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Assisted living residences may ease visitor restrictions meant to prevent COVID-19 from devastating retirement communities after cuts to home care services have left some seniors relying on family members for support.

The Winnipeg Regional Health Authority has temporarily suspended home care services considered to be non-essential — including bathing, laundry, cleaning, respite and more — as part of its COVID-19 response.

While the extent of the service rollback is still unclear, Julia Janzen of Homestead Manitoba says about half the residents at five of the company’s assisted living facilities are affected.

"Assisted living (facilities) sometimes get forgotten about a little bit, even with a pandemic," said Janzen, who is part of Homestead Manitoba’s management team. "We’ve worked for the last couple of weeks to bring our buildings to a point where we were comfortable with the people who were entering our building."

“Now though, all of a sudden we’re getting phone calls from family members saying ‘Well, can I come tomorrow because I have to give my mom a bath?’" – Julia Janzen of Homestead Manitoba

Like many independent, privately operated assisted living facilities, Homestead Manitoba proactively closed its doors to visitors and has allowed only essential service providers to come onto the property, Janzen said.

"Now though, all of a sudden we’re getting phone calls from family members saying ‘Well, can I come tomorrow because I have to give my mom a bath?’" she said. "We’re having to open up our doors again for more outside people. Even though they’re family, we don’t know where they’re coming from in order to care for their parents."

Home care case co-ordinators with the WRHA began contacting clients over the long weekend to let them know services would be cancelled or reduced. The health authority has asked family members to fill the service gap where possible. A WRHA spokesman told the Free Press the service reduction is intended to minimize the risk of transmission of COVID-19 to staff and clients; to conserve personal protective equipment for services that must continue; and to ensure staff time is prioritized so vital services can continue.

"Within community settings, in-home care and support varies in terms of level of care, type of care and frequency of care with each individual client," the spokesman said in a statement. "Similarly, an assessment of what services might be eligible for modification or postponement, and determination of how those changes can safely be implemented, will vary by client."

Information is trickling in slowly, Janzen said — assisted living facilities are not privy to their residents’ health information — and she is hearing from seniors who have lost all regularly scheduled home care appointments for showers and baths, linen changes and laundry.

"We are, on a daily basis, now trying to figure out and respond to these changes, because these seniors need that," Janzen said.

Homestead Manitoba has a plan in place to screen caregivers for the virus before being allowed inside. Caregivers must answer a questionnaire and follow handwashing and social-distancing protocols while in the building, and are escorted by staff who sanitize touch points in common areas. The reduction in home care also comes with a risk of falls and injuries as the seniors' children attempt to provide care, Janzen said.

"We would much prefer a home care worker to come in because we know that they’re checked on a regular basis, they have all the PPE that’s required, and they have the training so that whatever needs to happen is done safely," Janzen said. "But we have to. We have to let some of these families in."

Bethel Place executive director Joanne Schmidt said staff at the facility are monitoring the demand for increased visits and is managing on a case-by-case basis. At Brightwater Senior Living of Tuxedo, which has nurses and caregivers on staff around the clock, people who have lost services will be cared for, president Quintin King said.

"A very small number of our residents have private or WRHA-provided care services. In a situation where those outside services are being temporarily limited through safety restrictions, those residents have access internally," King said.

“We would much prefer a home care worker to come in because we know that they’re checked on a regular basis, they have all the PPE that’s required, and they have the training so that whatever needs to happen is done safely.” – Julia Janzen

Provincially funded long-term and personal care homes have been strongly recommended by Shared Health to suspend visitor access entirely due to the risk the virus poses to those populations. Roughly half of Canadian deaths from COVID-19 have happened in long-term care facilities, the Canadian Press has reported. Shared Health chief nursing officer Lanette Siragusa said Wednesday those restrictions remain in place and allowing caregiver visits at retirement homes and independent assisted living facilities has to be carefully considered.

"There would have to be very stringent screenings and reasons that would be evaluated in terms of what is the staff requirements and what is the patient requirements, and how do we make sure those needs are met," Siragusa said.

danielle.dasilva@freepress.mb.ca