Family caregivers can return to Nova Scotia long-term care homes

The easing of COVID-19 restrictions for those in long-term care across Nova Scotia is nothing short of life-saving, according to some families.

On Tuesday, the province announced that designated caregivers will soon be able to help support and care for residents once again.

These designated caregivers could be family, friends, or other support people. They must help with specific caregiving tasks like personal care, mobility or eating, and have an established relationship with the resident prior to the pandemic.

"It's going to save lives," said Catherine Johnston, whose 92-year-old father has been at Camp Hill for four years.

Restrictions lifted as of Friday

Long-term care facilities will work with residents and families to identify up to two designated caregivers per resident, but only one may visit at a time.

Individual care homes will work to bring in these changes as early as Friday.

Johnston said her father, who deals with Parkinsons, is also a Second World War D-Day veteran.

Over the past few months, Johnston said in their limited visitations family members have had to watch the constant mental and physical deterioration of loved ones before their eyes.

"Some have already died and others were going to die very soon, because you cannot keep somebody in confinement for six months without any contact with a loved one," she said.

Since mid-June, people have been able to visit loved ones in long-term care homes but they had to stay outdoors and keep two metres apart.

Now, Johnston said she can help her dad with daily tasks like holding a glass of water for him, or helping him make decisions.

Johnston said her father still has a strong mind but a very difficult time speaking, so they have a special way of communicating. She can also wait 15 minutes for him to get a message across, if that's what it takes, and she said no one else would do that for him.

At one point, Johnston said her father told her he was beginning to feel like he was in solitary confinement and the situation was "worse than prison."

Although Johnston said her father is mentally very strong, even he was losing hope that restrictions would ever be lifted as they watched all other sectors of society start to open up again.

"Unfortunately, because COVID is of course harder on our loved ones in long-term care, they just were left behind," Johnston said.

The caregivers will also be trained on public health requirements including masking, good hand and respiratory hygiene, and procedures at each facility. Each caregiver will be provided medical masks to wear while with residents.

Facilities will also set up processes to screen caregivers upon entry, and easily identify them in the building.

Potential caregivers should make arrangements with individual facilities for training and visitation.

Most families still won't benefit from change

Michele Lowe, managing director of the Nursing Homes of Nova Scotia Association, said the announcement is great news, but that it's likely a small number of people will benefit from the change.

She said designated caregivers are the people who, before the pandemic, would show up faithfully to support the feeding and basic care of a resident for several hours a day.

"This is not an opportunity just to come in for a visit all day. There's a specific rule that has been identified," Lowe said.

But there is no time limit on how long caregivers can stay, she added.

For those families looking to drop in for a visit, this change is "not for them," Lowe said.

The new rules will also impact some nursing homes differently than others, Lowe said, since buildings with private rooms can more easily bring in caregivers than those with shared rooms.

In a small shared space, a caregiver is not just interacting with their loved one but exposing the other person to a new situation they may not want, Lowe said.

Getting around these barriers would be much easier with more government investment into buildings with single rooms, which the long-term care sector has long been calling for, Lowe said.

Another challenge is there is no new funding attached to this announcement, Lowe said, even though this is a full-time job for two or three staff who have to train family members and ensure they're following protocols.

But Lowe said in a short-staffed sector like long-term share, if it comes down to making sure residents are properly fed and cared for versus training a family member, staff won't be redirected just to "support a level of visitation."

Another issue is that some larger Canadian insurers made exclusions in their liability insurance for long-term care facilities, Lowe said, and while they've worked with the province there are still holes there.

For some nursing homes, it's just too much of a liability to bring people in who aren't staff and who could catch COVID-19 or bring it in, she said.

"That certainly has some administrators very, very concerned about moving forward with this," Lowe said.

Families hope mental, emotional support recognized

Lesley Barnes, whose father is also in Camp Hill, said that regular staff are wonderful but "they can't do what family can do."

Barnes said she is hoping the new rules cover people coming in to help with residents' mental and emotional needs as well as physical, although the province didn't spell that out specifically in their announcement.

"He gets up everyday and he says, 'What's the point now of getting up when I know I'm not going to see you until next [week]?'" Barnes said.

She is also concerned that not all long-term care homes will cooperate with the new guidelines, and has heard some have already stated they won't allow indoor visits out of concerns for limited space.

There are 133 licensed long-term care facilities in Nova Scotia.