How do you continue to serve as guardian when nursing facilities are restricting access to residents? Nursing home facilities are restricting most visitors to protect against the coronavirus. How does a guardian maintain contact with a ward when the guardian cannot visit him or her? How can the guardian oversee the ward’s care if the guardian cannot visit the facility? The National Guardianship Association and the American Bar Association Commission on Law and Aging have issues guidelines to help guardians continue to serve their roles during these restrictions.
Federal Restrictions on Nursing Home Visits
Nursing home residents are some of the most vulnerable members of our society. To protect against the coronavirus, the Centers for Medicare & Medicaid Services (CMS) has instructed nursing homes to restrict “all visitors and nonessential healthcare personnel” with very limited exceptions. While this is an important restriction to protect nursing home residents, it can interfere with your ability to serve as guardian.
Exceptions to the Restrictions on Visitors
Under the Federal restrictions, access to nursing homes is restricted to essential health care workers. “Essential” is interpreted narrowly due to the risk to residents. Guardians are not considered “essential” healthcare workers under the restrictions.
Visits are allowed for “compassionate situations,” which can include end-of-life care. Facility decisions about these visits are made on a case-by-case basis, with careful screening for Covid-19 symptoms.
Responsibilities of a Guardian Who Cannot Visit the Ward
Despite the restrictions on visits, a guardian is still required to maintain contact with the ward. Something we once took for granted is now a challenge. How can you maintain contact with a nursing home resident when you are not allowed to enter the facility? How can you oversee the ward’s care without visiting the facility? Following are some recommendations for serving as guardian while restrictions are in place.
- Remote Access Technology. As a guardian, you should try to use technology to maintain contact with your ward. This can include communicating by Facetime or Zoom. Many nursing homes are assisting their residents, who may be using these technologies for the first time. Telephone calls are an important way of staying in touch with the ward. This can help you both monitor the ward’s condition, and help protect the ward against feelings of isolation.
- Facility Staff and Records. You should contact facility staff so you can continue to participate in developing the care plan for the resident. As guardian, you should also seek information from the facility regarding their procedures to protect against coronavirus, and their screening activities. If facility records are available electronically, you should ask to review them periodically.
- “Through the Window.” While technology can help protect against isolation, many residents will benefit from actually seeing their guardian. By contacting the facility ahead of time, you should be able to arrange a “visit” through a window, door or other reasonable barrier. Your physical presence may provide some comfort to the individual. Actually “seeing” the resident may also help you assess the resident’s condition and circumstances at the facility.
Fulfilling the role of guardian is a challenge while nursing facilities are restricting visitors. Despite the restrictions the duties of the guardian remain. Even though the guardian cannot physically visit the ward, the guardian must continue to maintain contact with the resident. The vital role of the guardian is even more important during these challenging times.
About the Author: Tim McCurdy helps families navigate the guardianship process to protect their loved ones.