Before the pandemic, Mariam Barakzoy routinely helped feed, bathe and give breathing treatments to her bedridden 88-year-old mother Zakia Azimi at a Rancho Bernardo nursing home.
But that personalized care stopped a year ago when long-term care facilities in California and nationwide barred visitors to halt the spread of COVID-19.
For a few months last year Barakzoy was allowed a single one-on-one visit each week with her mom, who has advanced dementia. But that ended in November when cases again surged. The rest of their contact has been via Skype.
Barakzoy blames the visitation restrictions for her mother’s deteriorating physical and mental condition.
“There’s missing teeth in her mouth that I can’t account for,” Barakzoy said, choking up with tears. “It’s just the physical decline. It’s a mental decline. It’s an emotional decline. I feel like there’s no mercy. I know I’m not alone in this.”
She isn’t. Families and advocates are pushing the California Department of Public Health (CDPH) to allow in-room visits at long-term care communities.
The effort comes as huge strides in vaccinating long-term care residents and workers have caused COVID-19 cases to dive. Since late December, new cases have dropped 98 percent in the state’s nursing homes, according to the California Department of Public Health’s dashboard page.
In an emailed statement to KPBS, CDPH said it is “finalizing adjustments to visitation policies while also remaining focused on ensuring all nursing home staff and residents have the opportunity to be fully vaccinated against Covid-19.”
“CDPH understands the importance of ensuring that residents of long-term care facilities maintain contact with their family and friends,” the statement read. “Visitation policies are designed to protect the health and safety of residents, staff and the public while also considering a resident’s physical, mental, and psychosocial well-being and quality of life.”
Mike Dark, a lawyer for the group California Advocates for Nursing Home Reform, said the agency is not acting quickly enough. He believes nursing home residents can still be safe while having friends and family visit them in their rooms.
“We understand that things like social distancing, mask wearing are going to have to continue, especially as new variants emerge,” Dark said “But until visitation begins again, we’re going to continue seeing long-term residents suffer as much from those deprivations as from the virus itself,”
Dark said he’s never before seen the volume of complaints from people with family in nursing homes as he has during the visitation ban over the last year.
“Over the years, we have seen all kinds of instances of neglect and abuse,” Dark said. “But what we're not used to seeing is the kind of calls that we've been getting over the last nine or 10 months where family members are reporting that their loved ones are dying of dehydration, malnutrition, of not being attended to physically so that they avoid bedsores, kidney infections and the like.”
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Dark said before the pandemic, family members like Barakzoy often took over key caregiving duties for residents to compensate for staffing cuts made by facilities to boost their own profit margins.
The visits also aided accountability.
“They also provide a kind of level of scrutiny or surveillance that even state regulators were not able to provide,” Dark said.
This week, the national advocacy group Consumer Voice for Quality Long-Term Care called on the federal Centers for Medicare and Medicaid Services to restore full visitation rights at nursing homes across the country.
“Now, although the risk to residents from COVID is decreasing, the risk of harm from isolation and neglect is increasing, as residents continue to go without care and companionship for a longer period of time,” the statement said.
