mandatory, not optional.” Her organization helped start the movement to fight for our loved ones in nursing homes with the organization Visitation Saves Lives.
Maitely Weissman is a co-founder of the Essential Caregivers Coalition, an organization fighting for “formal recognition of essential caregivers in public health policy.” She believes that essential caregivers should be able to provide the special kind of care that only close loved ones can. She wants these caregivers to follow the same safety mandates as the paid staff working in care facilities. Her organization along others such as the Nursing Home Lives Matter campaign, have created the website isolationkills.org to help caregivers find others in their state working to restore rights to residents in long term care facilities.
This fight is backed up by solid science. Bert Uchino, a University of Utah professor and researcher who studies how social relationships influence health, argues that “The combination of social isolation and loneliness is very unhealthy for anyone, but for older adults, it’s particularly bad…Just about every biological system is impacted in one way or another by psychosocial relationships.”
Other experts argue that “The sudden disruption in residents’ contact with loved ones has caused notable declines in residents’ cognition and function, depression, as well as anguish for family members.” A 2012 study on loneliness in seniors found that it was linked to a greater risk of death. It is quite literally “a predictor of further decline and death”. A Doctor who cares for patients in 25 nursing homes across San Diego California, Dr. Aram Harijan, said that without family visits some residents stop eating, potentially leading to starvation.
My 95 year old grandfather’s death is a perfect example of what Dr. Harijan is describing.
Common sense solutions that work should play a larger role in how decisions are being made. Policy makers should work to restrain the power of state bureaucracies in order to protect those most vulnerable.
As currently written, HB 1172 addresses the visitation rights that have been taken away from residents living in Colorado healthcare facilities. I urge you to please contact each one of the members of the House Health & Insurance Committee and urge them to pass this bill out of committee.
Karl Honegger is a board member of the Colorado Union of Taxpayers. He lives in Broomfield
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