Front Burner - ‘It feels like I’m in jail’: Post vaccine isolation in LTC

Episode Date: March 29, 2021

Most long-term care residents have now been vaccinated, prompting BC to announce looser restrictions on visitors. But in Ontario, residents are still starving for human connection — and they’re calling for changes.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hello, I'm Vashie Capello, sitting in for Jamie Poisson. As COVID vaccines roll out across the country, many Canadians are feeling a sense of imminent relief and finally some freedom to get back even a small slice of normalcy. But for many of those hit the absolute hardest by coronavirus, that euphoria is a long way off.

After failing to keep the pandemic out of long-term care homes, public health officials are now under fire for leaving severe restrictions in place on fully vaccinated residents. He begs me to get him out of there. It's a slow death camp. She basically told us she has nothing to live for if she can't see us and can't spend time with us. In B.C., that's about to change somewhat. As of April 1st, the province will be relaxing visitation restrictions in long-term care. But over in Ontario especially, many residents and their families are starving for more connection.

Today, we'll hear more about that from a long-term care resident in the Greater Toronto Area, and we'll also speak to a geriatrics doctor about how to balance the need to prevent further outbreaks while allowing for people to get the interaction they so desperately crave. I'm joined now by two members of the Ontario Association of Residents' Councils, an organization that represents long-term care resident groups across the province. Devorah Greenspawn is the treasurer of the OARC, and she's also a resident at Extendicare Bayview in North York. And Dee Lender is the group's executive director.

Hi to you both. Hi, Vashti. Devorah, I wanted to start with you. You've received both of your vaccine doses. Congratulations. Just wanted to start by asking you how you're doing. I'm doing fine. I'm still in part quarantined.

I am allowed to leave my room and go within my unit, but I can't go anywhere else in the home to intermingle with any of the residents I used to intermingle with. And are those residents vaccinated too? Like, do most of them have both their vaccines? Actually, 96% of the Holmes residents are vaccinated. Oh, wow. And so you still have a lot of restrictions on what you can do. Yes. And what's that like?

Well, it's getting to the point where if I didn't have OARC's activities, I think I would be climbing the walls. It's getting to the point where some days I really don't want to get out of bed because there's nothing to do and I can't speak to very many people. And for you, when you say some days you have trouble wanting to get out of bed, is it a feeling of loneliness? Well, it's a feeling of loneliness. It's a feeling of frustration. And it's a feeling of boredom. Because where we had activities, and I would go out for courses three times a week. Now,

I can't go anywhere. They have open, we have an indoor courtyard and they have open mat. So when the weather is nice, I go out there and of course we have to social distance. But at this point, the weather hasn't been that great. So there are not too many people going out. So I can just go wherever I want. out so I can just go wherever I want. And I guess I'm a fortunate one because I walk and I can take myself out. Most residents have to be taken out. What does that feel like to have your movement restricted, to have so few things that you're quote unquote allowed to do? What does that feel like?

few things that you're that you're quote unquote allowed to do what does that feel like it feels like i'm gonna go crazy it feels like i'm in jail it's it's like if i want to go out and i come back i go into 14 days quarantine so really it's not worthwhile going out what about interaction with your family like what can you can you do? Can you see any of them? Can you talk to them? What do you do? Can't see anybody. We Zoom and the telephone. And every Saturday, I Zoom with my family, my kids and my grandkids, my great grandson,

which is wonderful because I can see them. But it's bittersweet because I can't touch them like they're there. But, you know, you can't hold a hand or sort of give a part hug. It's just you see a picture, but it's better than nothing, that's for sure. Have you been able to hug anyone? No. Since the beginning of the pandemic? Yep. That makes me feel very lonely.

I really miss the human contact. Even in the home, all these staff who are really very thoughtful and compassionate and caring, but all you see are their eyes and you can't see a smile. And I find that really, really difficult to live without any human contact. I think anybody would would feel that way. OARC keeps me going. We have chats once a week where we get together on the phone and we we talk and we share our problems and we share what's going on in our homes and how we feel and it's a really very cathartic. That's a good place for me to bring in Dee, I think.

Dee, what we've just heard from Devorah, you talk to many residents right across the province. How common is that feeling? Hi, Vashi. What Devorah has articulated is stated over and over and over again in many different ways by almost every resident that I've had the privilege of speaking with in the last year. of speaking with in the last year. The grief, the suffering, the loss, the negative impacts of all aspects of life.

You know, the pendulum swung to the one extreme where the prevention of physical disease was the first priority to the neglect of the psychosocial and emotional well-being of residents. to the neglect of the psychosocial and emotional well-being of residents. I've heard many, many, many stories and residents say that, you know, they've seen their peers who were once mobile before the pandemic are now in wheelchairs. Many residents I know who were actively engaged in physiotherapy have had to start from the very, very beginning again. Their endurance has gone down.

Even residents who are not affected with dementia who are cognitively well have said that they feel less sharp, less ability to think through things, missing their families. missing their families and then as Dvorah said not seeing a smile not having the opportunity to have safe physical touch it really has been a trauma and you know yes absolutely the people who have passed away there's trauma there for families, but the trauma is multi-layered with the team members, the staff, the residents. It really has been a really dreadful experience. And Devorah, now that you've lived so many months like that, but you have reached the point where you have both your vaccines, where as you say, the majority of people in your home have also received their vaccines. How frustrating is it to you that there hasn't been more change, that the restrictions haven't been altered more? It's very frustrating. You know, when they mentioned residents losing their physical ability, I was

one of those. I hadn't had therapy for I don't know how long. And when I started to walk, it's still taking me a long time to walk the way I used to. To answer your question, it's extremely frustrating. And so if someone from the provincial government were listening right now, what would your message to them be? My message would be that residents who live in long-term care are not just physical shells. physical shows. They have emotions and feelings. They want to be able to do things. They want to be able to see their loved ones. So I think they have to realize that they have to give us some sort of choice, whether we want to take the risk of seeing our families. I can't live in a bubble. I feel that I would take the risk to see my family and to be able to touch a hand. I mean,

we can always wash our hands and sanitize them after, but at least touch a hand and see each other and see each other smile and hear each other's voices. I really think the government should maybe lessen the restrictions and allow us to have, if not inside visitors, outside visitors.

Dee, I'll give the final word to you. Your message to the provincial government right now? I would say thank you to the government for all that they've invested in the last year through resources and so on. But I would plead with the government to have the pendulum swing a little bit further back into balance, that safe physical touch be adopted, that clear face masks be adopted so residents can see smiles. There needs to be quality of living. And the reality is for many people in long-term care, this is where they will live out the rest of their life. And to live in this way, in this restricted, traumatic way is not good. And we have to make changes now.

Okay, thank you so much, Devorah and Dee. Sorry, go ahead. just now. Okay, thank you so much, Devorah and Dee. I just wanted to say that as a senior, I'm 88 years old, and I feel that my life is passing me by. That's a heartbreaking feeling. Thanks, Devorah and Dee. I do appreciate you sharing your experience and being so honest about it. Thank you both very much. Thanks, Vashi. Thank you, Vashi. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization. Empowering Canada's entrepreneurs through angel investment and industry connections. Hi, it's Ramit Sethi here.

You may have seen my money show on Netflix. I've been talking about money for 20 years. I've talked to millions of people and I have some startling numbers to share with you. Did you know that of the people I speak to, 50% of them do not know their own household income? That's not a typo. 50%. That's because money is confusing.

In my new book and podcast, Money for Couples, I help you and your partner create a financial vision together. To listen to this podcast, just search for Money for Couples. I want to bring someone else into this conversation. Dr. Nathan Stahl is a geriatrician at Sinai Health System and a fellow at Women's College Research Institute. Hi, Dr. Stahl. Thanks so much for making the time for us today. Thanks for having me. the last words from Devorah about how she feels her life is passing her by. What were you thinking as you heard Devorah describe what life is like for her right now? You know, I've actually spoken to Devorah several times throughout the course of the pandemic. And unfortunately, what she said has really not changed. And, you know, of course, it's tragic. not changed. And, you know, of course, it's tragic. And what Dee had highlighted about the negative impacts on residents are things we see every day. I think, and I hope what we'll explore

as I talk with you that I find most frustrating about this is that at this point, with nearly every single long-term care resident of the province vaccinated and we have single digit cases among residents in the province of Ontario at this point what we're doing is is just totally unnecessary to residents and so uh you know it's a combination of sadness but just really asking ourselves what are we doing at this point? And why did we have these people live in isolation for the past year until they got vaccinated to keep them in the same situation they were in to start with? Okay, let's get into that. Because we got a statement from the press secretary for the minister in charge of long term care. And I just want to put a part of it to

you. We are nearing completion of offering both vaccine doses to all long term care residents. And as we continue to vaccinate staff, essential caregivers and other vulnerable groups, we are seeing positive effects. Until more people have the opportunity to receive the vaccine, we must continue to be vigilant in following public health guidance, especially as we are seeing the spread of variants of concern. concern. Is your point that the status of long-term care homes right now don't necessitate maintaining the same restrictions as have been in place for months and months and months? Yes. You know, I'm the Assistant Scientific Director of our province's, in Ontario, COVID-19 Science Advisory Table. We looked at the early impact of the vaccine after the first eight weeks of the rollout. And this was up into the end of February.

And we saw that there was a risk or reduction in 90% in cases and 96% in deaths. And at that point, 92% of residents had received at least one dose. And now we're up to 99%. And most of the residents have actually received both doses now. And, you know, as I mentioned, here in Ontario, we're seeing, you know, 2500 cases today in the province of Ontario, and less than 10 of them are in long term care residents. So you know, what was previously, you know, an unbelievable thing to say, you know, it's the fact that one of the safest places to actually be during the third wave is actually in a long term care home. I agree our vaccine coverage could be better in staff. Only about 75 percent of staff have been vaccinated.

But the reality is that our ultimate goal here is to protect residents from becoming very sick and dying. And we have done that by vaccinating the residents. The variants that we have circulating here in Ontario, for the overwhelming most part, are ones that the vaccine still work against. And we're not suggesting to abandon surveillance in the sector. suggesting to abandon surveillance in the sector. What we're suggesting is, much like other provinces like British Columbia have moved forward towards doing, is to loosen the public health restrictions, continue some surveillance, but really remember who you're dealing with here, which are the, you're dealing with residents who have limited life expectancies, who have already spent a year in some of the most strict public health restrictions of any member of society, the harms as Dee and Devor described are not benign.

You know, we actually have data, not just that they're being prescribed more medications that are harmful, not just that their memory is declining faster, not just that they're losing physical function, but they're actually dying faster than they would or in higher numbers than they normally would because of what we're imposing on them. And at this point, I believe, and clearly the province of British Columbia and Bonnery and Henry feel the same way, that the risks of ongoing restrictions in this way simply outweigh the benefits when you have such a high coverage of vaccination. And we know vaccinations work in this population.

We are in a very challenging place as we know with the pandemic across the province. In some communities, rates are increasing quite dramatically. So we will need to take this slowly but it is an important step forward to being close again and supporting our seniors and elders who have suffered so much in this pandemic. When you refer to BC and Dr. Henry, let me ask you a little bit about what they've done and if you see that as possibly being mirrored in Ontario, they are removing the requirement for one designated visitor so more family and friends can visit. Residents can have up to two visitors at a time plus a child.

And the visits can happen in residence rooms without staff present. As well, residents will be supported to go on outings with no requirements for isolation when they come back, including outings with family and friends. Already, that sounds like, to me, at least a very different world than the one that Devorah is living in right now. Do those changes make sense? Like, do you think they could be mirrored in Ontario? Yes, you know, I absolutely think so. When you think about the activities that British Columbia is exploring or is talking about opening up to its residents, congregate social activities and dining, allowing more visitors, including children with many of the residents. their great-grandchildren. When you think about absences and no longer requiring a resident when they go out, even for something as simple as leaving the property to visit a loved one in a park to get some fresh air, they need to go into 14 days of isolation in their room and all the

staff are then required to apply what are called droplet contact precautions where they need to wear masks and gloves and a gown. And some of the things you heard Devorah talk about where they're no longer able to see the smiles and have the same human interaction. And, you know, some of the congregate activities as well, having congregate dining between residents of a home, having congregate social activities, the things that they've missed out on on a year during this time of isolation are so essential. And I think at this point, we are behooved and we actually have, you know, I would argue a moral imperative in some sense, to lucid restrictions for this population, given their limited life expectancy, we cannot wait for the things that,

you know, the province of Ontario has suggested we need to wait on. Higher vaccine uptake among staff. We may never get to full, you know, to a 90% vaccine uptake among staff. Higher vaccine uptake in essential caregivers. We are not saying to abandon all the other infection prevention and control precautions that are being taken in long-term care homes. We're actually just saying to give these people back some of their freedom, provide them with some humanity, and put the home really back in long-term care home or personal care home so that people do not suffer the adverse impacts and harms of the restrictions that they're living under. And also, we owe it to them.

We asked them to take this ultimate sacrifice to live in a way we didn't ask them, actually. We told them that they were going to have to live in this way. And they looked forward to being vaccinated. And, you know, I went out with some of the vaccination teams. There was celebration. There was music. They called it V-Day, our vaccination day for residents. And there was this huge excitement that life was going to change after this for the residents, that they had finally arrived at the moment when life was going to be different. Oh my goodness, you are such a champ.

I know you have six children. That was nothing. And if you ask someone like Devorah, you know, three months later for some residents, nothing has changed. And that's not acceptable. That has to change. Thanks, Dr. Stahl. Appreciate it very much. You too. Bye-bye. After we recorded our interview, a spokesperson for the Ontario Ministry of Long-Term Care emailed us with an update. 78% of long-term care staff have now received one vaccine dose, and 65% have received both doses.

That's all for today. I'm Vashi Kapelos. I'll be back again tomorrow. Thanks for listening to Frontburner.