Some Ontario doctors, families worry rules for care home visits causing harm to residents

The province's new COVID-19 visitor guidelines for care-home settings are "overly-restrictive" and "a little bit cruel," says a doctor with a 91-year-old grandmother in a Toronto retirement home. 

"When homes are focusing simply on case counts and deaths and they're missing the collateral damage here, they're not showing the full picture of what is going on and what the side effects are of these lockdowns," said Dr. Nathan Stall.

Stall, a geriatrician who practises at Mount Sinai Hospital, is the grandson of Naomi Berger, 91, who lives at Toronto's Amica On The Avenue retirement home. She is allowed one visit a week by one visitor for 30 minutes in a face mask and at a distance. 

"We're worried about the physical deterioration," Stall told CBC Toronto. 

He's joining a chorus of families, researchers and physicians who argue the province's new COVID-19 visitation guidelines at long-term care homes, retirement homes and other residential care settings are inappropriate. 

Last Thursday, the province announced it would allow for a "gradual resumption of visits" in these care settings. However, the plan comes with "strict health and safety guidelines" and care-homes are allowed to tailor them "to their individual circumstances." 

Stall says the problem is many "homes are going rogue" and taking the easy way out. He says they are continuing complete lockdown measures, because it is easier and less expensive than letting people interact with their loved ones in full protective equipment. 

"For-profit corporations are choosing to go above and beyond that, to implement their own conservative policies, restricting access to loved ones in these facilities and that's terribly distressing," he said. 

Care home 'taking proactive measures,' manager says

Chris Huggins, the general manager for Amica On The Avenue, says the retirement home is following provincial guidelines.

In a written statement to CBC Toronto, Huggins says visitors are allowed in the building if they test negative for COVID-19 and wear a surgical or procedural mask and maintain a physical distance. 

"Since the beginning of the pandemic, we have taken proactive measures that went above and beyond stated guidelines to ensure the health and safety of our residents and team members," Huggins writes.

"This approach, when carefully followed, has proven to be most effective at stopping the transmission of COVID-19 in its tracks." 

The home was in outbreak status as of April 7, when two residents tested positive. Both have recovered and the outbreak was declared over on May 12, Huggins said. 

Just recently, a staff member tested positive for the novel coronavirus. However, Huggins says that staff member was wearing personal protective equipment when interacting with patients, and the "risk to our residents is low." 

'She thinks she's been forgotten'

After months of separation, Anil Reddi wore a mask as he finally met face-to-face with his 93-year-old mother outside her long-term care home in East York, but still they weren't able to hold hands. 

"Right now, she thinks she's been forgotten. She doesn't know she is loved. I want that to change," said Reddi. 

Monday, Reddi lined up to get a test for the novel coronavirus, hoping next time he'll be able to go inside. 

"It broke my heart just to see her like that, just to see her sort of wasting away," Reddi said.

"She may survive COVID, but I don't know if she's going to survive the separation. She's so down. She's stopped eating." 

Ontario Health Minister Christine Elliott defended the guidelines Monday.  Provincial officials devised the plan with many "considerations," she said. 

"Not everybody is going to agree on exactly everything that is going to be done during this pandemic," Elliott told reporters at the daily provincial COVID-19 briefing Monday. 

"But this has been done by public health experts that are knowledgeable about the transmission of the disease and they want to make sure family members can see each other in the safest way possible." 

Ontario public health officials say about half of the province's 630 long-term care facilities have reported outbreaks of COVID-19, though fewer than 70 remain active.

Vivian Stamatopoulos, a researcher at Oshawa's Ontario Tech University who specializes in family care giving and long- term care, says families provide "substantial, important care that is required to fill in the gaps" that she says exist in the system.  

"In general, isolation has deadly impacts on the elderly," she said. 

She doesn't think the government has done a good enough job weighing the risks of infection against the risk of isolation. 
 
"I think these guidelines are quite frankly ridiculous and I think they were a slap in the face to family, who have been waiting very patiently in anguish for over three months now for some sort of solace and opportunity to see their loved ones."