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Visiting Your Relative Living in a Care Home

By June 25, 2020 No Comments

Introduction

As has been announced by the Scottish Government, care homes are starting to support residents to see their families in person again. However, all of our residents remain at a higher risk from COVID-19 (Coronavirus) because of their age and / or other medical conditions. Therefore, visits will need to be managed. Our approach will be individualised to ensure:
• The risk of infection is minimised;
• The safety of our residents, their visitors, and our staff;
• That residents who are Shielding are given additional protection.

Every person’s experience is unique, but we hope this document might help address some of your concerns. If you want more advice, please contact the Home Manager who will be very happy to speak to you.

When will visiting happen?

The current proposed phasing of introducing controlled visiting is shown below. Each stage is dependent on the guidance of the Scottish Government based on advice of the Scientific Advisory Committee and applies to homes which do not have active outbreaks of COVID-19.
Staged approach to visiting
(Each stage is dependent on the scientific advice given at the appropriate time)

 

What do I need to do before I visit?

Visiting will be arranged with you via the Home Manager. Visits will initially be restricted to one designated person, once per week and for limited periods of time, no more than 30 minutes, at pre-arranged appointments to ensure we limit the number of people in the care home and to allow us time to clean the visiting area between visits. You must wear a face covering so please bring one with you if possible. If any further Personal Protective Equipment (PPE) is required, the care home will provide this for you.
You are asked not to bring in food parcels, flowers, helium balloons and the like. This approach is to reduce the opportunity for the virus to be carried into the care home and being passed unknowingly to your loved one. However it may be possible to bring in an object that you can give to your relative if they have dementia which will remind them of the connection the two of you have. This would need to be something that could be easily sanitised by staff e.g. a meaningful photograph could be laminated or placed into a wipe-able container.

What do I need to when I visit?

It is critically important for the health and wellbeing of your loved one that you do not visit if you have been feeling unwell in any way.
You will be asked a series of questions by the staff:
– Are you feeling unwell?
– Do you have a new/continuous cough?
– Have you had any sickness or diarrhoea within the last 48 hours?
– Have you noticed a change in your temperature?
– Have you noticed a change to your normal sense of taste or smell?
– Have you been in contact with anyone suspected as having, or who has tested positive for COVID-19, in the past 14 days?

You may have your temperature taken by a member of staff.

You will be asked to complete a form with your contact details; this is to assist Public Health, Trace and Protect colleagues should there be a need to contact you.

A Visitors’ Protocol, which you will be given when you arrive, will explain the things you need to do, e.g. hand washing requirements and wearing Personal Protective Equipment (PPE).

You will be asked to sign that you have understood and agree to the Protocol, including the need to wear PPE at all times. The care home will provide the necessary PPE which should be placed in the bin when you leave.

How quickly can I see my family member?

We acknowledge and appreciate how supportive families have been during this difficult time and we recognise that you will want to see your relative as soon as possible. Please be patient with our staff while they are facilitating these meetings – resident safety is our priority.

What might the first visit be like?

When you visit your relative again it may look and feel different from before. Initially visits will take place in the garden where social distancing can be maintained. In the case of inclement weather we may have a gazebo type structure to keep you and your loved one dry.

Initially, as explained above, visitors will be limited to one designated family member. At each stage, when guided by the Scottish Government, this limit will be revised and altered dependent on the outbreak status of the virus and any outbreak within the home.

Staff will be with you and your relative during the visit to provide refreshments, advise on infection control measures and provide support if needed.

How will my relative recognise me if have to wear a face mask?

We recognise that this may difficult and you will need to take time to explain why you are wearing the mask. It is probably worth mentioning the virus in general, to help your loved one understand why you are wearing a mask.

It is critically important to the health and wellbeing of your loved one that you wear a mask correctly. Please remember that your loved one may have become used to our staff wearing a mask and may be unlikely to be fearful of seeing you wearing one.

Meeting outside reduces the risk of you passing on the virus but it does not eliminate it completely.

When wearing a face mask during your time with your family member you should:
• Speak slightly louder and clearer.
• Use the tone of your voice to convey your message.
• Consider writing information down for your relative to read, if they can.
• Use gestures / signs to communicate.
• Keep eye contact.
• Try and wear clothing that your relative may recognise.

What about if my relative with dementia wants to cuddle or touch me?

One of the hardest aspects of the COVID-19 situation is the need for physical distancing between those of different households, including family members. Not everyone will understand the need to maintain a physical distance and may want to greet you with some sort of physical contact. This response is understandable after not seeing each other for a long time. Because of this we will need to consider different options to reflect each individual resident, their understanding, needs and rights. It is important that a two metre distance is maintained to protect your loved one, you as the visitor, our staff and the wider community.

A gentle reminder from yourself or a staff member may be all that is required.

We realise this is also difficult for you, however we would ask you not to initiate physical contact.

Will my relative still remember me after all this time?

For many people the worry of a relative no longer recognising you can be overwhelming. But it is important to stress that despite the time spent apart many people, living with dementia will remember their relatives. However, some people may struggle at first.

If your relative doesn’t recognise you straight away, try not to worry and give them time to remember. It may take more than the initial meeting for those memories to be reconnected. Also, you might need to:

– Re-introduce yourself and remind them of the relationship between the two of you.
– Consider taking with you an object that you can give to your relative with dementia which will remind them of the connection the two of you have. This would need to be something that could be easily sanitised by staff e.g. a meaningful photograph could be laminated or placed into a wipe-able container.

Talk about the distant past first rather than the recent months. By doing this you are more likely to make your relative feel at ease because they may find it easier to recall long term memories.

If, despite all of your attempts your relative doesn’t recognise you, remember that their emotions still remain. They will still benefit from seeing you, hearing your voice and enjoying your company even if they are not sure who you are.

If your relative cannot remember your connection, try not to convince them or correct them about your relationship. For example, if you are their daughter but they call you mum try not to contradict this. Remember despite the difference in the words they still often have the same feelings connected to them i.e. love, trust and friendship.

What about if my relative wants to walk around with me?

It is possible that your relative will want to walk with you. It is ok to do this provided you maintain a physical distance of two metres.

What if my family member’s health has deteriorated since I last saw them?

It is possible that your relative’s health may have changed. All of us have been affected by the lockdown and this is equally true of residents living in a care home.
Nevertheless, for some people, there will have been a cognitive decline. Try and not feel guilty about this; there is nothing that you could have done to prevent this.

These changes in a person’s brain, are part of their health journey which continue despite the change and extraordinary times we are all going through.

If your relative’s dementia has worsened, you may need to adopt different approaches and communication techniques. Your relative may need longer to respond or need more help to do things. But maintaining that relationship is just as important now as it was before the pandemic.

What if I don’t feel able to visit my relative?

Feeling nervous or anxious about seeing your relative face to face again is a normal response to recent events. Only visit your relative when you feel able to do so and when they agree, as they may also be worried about you coming into the home for your own health.

Staff at the home will continue to care for your relative and they will not judge your decision not to visit in person. Alternatives include use of video calls, recorded messages and telephone calls.

Consider if it is the thought of going back into the care home which is the cause for your anxieties? It is perfectly normal to feel anxious about returning to a place that may have been through such difficult times. The care home itself may have changed significantly since your last visit. Seeing staff in PPE may be a clear reminder of the difficulties the home has gone though. The staff, residents and their families may have lost someone to COVID-19. It is likely that over the time you have visited your relative you have become close to other residents. If these residents have died then it is likely to have an emotional impact on you.

Will my visit be too upsetting for my relative?

When you see your relative again it will most likely be a very emotive time for both of you.

Try not to be too upset if your relative doesn’t seem really happy to see you. Your relative may not be aware that they have not seen you for such a long time. Dementia affects a person’s perception of time, so in their reality they might have only seen you this morning. Consider taking a photo of the visit so that this can be shown to your loved one to remind them.

Try and ensure that you have someone you can talk to after your visit. Don’t be surprised if you feel down afterwards. This is an understandable response to the situation.

What happens when I leave?

This will be a difficult moment for both you and your relative. Start preparing 10 minutes before you actually have to leave. Agree, in advance, a time with the Home Manager when you can visit again so you can let your loved one know when to expect you. You could write this down and ask the staff to leave in a place for your relative to refer to. Arranging the date and time of the next visit will create a focus for your relative and you. It will also help to prepare you for ending the visit by preparing for the next one.

At all times our staff are here to help you and our residents; please do not be afraid to speak to staff about your loved one or things that are worrying you. They will continue to support your relative after the visit ends.

Acknowledgements

This leaflet was developed by members of the Care Homes Clinical and Professional Advisory Group, a multidisciplinary group which has been established to provide advice and guidance for care homes in Scotland during the pandemic. It was adapted from the Methodist Homes (MHA) COVID-19 visiting guidelines.

 

To view letter in PDF format, please click here.