Nursing home visits are challenging at any time, and even more so during the pandemic. Most nursing homes now have strict visiting rules in place to protect residents from exposure to COVID-19, such virtual, window or drive-up visits (with visitors staying in their cars). Some nursing homes allow for socially distanced outdoor or indoor visits (although indoor visits are limited to isolated areas designated for family, not visits in the resident's room).
No matter what form the visit takes, you'll want to make the most of the time with your loved one. "It is very lonely for seniors in nursing homes today and they crave validation, fond memories of family events and affirmation of their value and dignity," says Teri Dreher, a board-certified patient advocate and owner of a patient advocate company in Chicago.
Prepare for a Good Nursing Home Visit
Do your homework before the visit. To prepare, you can:
-- Find out about the rules and restrictions. Ask what kind of visit is permitted and how much time you're allowed.
-- Consider the time of day. Does your loved one need to stick to a schedule of meals or naps that can't be interrupted? Does the visit need to be coordinated with the weather?
-- Ask if you can bring along a friend or a family member, such as your spouse, sibling or child. Visits are a great time for older adults to see their grandchildren, even if it's just through a window.
-- Make arrangements for potential challenges. These may include a loved one's soft voice that you may not hear from 6 feet away in a socially distanced visit or poor hearing that may keep your loved one from understanding you. Nonprescription assistive hearing devices or face masks with a clear "window" (if your loved needs to read lips) can foster better communication.
-- Think about questions you'd like to ask staff during the visit. "Make certain all of your questions for the staff are prepared well in advance before you arrive. Make your questions succinct; thank the workers and always be polite. Health care workers in nursing homes today are under a lot of pressure and have more restrictions on their time," Dreher advises.
During your visit -- whether it's in person, through a window or via video call -- take note of your loved one's health. "Observation, even if just through a window, can give you some idea of your loved one's physical condition -- for instance, if their clothes are clean, if their hair is brushed or if they've lost weight ," says Robyn Grant, director of public policy and advocacy at the National Consumer Voice for Quality Long-Term Care.
Grant says it's important to observe the facility (for example, is it clean or does it smell?) and staff behavior. "Are they wearing face masks? Are they washing their hands or using hand sanitizer before and after contact with your loved one?" Grant asks.
She also recommends asking your loved about his or her experience in the nursing home, such as:
-- Are there enough staff to help you when you need it?
-- How do you spend your day? Are you getting outside your room?
-- How have your meals been?
-- Are staff giving you baths or showers and changing your clothes daily?
What to Do Together
The nature of visiting restrictions may determine what you can do. You may be permitted to stroll or roll (if your loved one is in a wheelchair) around the nursing home grounds. If that's not possible, perhaps you can still:
-- Play a video game (such as a card game) while sitting 6 feet apart. Electronic devices such as iPads can make that work.
-- Listen to favorite music together.
-- Sing songs on a video call.
-- Use a video call to give your loved one a tour of something (your house or yard) or have grandchildren demonstrate an activity they're involved in (playing a musical instrument, for example).
-- Assist your loved one with errands. Make a shopping list together so you can go out and get needed items.
-- Present your loved one with something special. Find out what's permitted in advance, and consider bringing some special sweets, a meal from your loved one's favorite restaurant or meaningful objects (label them first). "Framed pictures of family members, new pajamas, a soft blanket and favorite magazines are nice gifts. Anything you can do to bring love and joy will be very appreciated," Dreher says.
How do you decide what to do? "Take cues from your loved one and let them guide the visit," Grant advises. "Remember the visit is about them and their needs."
What to Talk About
Conversation will take center stage during your visit, even if your loved one isn't able to chat much anymore. Some guidelines:
-- Express positive emotions. "Tell your loved one how good it is to see them, how much you've missed them and how much you've thought of them," Grant recommends. "If they're excited to talk to you, let them lead the conversation."
-- Keep it light. "Try to keep the visit social and not bring up stressful topics," Dreher suggests.
-- Be aware of who's steering the conversation. "If they're excited to talk to you, let them lead the conversation. They may just enjoy sharing their thoughts and experiences. Alternatively, if they're quiet or withdrawn, you can lead the conversation, sharing positive experiences and thoughts," Grant advises. "Try to answer the questions they ask and remember to keep the focus on their needs."
-- Reminisce about happy times, such as previous holidays, special milestones or nice things the person has done for you in the past that you still appreciate.
-- Bring your loved one up to date about positive things happening in your life or your family members' lives. Let your loved one know what's happening outside of the nursing home walls so they can feel involved in your life.
-- Remind them of things they can look forward to. Having an eye on something positive in the future brings purpose and helps people get through tough times.
If your loved one wants to talk about something serious, listen and show empathy. It could be a helpful cathartic moment for them.
Some Final Advice
Remember that your loved one is in a nursing home because he or she is frail and needs lots of assistance to get through the day. Try to be gentle:
-- Be sensitive to memory changes. If your loved one has any cognitive impairment, don't press them about people or past experiences if they don't remember. If they repeat themselves or ask the same questions, be patient.
-- Make a "soft" exit. It can be hard to leave when your visiting time is over. Consider coordinating your visit with an upcoming activity, such as a nap or lunch. Once your loved one is absorbed in what's happening, your departure won't feel so upsetting.
-- Share feedback with staff. Report any concerns to a nurse or go up the chain of command to the nursing director or administrator.
And schedule another visit soon. It will bring meaning to your loved one and give them a reason to keep going, especially during the pandemic.
Heidi Godman reports on health for U.S. News, with a focus on middle and older age. Her work has appeared in dozens of publications, including the Harvard Health Letter (where she serves as executive editor), the Chicago Tribune, Baltimore Sun, Orlando Sentinel and Cleveland Clinic Heart Advisor.
Heidi spent more than 20 years as a TV news anchor and health reporter at ABC affiliate WWSB and more than five years as the host of a daily health talk radio show on WSRQ-FM. Heidi has interviewed surgeons in operating rooms, scientists in laboratories and patients in all phases of treatment. She's earned numerous awards for outstanding health reporting and was the first TV broadcaster in the nation to be named a journalism fellow of the American Academy of Neurology. Heidi graduated from West Virginia University with a degree in journalism.
Connect with Heidi on Linkedin or email her at email@example.com.