Vaccinated but still isolated: Minnesota senior homes slow to lift lockdowns on family visits

Carol Tonkin thought her 94-year-old mother's nearly yearlong struggle with loneliness and depression would finally come to an end after she was vaccinated against the novel coronavirus in late January.

No longer would Eunice Wollum be confined to her bedroom for days at a time, occasionally pleading in vain for the opportunity to see her family. Finally, Tonkin thought her mother would have enough protection against COVID-19 to visit with her eight grandchildren and great-grandchildren, whom she has not seen since October. Rules barring physical contact would finally be lifted, Tonkin hoped, enabling them to hug, kiss and hold hands.

For now, though, little has changed. A lockdown that was designed to protect residents from the coronavirus remains in effect at Wollum's facility in St. Anthony and regular visits have yet to resume. Wollum still spends much of her day gazing out her window at a busy thoroughfare, with little human interaction.

"What was the point of getting vaccinated if my mother can't see or touch the people she loves?" asked Tonkin, a dental hygienist from Fridley. "Her mental anguish has gone on far too long."

Across Minnesota, many senior homes continue to maintain heart-wrenching rules that limit family visits, despite hopeful signs that the pandemic is loosening its deadly grip and vaccinations are helping to keep vulnerable seniors alive. Policies that limit visits to one or two designated caregivers remain in place, and physical touching is still not allowed. And at many facilities, residents who leave the premises to spend time with loved ones are still being asked to quarantine in their rooms for up to 14 days upon their return, even if they are healthy and fully inoculated against the virus.

The persistent lockdowns have confounded many senior home residents, who have begun to wonder why they were vaccinated and how much longer they must wait for their isolation to end.

New federal guidelines are likely to increase pressure on Gov. Tim Walz and his administration to take stronger measures to mandate the reopening of senior homes. Citing high vaccination rates and declining COVID-19 infections, the Centers for Medicare and Medicaid Services (CMS) on Wednesday recommended that nursing homes allow indoor visits "at all times and for all residents" regardless of whether people have been vaccinated, with a few exceptions. A spokesman for the Minnesota Department of Health said the agency is reviewing the guidance.

The CMS recommendation signals a turning point toward the reopening of senior homes, because state regulators typically base their rules around federal guidelines.

It came just two days after the federal Centers for Disease Control and Prevention (CDC) also relaxed its safety restrictions, saying people who are fully vaccinated against the virus can gather privately in groups without masks or physical distancing.

The actions are widely seen as a response to improving trends. Coronavirus cases, hospitalizations and deaths have fallen dramatically in recent months following a late fall surge. In Minnesota, infections in long-term care facilities have plunged by more than 90% since mid-November, fueling expectations that visitor restrictions will ease.

"We need concrete guidelines so facilities know what to do," said Sen. Karin Housley, chairwoman of the Senate Aging and Long-Term Care Policy committee. "Our seniors have been isolated and lonely and cooped up for a year, and we need to get these families back together."

At a legislative hearing Wednesday, state health officials acknowledged that the vast majority of senior homes in Minnesota should be opening their doors to visits by family members because of declining infection rates, based on state guidance issued last fall.

As of March 5, only 86 of 2,059 nursing homes and assisted-living facilities in the state had reported COVID-19 cases in the previous two weeks. And only five of 87 counties had a positivity rate above 10%. Based on those measures, 95% of Minnesota's long-term care communities should be allowing visitors, state health officials said.

Despite the trend, persistent lockdowns remain a source of frustration for residents and families.

Cheryl Hennen, Minnesota's long-term care ombudsman, said visitor restrictions are the largest source of complaints to her office.

In many cases, she said, the restrictions have continued even in senior homes where nearly all the residents have been vaccinated and there are no active virus cases, she said.

Many residents have been deprived of vital human contact for so long that they are struggling with depression, cognitive decline and weight loss, she said.

"The effects of isolation are horrendous at this point," said Hennen, adding that her office has received and investigated 64 complaints about visitation restrictions since the start of the year.

"We have to understand that we are talking about people's homes. And we are talking about people having the fundamental right to be united with their families and their loved ones, and to come and go within their communities."

Even when families are allowed inside senior homes, they face an array of limits around these visits, Hennen noted.

In many cases, family members are still not allowed to go into residents' rooms and instead must meet in conference rooms while staff watch, which limits their privacy. Staff at many facilities set timers and limit visits to an hour or less. And some facilities are still requiring family members to talk to their loved ones from behind plexiglass barriers, which can be difficult for residents struggling with hearing loss.

Patty Wolff of Shoreview has gone nearly a year without being allowed to hug, kiss or hold hands with her mother, Phyllis Wolff, who lives at a nursing home in southwest Minnesota.

She is permitted one 30-minute visit with her mother each week, but only in a conference room and while staff members are watching.

During these visits, Wolff must keep at least 6 feet from her mother and talk through a mask and face shield. Because her mother has serious hearing loss, she has difficulty following conversations, she said.

"Without seeing our lips, it's been really difficult for Mom to know what we are saying," Patty Wolff said.

Wolff and her two siblings have discussed taking their mother to dinner at her favorite restaurant to celebrate Easter and her upcoming 91st birthday, but are worried about the confinement that will follow.

Like many facilities, her nursing home has a strict policy requiring residents to quarantine in their rooms for two weeks if they leave for nonmedical reasons.

During this time, Phyllis Wolff would be forced to have meals alone in her room and not be allowed to participate in group activities.

"It's beyond cruel at this point," Patty Wolff said. "I don't think it's fair for a 91-year-old woman to be locked in solitary confinement because she wants to enjoy Easter with her family."

As for Tonkin, she has become increasingly concerned about her mother's declining mental and physical health. Confined to her bed for most of the day, she has been losing weight and become increasingly withdrawn.

At times, her mother has burst into tears during their weekly visits and has pleaded with Tonkin not to leave.

"Last spring, when they shut everything down, we thought, 'This is hard, but we can sacrifice to make all these people safe,' " Tonkin said.

"But now this has gone on for so long that it's more important for Mom just to be hugged, and be surrounded by our love, than anything else."