Face mask or not? A separate room for visitors or can they just come inside? Nursing homes deal very differently with the corona rules for visitors, it appeared from initial observations by the Academische Werkplaatsen Ouderenzorg, (Academic Work Places for Geriatric Care) across the Netherlands.
Since 11 May, nursing home residents are allowed receive one designated visitor. “We are trying to map out how that works,” says Jan Hamers, professor of Care of Older People at Maastricht University and chairman of the Academische Werkplaats Ouderenzorg Zuid-Limburg (AWO-ZL). How does a home apply the rules, do they adhere to the rules and what are the experiences of residents, family members and employees?
“It is very emotional for everyone,” says Hamers. “Family members are often very happy to be able to see someone again, but also nervous, especially if their loved one has dementia. Will he or she recognise us? It is also a tense time for employees; they think it is great to see the residents having visitors again, but they are also thinking: we kept COVID-19 outside our doors all this time. What if we have an outbreak here after all?”
Partly because of that, everybody is generally sticking to the rules, appeared from the interviews and observations made by the researchers. “Although some did admit to having occasionally given a sneaky kiss or cuddle. The question, of course, is how will the third or fourth visit go.”
But there are considerable differences when it comes to the rules that apply. In some homes, visitors must wear a face mask and gloves, in others they don’t. Sometimes there is a room set up especially for visitors and an employee will also be present to ensure that the rules are abided by, while at other homes residents may have visitors in their own rooms behind closed doors. “Those homes say; we don’t want to know what is going on behind the door,” says Hamers. “They feel that the residents have a right to privacy.”
The difference in approach, according to Hamers, is because nursing homes are very different anyway. “There is not just one type of nursing home. Even within the same umbrella organisation, you see things are done differently at one location compared to another.” The difficult thing about this, Hamers admits, is that you cannot say afterwards: disregarding this measure was one step too far. “But this is how things are in practice, this is very important for policies. A guideline was issued, but in practice it is not used much. People interpret it in different ways. Some homes were very strict, the easing of measures is happening too quickly for them. Other homes were already easing up, they are not suddenly going to become stricter.”
The Academische Werkplaats Ouderenzorg will continue to monitor visits in the coming months. “In principle until 1 September,” says Hamers. “The group of homes will increase. We are not just looking at the experiences, but also at residents’ well-being. Some have spent eight weeks alone in a room. Also, they have all lost the hold they had over their own lives. What is the effect of that?”