Visiting or not remains a dilemma in some nursing homes

What’s next in nursing homes? The vast majority of the population has been vaccinated, and the number of outbreaks appears to remain stable, but nursing homes have not yet abandoned freedom-restricting measures.

Some establishments are still closing their doors to visitors in the event of the Corona outbreak. Like De Beekwal Nursing Home in Erbeek in Gelderland, where 17 residents and a group of staff contracted the virus last week. All 125 residents (vaccinated) must stay in their rooms. They are not allowed to receive visitors until Wednesday. “In order not to further spread the virus,” a spokesperson for the health care institution said.

Other nursing homes with small outbreaks – currently around 170 in the Netherlands – sometimes choose to isolate only infected residents, or temporarily close smaller living groups. The Aged Care Sub-Association Actiz calls it ‘Personalisation’.

Read also: One day it wasn’t easy in the nursing home

These measures are in line with current guidelines, says a spokesperson for the Ministry of Health: In the event of an outbreak, part of the site will be temporarily closed to visitors. But is this still necessary, now that all nursing home residents who want it have been vaccinated?

Yes, says professor of geriatrics Cies Hertog, who advises Cabinet as a member of the OMT. We are in an uncertain phase of the epidemic. We do not yet know how long the effects of vaccinations will last and whether we can expect the same effectiveness in the elderly. So we will have to organize visits in case of an outbreak, especially in organizations with low vaccination coverage.”

No, says geriatrics professor Marcel Old Reckert. “Residents of nursing homes are an at-risk group, but vaccinations have greatly reduced that risk. We are now in a different situation than last year.”

Loneliness

Olde Rikkert conducted Radboudumc’s research into the effects of corona isolation among the elderly. He did not notice any additional complaints of depression, but found an increased feeling of loneliness. Enough reason to be so careful about restrictions, according to Oldie Reckert. “With this group you cannot seek to eliminate all risks. In nursing homes where elderly people are spending their last lives, well-being should be a higher priority than surviving as long as possible.”

At most, you should consider measures for residents who are known to be unresponsive to vaccinations due to an illness and who want to protect themselves additionally, Oldie Reckert says.

Joris Celts, Professor Emeritus of Geriatrics, goes further. He describes it as “unheard” that the elderly are deprived of contacting their loved ones because of Corona. Life expectancy in nursing homes is often less than a year. Whether these people died a few months ago or after that is completely trivial. The question should be: How do Do they die right? when. “

According to Slates, the end of the good life is about finding peace and tranquility with loved ones. “This is the most important thing left in that last stage of life. And that contact with loved ones would allow the nursing home director to reject us, or else a few infections that you would walk around in could lead to an early death? It is absolutely absurd. These people are already living in Face death!”

Is the virus resistant to much at the expense of the well-being of the elderly in the last stage of their lives? OMT member Cees Hertogh believes this is a “false contradiction”. “It is very easy to say: give up infection prevention. And then? As if living with infection is so much fun. When the virus broke out in nursing homes last year, it had devastating effects. Even the people who survived experienced a decline in their quality of life. “.

Now that many nursing home residents have been vaccinated, Hertog thinks it’s still too early to abandon these measures. Although the population gets sick less often, Hertog also points to recent international studies suggesting that the potency of vaccines diminishes after a few months and that frail elderly people may be less protected. “But we don’t know enough yet what that means in the long run.” So Hertog started a study for the UMC in Amsterdam, along with GGD, on the effects of vaccines in nursing homes. “We hope that this study will provide further guidance, so that we can structure the procedures differently.”

Measurements experience

Jan Hammers, professor of aged care at Maastricht University, says nursing institutions are already testing the same measures. They are looking for solutions to prevent outbreaks, without having to shut down the entire place. Hammers and a group of colleagues have been following 76 nursing homes across the country for more than a year. Their last count, in April, showed that most nursing homes had barely dared to let go. In four out of ten nursing homes, no grandchildren had come. To visit her, and visitors often had to make an appointment.The covering of the mouth was mandatory, and hugs were almost not allowed anywhere.

Hammers have the impression that many nursing homes have since implemented relaxation exercises; The numbers have not yet been received. You hear that there are different reactions now. For example, infected residents are sometimes placed together in a closed pavilion, so that the rest can continue to receive visitors. This is a better solution than imposing a complete ban on visitors.”