COVID-19 Vaccinations for Older Adults: An Opportunity for Hugging Loved Ones

As of late March 2021, about 15% of the United States population has been fully vaccinated.1 Amongst vaccinated Americans, 49.8% of adults 65 years and above have been fully vaccinated.1 These efforts show the aggressive push and strategy of the Biden Administration to curb the pandemic on American soil. 

 

In California, 15.5% of people have been fully vaccinated and 29.9% of Californians have received at least one dose.1 Here in San Diego, 20% of residents have received at least one dose.2  You can follow the San Diego County vaccination dashboard here. With these rates, senior living facilities can breathe a small sigh of relief for being able to better protect their older adults through COVID-19 vaccinations.

 

As people continue to get vaccinated, the California Department of Social Services (CDSS) released a statement regarding visitation rights for Nursing Homes and Residential Care Facilities for the Elderly (RCFE).3 Specifically, this notice provided guidance on communal dining, group activities, and non-essential services. Based on these guidelines, the California Advocates for Nursing Home Reform (CANHR) created a factsheet to simplify visitation rights.4  The CANHR summarized content is stated below.

 

Virtual Visitation: Phone Calls and Video Chats

Facilities MUST allow and provide assistance in arranging alternate means of communication for visitors such as phone calls, video calls, and online communications. 

 

Outdoor Visitation

Facilities MUST allow scheduled outdoor visits on facility premises, weather permitting. Residents and visitors must wear face coverings. Residents and visitors also must keep at least 6 feet apart from each other, unless both resident and visitor are fully vaccinated. Staff must wear face coverings, screen visitors, and clean and disinfect surfaces. 

 

Indoor and In-Room Visitation

Facilities SHOULD allow indoor visitation, including in-room visitation, at all times and for all residents, regardless of vaccination status of the resident or visitor, unless a resident is in isolation or quarantine. Residents and visitors must wear face coverings. Residents and visitors also must keep at least 6 feet apart from each other, unless both resident and visitor are fully vaccinated. Staff must wear face coverings, screen visitors, and clean and disinfect surfaces. 

 

Residents in isolation or quarantine may only have indoor in-room “essential” visits, following appropriate infection prevention guidelines. 

 

Visits from “Essential” Professionals 

Visits from certain professionals are defined as “Essential” and MUST be permitted, including: 1) Health or legal matters that cannot be postponed; 2) Social workers who are legally responsible for a person’s care; 3) Adult Protective Services (APS) and Ombudsman; 4) Representatives of resident advocacy programs; 5) Qualified interpreters or persons to facilitate communication; and 6) CDSS, CDPH, local health department officials, mental/healthcare providers, and essential government authorities needing to enter or conduct investigations at the facility.

 

Compassionate Care Visits

“Compassionate Care” visits are defined as “Essential,” and MUST be permitted, including: 1) End of life; 2) Residents struggling with change in environment and lack of in-person family support; 3) Residents grieving following the death of a family member or friend; 4) Residents experiencing weight loss or dehydration and needing cueing and encouragement with eating and drinking; and 5) and Residents experiencing withdrawal, emotional distress, seldom speaking or crying more frequently.

 

Close Contact/Physical Touch (Indoor & Outdoor Visitation)

Fully vaccinated visitors of fully vaccinated residents may have close contact, including touching, hugging, and assisting with everyday tasks such as eating and getting dressed. Visitors and residents must both wear face coverings, and wash hands or use alcohol-based hand sanitizer before and after contact. 

 

Fully vaccinated visitors should present their COVID-19 Vaccination Record Card to facility staff at the time they are screened. 

 

NOTE: “Fully vaccinated” is defined as two weeks after receiving the second dose in a 2-dose series such as Pfizer or Moderna vaccines, or two weeks after receiving a single-dose vaccine such as Johnson & Johnson’s Janssen vaccine.

 

Rules for Visits

1) Visitors screened for fever and COVID symptoms; 2) Residents and visitors wear face coverings; 3) Visitors wash hands or use alcohol-based hand sanitizer upon entering facility; 4) Visitors stay at least 6 feet apart from others, including the resident they are visiting unless both resident and visitor are fully vaccinated as specified in the Close Contact/Physical Touch section. 

As much as visitation rules are subject to change based on local public health orders, Choose Well Member RCFEs are taking this time to celebrate the victories brought about by vaccinations for older adults. Founding Choose Well Member, St. Paul’s Senior Services recently completed 20 COVID-19 vaccination clinics with CVS Pharmacy, vaccinating 97% of senior residents and 86% of staff members. St. Paul’s registered with CVS for these clinics as soon as the opportunity was available and is one of the first senior organizations to receive vaccinations starting on December 30, 2020. CVS provided the vaccines and personnel to come onsite and administer the vaccine to residents and staff, at times going door-to-door to vaccinate residents who were less mobile. St. Paul’s is thankful for this partnership with CVS and showed their gratitude with a special ceremony during our 20th vaccination clinic.

St. Paul’s CEO Cheryl Wilson said, 

“After hosting 20 vaccination clinics with CVS over the last few months, we can proudly say 97% of our residents are now vaccinated! We are so grateful for the hard work and dedication of the CVS team, as well as the willingness of our residents and staff to get the vaccine. St. Paul’s is looking forward to a brighter future where our seniors can hug and interact with their loved ones again. It’s an exciting time for us!”

New Choose Well Member, County Gardens, also saw their residents roll up their sleeves to get vaccinated!  Jenny Castellanos, Administrator at Country Gardens stated,

“Here at Country Garden COVID-19 has impacted our facility in many ways from limiting visitations and outings and social gatherings. We continue to follow protocol and continue to keep our residents safe. It's our responsibility, as an assisted living facility owner, to help stop this virus. Now we have a new, safe, and effective tool to help us do that - COVID-19 vaccines. Residents getting vaccinated adds an important layer of protection for them to be able to enjoy life and get back to hugging their loved ones. As an administrator for Country Gardens, I encourage everyone to step up to beat COVID-19 and get vaccinated. We want everyone in our facility to be safe and get back to hugging our residents.”

 

While the vaccine provides much optimism, it is important to stay cautious as the pandemic is still ongoing. Public health guidelines continue to promote washing hands often, wearing a mask, and maintaining social distancing, especially around people who are not yet vaccinated. With proper precautions and continued vaccination efforts, everyone, including older adults, will be able to ‘enjoy life and get back to hugging their loved ones.’

 

 

Sources:

1. https://covid.cdc.gov/covid-data-tracker/#vaccinations 

2. https://sdcounty.maps.arcgis.com/apps/opsdashboard/index.html#/c0f4b16356b840478dfdd50d1630ff2a 

3. https://www.cdss.ca.gov/Portals/9/CCLD/PINs/2021/ASC/PIN-21-17-ASC.pdf 

4. http://canhr.org/factsheets/covid_fs/PDFs/fs_visitation.pdf