Visiting Loved Ones in Long-Term Care Facilities and Nursing Homes – Latest Guidelines

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Governor Inslee recently announced new visiting rules for long-term care facilities and nursing homes, which will give some families and friends increased access to see their loved ones. We know that people who live in nursing homes and other long-term care facilities are often older adults and people with chronic health conditions—the groups who are at highest risk of complications from COVID-19. Since people live together in close proximity in these facilities, COVID-19 can easily spread within these environments, so protections were put in place to safeguard residents from the disease.

The new visiting rules will include a four-phase plan that is different from the state’s four-phase Safe Start Plan for counties that you may have heard about. Nursing homes and long-term care facilities cannot be in a more advanced phase than the counties they are in (Skagit County is currently in phase 2). Facilities will also stay in phase 1 if the local COVID case rate per 100,000 residents exceeds 75, which Skagit County currently exceeds as of August 26.

The new rules took effect on August 12, and family members should check with the facility their loved one lives in, because not every site may be able to conduct visits right away. It may take some time for facilities to work through the application and approval process with Washington State.

What will visiting look like in the different phases?

Depending on the phase, visiting access will differ. As of the time of this article, Skagit County remains in phase 1 with a high risk level.

Long-Term Care Facilities in Phase 1:

  • Indoor visits are limited to compassionate care situations. Compassionate care situations include end-of-life circumstances and for psychosocial needs (ex. distress brought on by the death of a loved one or a sudden lifestyle change).
  • Outdoor visits are allowed and limited to two visitors per resident per visit. These visits must include masking, social distancing, and appropriate hygiene.
  • Facilities may invite “window visits” at their discretion with safety protocols in place.
  • Remote visitation through technology must be facilitated.

Additional Access for Long-Term Care Facilities in Phase 2:

  • Adds ability of a designated “essential support person” to visit a resident once per day if the resident is unable to participate in outdoor visits and if remote visitation technology is unavailable.

Additional Access for Long-Term Care Facilities in Phase 3:

  • Indoor visits are generally permitted, with limitations. Facilities will establish visitor hours, visitor limits, and safety precautions. Preference should be given to outdoor visits.

Additional Access for Long-Term Care Facilities in Phase 4:

  • Normal visitation resumes.
The graduated restart plan is based off of the Washington State Safe Start Model.

Families should also know that a facility or agency must meet certain criteria before entering a new phase, including a current 28-day period without a resident or staff member testing positive for COVID-19 and having at least a 14-day supply of Personal Protective Equipment (PPE) stocked.

Questions or Need Help for a Loved One?

This can be a stressful time for family members and caregivers. Washington State has established a FamHelp Long-Term Care Phone Hotline at (888) 856-5691 that is open between 6 a.m. and 10 p.m. to answer questions about long-term care and other DSHS facilities.


Reach Out: We Can All Do Our Part

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Social distancing has impacted us all differently. For some people, it has meant spending day-in and day-out with antsy children, while others have had way too much time on their hands. Others may be experiencing unexpected financial hardship due to COVID-19, causing an increase in stress and anxiety.

For some older adults in our community, social distancing has put a lot of new restrictions on their ability to access care and resources, as well as their ability to connect with the outside world. Thankfully, there is a lot each individual can do to support the emotional well-being of our senior population. We can all do our part!

The American Foundation for Suicide Prevention has a list of ideas for reaching out to our senior population during this time:

  1. Check in regularly on your older adult friends, neighbors and family members.
  2. Call or video chat with them, since texting and social media may not be the best method of connecting. (Note: You may need to help friends and loved ones with new technology!)
  3. Seek advice from them based on their experience and wisdom. People realizing they are needed can make all the difference!
  4. Ask how they are doing during this period of time, how their routines might have had to change, and what kinds of things they are doing to cope with the stress. Encourage your loved ones to stay connected with community by reaching out to your local senior center for ideas.  
  5. Encourage them to keep doing activities that are safe during COVID for their local area, and that they identify as being most helpful for them, such as daily exercise or a walk, stretching, listening to or playing music, reading, enjoying favorite or humorous shows, puzzles, games, social activities, and meditation or prayer. Here are some activity ideas from AARP, and the National Institute on Aging. (Note: While it is still required that we keep a 6-foot distance and wear masks, there are many safe activities that can be done outdoors with loved ones that follow these requirements and minimize chances of transmission.)
  6. Help them seek medical advice or care if they are experiencing symptoms of physical or mental health decline.
  7. Offer to bring them a meal, run an errand, or walk their dog. Call Skagit County Public Health at (360) 416-1500 to get information about senior nutrition assistance.
  8. Express gratitude and appreciation for any support you get from your relationship with them. Let them know what you admire about the way they conduct their life.

All of the above ideas can be accomplished without much direct physical interaction, which is great during a time when we must adhere to social distancing requirements. It is important to remember that there is a big difference between “social distancing” versus “physical distancing.” Just because we are keeping our physical distance does not mean that we cannot still socialize. We just need to be more mindful about the ways we do it!

When connecting with loved ones, make sure to look out for possible signs of social isolation, anxiety, or depression. It is important to reach out early and often, because mental health issues—just like physical health issues—can become very serious if left unchecked.

Signs that a person might be isolated:

  • Deep boredom, general lack of interest and withdrawal
  • Losing interest in personal hygiene
  • Poor eating and nutrition
  • Significant disrepair, clutter and hoarding in the home

Where can you find support if you recognize any of the signs above?

If someone is experiencing excess stress due to COVID-19, call Washington Listens at 833-681-0211 for support and resources.

What to do if someone is experiencing a mental health crisis?

Where can you direct local seniors if they are experiencing hardship due to quarantine or isolation?

At-risk individuals who are in quarantine or isolation and find themselves in need of assistance with getting/picking up supplies or food can call the Skagit County Resource Assistance Line at (360) 416-1892 between 8 a.m. and 4:30 p.m. daily.