Long-term care visitation policies vary as COVID-19 cases rise - Roll Call

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States are addressing the issue through a variety of policies, leading to a patchwork of approaches in different types of facilities or in different areas. 

Health care providers say prolonged separation accelerates cognitive and emotional decline in long-term care patients.

Ashwin Kotwal, a geriatrician and assistant professor at the University of California, San Francisco, said the virus restrictions take both a physical and mental toll. Patients lose muscle mass faster when confined to their rooms or beds, making them more prone to falls. He has also seen depression spike in his patients, brought on by loneliness.

“You can prescribe the antidepressants and medications, but that's not targeting the underlying cause,” he told CQ Roll Call. “And for many of my patients — especially those diagnosed with serious illnesses, like cancer, or end-stage [chronic obstructive pulmonary disease], or heart failure — we’re thinking about people who might be in the last years or decades of their life. And the idea of having to go through these prolonged social restrictions with no clear end in sight, you can really see why people become hopeless.”

State and federal conflicts

Long-term care facilities are restricting visitors once again as the United States continues to log record-breaking new case numbers. Guidance from the Centers for Medicare and Medicaid Services, which oversees nursing homes, calls for facilities to halt most indoor visitation if there have been any COVID-19 cases at the institution in the past 14 days, or if the county positivity rate is above 10 percent. The exception is for instances of “compassionate care,” which include but are not limited to end-of-life situations, emotional crises or instances of a patient’s rapid decline.

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