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As the number of COVID-19 cases decreases, the Ministry of Health is loosening the restrictions. The industries that were closed so far are slowly opening up. Already in March, primary care physicians started seeing patients in clinics, and planned procedures are resuming. Are we also ready to allow families of patients to visit hospitals? Will the residents of DPS deprived of contact with their relatives be able to hug their relatives soon? Decisions were left to the directors of individual institutions.
- Families of people staying in nursing homes still have problems with visiting
- I imagined my son thought I’d abandoned him. Forever – says Mrs. Małgorzata, who was unable to meet him for many months
- Ms. Beata was in a similar situation: – The coronavirus has not disappeared, it’s true, but I’m afraid that one more month of not seeing me and my mother will not recognize me at all
- You can find more such stories on the TvoiLokony home page
Most DPS and nursing homes are still closed
In March 2020, the Ministry of Family, Labor and Social Policy prepared recommendations regarding the limitation of visits and access to the premises of the DPS by outsiders. According to the report of the Helsinki Foundation for Human Rights prepared at the end of 2020, most local governments to which these institutions are subject ordered the introduction of restrictions in the form of a ban on visits or the use of special procedures.
Before entering the Nursing Home, visitors were to be quickly tested for the presence of coronavirus, and the meeting place was designated in the open air; of course, sanitary regimes had to be respected as well. Overall, however, contact was suspended. Let us remind you that, according to the Minister of Family and Social Policy, Marlena Maląg, Currently, nearly 113 thousand people live in stationary institutions and nursing homes. people.
Last summer The Ministry of Family, Labor and Social Policy pointed to the possibility of lifting the restrictions, but left the final decision to the directors of the institutions. These, in turn, as the said report says, were afraid to ease the rigors and make decisions. They argued that the guidelines of the Chief Sanitary Inspector were too general.
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Later in the report of the Helsinki foundation we read that “long-term isolation and limitation of interpersonal contacts negatively affected the well-being and health of the inhabitants and limited their environmental rehabilitation”. In institutions, there were also growing conflicts, difficult situations, apathy, and closing in on oneself. Although DPSs were obliged to ensure the possibility of maintaining relationships between residents and relatives via telephone or the Internet, there were major problems with it, mainly due to staff shortages.
The authors of the report remind that DPS residents have the right to privacy and family life protection under Art. 8 of the Convention for the Protection of Human Rights and Fundamental Freedoms and Art. 47 of the Polish Constitution, as well as Art. 49 of the Polish Constitution in the field of freedom of communication), and the fact of staying in this type of facility cannot deprive them of the implementation of this right. It includes, inter alia, the ability to maintain relationships with the outside world, contacts with family, friends and loved ones.
Deputy Minister of Family and Social Policy, Stanisław Szwed, informed in March 2021 that the ministry asked voivodes and directors of nursing homes to ease the restrictions on visiting residents while maintaining security measures. He also noted that the final decision will always rest with the director of the facility after consultation with the Sanepid.
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Most of the DPS were still closed throughout April, not much changed in May. The directors argued that the ban should be maintained, inter alia the fact that not all charges were vaccinated because, for example, their family did not agree to it. Meanwhile, the lack of real contact is a huge stress not only for people staying in nursing homes, but also for their families.
The review of the situation performed by the Helsinki Foundation did not apply to private nursing homes, and they were not covered by public support, e.g. in terms of access to tests, personal protective equipment and disinfectants.
The family has a voice
Ms Małgorzata, whose son has been living in DPS-e for several years in a large provincial city, says:
– My son is now an adult and we see each other regularly over the years since he has been in the nursing home. I take him home for Christmas and almost all weekends.
The son does not speak and does not understand how the days go by, but if we do not see each other for a long time, longer than usual, when we see each other, he is a bit offended and shows a clear dissatisfaction at the beginning of the meeting.
When the pandemic started, at first I just quietly waited until I could see it, and the lockdown was completely understandable to me. Unfortunately, I felt worse and worse, because I realized that because he does not speak and we do not know exactly how much he understands, I am not able to call him and explain to him why we are not seeing each other. I imagined he thought I’d abandoned him. For ever. I tried not to worry about it, but it was very difficult for me.
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In the summer it turned out that I could visit, but I was not allowed to take him home. A special gazebo in the garden was built in the facility, where you could meet for 15 minutes. Of course, I took this opportunity immediately, but our meeting turned out to be terrible. At first, my son didn’t even look at me. I had the impression that after these months of non-sight, she is in much worse condition. He also didn’t want me to hold his hand. It was one great despair … I quickly arranged for another meeting. This time it was a bit better, although the experience was still horrible. Soon the facility door slammed shut again, and the possibility of short meetings disappeared. I felt a lot worse because I saw how bad he was, he was shuffling, he seemed old and very, very sad.
To make matters worse, the son fell ill with COVID-19 in November and was taken to hospital. I experienced enormous stress because I couldn’t get a call anywhere, nobody wanted to talk to me, even though I am my child’s legal guardian. Fortunately, the son was slightly infected. Then I took advantage of the legal loophole.
Our son does not live with us because we are unable to look after him and work at the same time. When he was released from the hospital, I took a few days off and took him home. I was very scared of what might have happened in the hospital, but luckily we finally got to see each other and it was really touching. During this time of not seeing, it constantly seemed to me that I also had COVID-19 because I had a headache all the time. Meanwhile, when I saw him, touched him, the pain immediately subsided.
I can say that the fact that Daniel was infected was a really lucky twist of fate for us, because we were finally able to see each other. The long, several months’ separation ended.
Later, despite the fact that there were still no visits to the facility where he lives, we managed to negotiate that we could take him home as a healer. Instead, I tried not to imagine what he was thinking and how he felt that he might feel abandoned and didn’t know what was going on. It is difficult for me, because the ban on meetings is still in force, the fact that my son is already vaccinated does not help, and I also underwent COVID-19 in the meantime. I manage to negotiate a meeting only thanks to the good will of the management of the facility.
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What harm can such a separation cause for a person whose mental balance is as fragile as that of a resident of a nursing home? I don’t think we can imagine it. I also think that a mechanical approach to human needs, that is, we have a pandemic and close those who are unable to protest, we deny them the closeness of the family, is cruel and harmful in the long run. Someone might say yes, but people are dying from COVID-19. But people also die of longing …
As far as I know, the problem is that staff are not obliged to get vaccinated, so we don’t know, because we don’t talk about how much of it is already vaccinated. This is a factor that adds to the confusion.
Mrs. Beata has a mother in the nursing home.
– My mother recently turned 90 and unfortunately her condition has deteriorated significantly recently. He is still physically fit, but his head is in trouble. In the fall, she stopped distinguishing between day and night, and even became active at night, calling her family at 2-3 in the morning. She began to live in her world. At first, a babysitter would come to her for a few hours during the day, but soon my mother required XNUMX/XNUMX supervision.
Both my husband and I work a lot, and the night alarms made it impossible for us to function normally. We decided to place our mother in a nursing home. It is a private and quite expensive facility. This year I haven’t seen my mother yet. Visits have been paused and we can watch parents thanks to live coverage from staff phones. They show us how our loved ones are doing, for example, in improvement classes. As for me, it is a bit too little, because in addition, a telephone conversation with my mother is usually not possible. Her dementia is progressing …
All nursing home residents were vaccinated earlier this year, and I, as a healthcare professional, also had two doses of the Pfizer / Biontech vaccine a long time ago. Therefore, I was unpleasantly surprised when the director of the facility did not allow me to visit my mother. He argued that despite being vaccinated, I could still spread the virus. The coronavirus has not disappeared, it’s true, but I’m afraid that one more month of not seeing me and my mother will not recognize me at all.
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Recently, with the fall in the incidence of COVID-19, there has been a spark of hope, reportedly parental visits in compliance with the sanitary regime – necessarily wearing masks – are to be restored this month. I am happy and, at the same time, a little worried. I will never make up for what I lost – says Beata.
The great majority of hospitals still do not allow families to enter wards
We look at the situation in hospitals a bit differently. The responses to isolation of both patients and their families are different.
People hospitalized, especially for a short time, see no special problem. Many say that without visiting it is even more convenient for them, because processions of family and friends to all beds in a multi-person room can be tiring. It is known that hand-holding is lacking, but everyone has a phone with them and when the prospect of returning home is determined, the problem seems marginal. What counts is the therapeutic process, good doctors, efficient nurses, because the sum of their activities guarantees a return home in good health, which is what it is all about.
Doctors, on the other hand, pay attention to the peace they have gained from the pandemic. Many relatives of the patients lacked deeper reflection and responsibility, and each attention ended in aggression. Hence, most advocate a slow and gradual lifting of visiting restrictions. The situation is different, for example, in gynecological wards. Future mothers who wanted to give birth very much in the company of her husband, unfortunately, do not have such an opportunity.
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However, there are places where work has been organized in such a way that the sick were given a chance to meet their relatives. Interestingly, such a possibility also exists in the case of the infectious diseases ward, where COVID-19 patients are treated.
Dr. Paweł Basiukiewicz, head of the covid department at the Western Hospital in Grodzisk Mazowiecki, says: – We organized it in such a way that the family was asked to write an application for the possibility of visiting. These are formal and administrative issues, but we do not put any obstacles. At the entrance, everyone is informed that they are entering the infectious diseases ward, where there is a threat of coronavirus infection, especially if it is a so-called high-risk visitor. Besides, most of the visitors are convalescents or have already been vaccinated. We have been operating this way almost since December. During this time, one person withdrew from visiting after being informed. Generally people know where they come – says the doctor.
And he adds: – Before entering the room, they are given personal protective equipment, which is not lacking. They get dressed and go to the room. We try to provide visitors with maximum discretion and intimacy, nobody stands over outsiders and looks at their hands. However, you must always be aware of the risks. Nevertheless, in many fields this presumed risk is low – if someone touches a door handle that someone who greeted someone with coronavirus has previously touched, they are unlikely to get infected. We know from mid-2020 that the coronavirus does not spread through flat surfaces. These types of infections are incidental. Everyone who enters and leaves the ward washes and disinfects their hands. Visitors are aware of the sanitary rules and do not make any claims.
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Dr. Basiukiewicz says that first there was little interest in the visits. – At the beginning, the visit was timid, because the staff was afraid of claims in case someone got infected after all. However, I have always believed that it is worth taking this small risk in exchange for the benefits that the patient and his family receive. At first, the visits were incidental, but now relatives visit the sick without any problems. Their organization is at the discretion of the hospital management and in most hospitals these visits are indeed limited. I understand the restrictions in such a way that we do not let five guests to the patient on R-kęka, as it used to be before. We organize the procedures, let one person in, and we also want to keep other patients intimacy. They may feel uncomfortable with crowds of people in the room, apart from epidemic issues. We let one person in, then another may come for an exchange.
How was it received by patients and their families? – The response is good because it is simply needed. During convalescence, the sick need visits to give them strength. It really gives you wings. I had a patient aged 93 and thought she was going to die. She stopped communicating, she had a fever, breathlessness, but her granddaughter came to her, she sat for quite a long time, then she visited her a second time and finally the sick girl went home after a week. It was improving day by day, the doctor continues.
– In medicine, we have stopped appreciating the placebo effect, which is very important. It goes, among others o the influence of emotions, attitude of the patient and the environment towards him. I don’t think you need to convince non-medics to do this, but medics have somehow forgotten how important it is. The placebo effect is sometimes up to 30 percent. therapeutic effect. It’s not that relatives come to the covid ward as a group, but every day someone visits us. They are informed, they put on masks and aprons. They are not scared. Once our seriously ill patient was visited by her husband and son and they played a violin concert in the corridor – says Dr. Basiukiewicz.
– I would like to remind you that the CDC guidelines clearly state that the basic needs of the patient are covered. In this situation, visitation should be allowed. Of course, the visitor must be made aware, should wear personal protective equipment, should have an appointed meeting time and maintain an intimate atmosphere. Hospitals must be encouraged to let patients’ families in, because it has been 14 months when patients do not receive spiritual help – summarizes the physician.
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