Why B.C.'s 'essential visitors only' rule means no visitors at all for most seniors in long-term care

The last time Becky Reichert got to see her mom in person, it was one of those fleeting good days.

Diana, 76, was able to leave her long-term care facility and come to the house for a home-cooked Christmas dinner around the table with her grandchildren.

"I don't know if mom registered what was going on or if mom knew where she was, but she was comfortable. She had a great meal, we got smiles and that's all we've got right now," said Reichert.

The vast majority of seniors living in long-term care homes in B.C. – Diana included – do not have an officially designated essential visitor on file with their facility. This means an "essential visitors only" restriction makes it so they do not get any visitors at all.

Families and advocates say they don't understand why B.C. hasn't yet made it mandatory for every long-term care resident in the province to have at least one essential visitor of their choosing.

"We have couples who've lived together for 75 years who've been dramatically separated, to start with, by one of them having to go into care," said Isobel Mackenzie, B.C.'s seniors' advocate.

"Often the other spouse will visit every day and now they can't visit at all."

Visitors can help during staffing crunches: Mackenzie

As of Jan. 1, the province has limited visits to long-term care homes to one essential visitor per resident. Provincial Health Officer Dr. Bonnie Henry said the cutback was made because a number of care homes were struggling with staffing.

Both Reichert and Mackenzie understand why visitation needs to be tightened as the highly transmissible Omicron variant races across the province. But they said denying residents a single, fully vaccinated, rapid-tested visitor doesn't make sense when workers need an extra hand.

Family members often help with tasks like getting dressed, combing hair, or going for a walk – tasks that can fall to the wayside when employees are overworked.

"On a functional level, I suppose they can keep her alive. But staff can't look through photos and name people and tell stories that mom doesn't remember anymore. Staff can't give her hugs," said Reichert.

Currently, it's up to individual care homes to decide who's approved as an essential visitor. More than half of people who applied for essential visitor status in the first four months of the pandemic were denied, a survey of care-home residents and their families found. 

The survey also found more than half of residents saw a major decline in cognitive function and emotional well-being after losing visitation. The proportion of residents who started taking anti-psychotics and anti-depressants rose by seven and three per cent, respectively. 

Those changes come on quickly, Mackenzie noted.

"Even if it's only for two or three weeks ... some people are going to go into a deep depression, they're going to withdraw, they're not going to eat," said Mackenzie, who's worked in seniors' care for 25 years.

Restrictions to be 're-evaluated' this month

Mackenzie has been asking the province for more than a year to make it mandatory that residents be entitled to at least one essential visitor. So far, fewer than 25 per cent have that contact on file.

Provincial Health Officer Dr. Bonnie Henry did not respond directly to a question Tuesday about whether the province plans to make it mandatory for each resident to have an essential visitor in B.C.

Instead, she reiterated that the province plans to open up visitation as soon as screening is more widely available.

"The intent was always once we got the rapid testing available and had more plans in place to support staffing, that we would transition to one designated social visitor per resident in addition to essential visitors," she said. 

The restrictions are set to be re-evaluated on Jan. 18 — but Reichert isn't holding her breath.

"My big fear ... is we're heading back into this awful reality of getting glimpses of of how your loved one might be doing for months," she said.

"I'm terrified that we're reliving a nightmare."