. @GregAbbott_TX @DanPatrick @travisfortexas @SenatorNichols @CMSGov #TeamTexasHHS #MichelleDionneVahalik #PhilWilson #VictoriaFord

When is @TexasHHSC going to distinguish between #EssentialFamilyCaregivers and casual visitors to #nursinghomes?

#EssentialCarePartner #eldercare https://twitter.com/LouiseAronson/status/1282348028318248960
Additionally, @TexasHHSC, please see the following articles by experts, stating the harm that is occurring to residents in the absence of their #EssentialCarePartners...

The 1st, by @CharchuRn https://twitter.com/NathanStall/status/1284655062724284418?s=20
Experts make case for allowing more family-member visits in nursing homes https://www.mcknights.com/news/experts-make-case-for-allowing-more-family-member-visits-in-nursing-homes/
Experts make case for allowing more family-member visits in nursing homes - News - McKnight's Long...

Long-term care facilities should reconsider their restrictive visitation policies aimed at ensuring the well-being of residents during the ongoing coronavirus crisis, according to several experts.

https://www.mcknights.com/news/experts-make-case-for-allowing-more-family-member-visits-in-nursing-homes/
"CMS’s guidance should take into account visitors who are 'essential care partners' & give nursing home leadership more leeway to allow these visitors reentry—under careful procedures, of course..." (continued...)

— @DavidCGrabowski @jasonkarlawish https://www.washingtonpost.com/opinions/2020/07/13/residents-good-nursing-homes-should-consider-re-allowing-visitors/
Opinion | Continued bans on nursing home visitors are unhealthy and unethical

Blanket bans on all visits fail to capture how some friends and family are critical to good care.

https://www.washingtonpost.com/opinions/2020/07/13/residents-good-nursing-homes-should-consider-re-allowing-visitors/
"...for many nursing home residents, a visit is not simply a social call. Many family members are not company as much as essential caregivers and care monitors. Their involvement is vital, especially at facilities with shortages in staffing."— @DavidCGrabowski @jasonkarlawish
. @TexasHHSC, this applies to the U.S. and to Texas too: https://twitter.com/NathanStall/status/1277640935942356993?s=20
"We are not considering the risks of what lockdown is doing, we are only focusing on preventing #COVID19 from getting into homes." @TexasHHSC: 👇 https://twitter.com/NathanStall/status/1277710281779675136?s=20
"The risks associated with ongoing and prolonged visitor restrictions have started to outweigh the risks associated with potential #COVID19 infection...”

@TexasHHSC https://twitter.com/NathanStall/status/1277784316291043329?s=20
@TexasHHSC, "The goal was to protect residents from the coronavirus as the pandemic began to escalate...and now, families argue, the harms of isolation exceed potential benefits" by @judith_graham https://twitter.com/NathanStall/status/1282709701080363011?s=20
The collateral damages of lockdown in #LTC: depression, weight loss, pressure ulcers, falls & worsening responsive behaviors.

From veteran reporter (and LTC expert) @MoiraWelsh...

This applies not just to Ontario, but also to Texas LTCFs: https://twitter.com/NatalieGNichols/status/1279082831881388033?s=20
@TexasHHSC "Advocates are calling on the state to mandate that each resident in a senior care facility have at least one 'support person visitor' who would undergo the same screening for COVID-19 as people who work at the facility." https://twitter.com/CANHR_CA/status/1280247661048684544?s=20
@TexasHHSC, England/Wales data reveals that, beyond deaths linked to Covid-19, there were 83% more deaths from dementia than usual in April, because a reduction in essential medical care and family visits were taking a devastating toll. — @guardian https://twitter.com/NatalieGNichols/status/1276605967409479680?s=20
“The collateral damages are extreme...Many people are going to spend their final days, their final mo's living in lockdown – isolated, lonely, w/no direct contact w/their loved ones.” @NathanStall, geriatrician, Mount Sinai Hospital (continued...) https://www.theglobeandmail.com/canada/article-tk-toll-of-ltc-visitor-restrictions/
Family members and advocates urge Ontario to open up seniors homes to caregivers

Since the COVID-19 pandemic began, nursing home residents have died of dehydration and malnutrition amid allegations of neglect owing to severe staff shortages

https://www.theglobeandmail.com/canada/article-tk-toll-of-ltc-visitor-restrictions/
“...We absolutely need family bc they are known to be a vital safeguard for residents…against abuse and neglect.” — @DrVivianS

Since the COVID-19 pandemic began, NH residents in Canada have died of dehydration & malnutrition amid allegations of neglect...

It's the same in Texas
@TexasHHSC, a study published in JAMA over a month ago, on June 15, reports on the experiences & outcomes of 26 Dutch nursing homes who re-allowed visitors. In addition to the reported positive impact on wellbeing, no new COVID infections were reported. https://www.jamda.com/article/S1525-8610(20)30526-0/fulltext?fbclid=IwAR17YXAYm7fLFUBA6uyRjZM2Jxad8KMj3gEe9bquLFuC71gNK1xYhizYXkE
Allowing Visitors Back in the Nursing Home During the COVID-19 Crisis: A Dutch National Study Into...

To prevent and control COVID-19 infections, nursing homes across the world have taken very restrictive measures, including a ban for visitors. These restrictive measures have an enormous impact on...

https://www.jamda.com/article/S1525-8610(20)30526-0/fulltext?fbclid=IwAR17YXAYm7fLFUBA6uyRjZM2Jxad8KMj3gEe9bquLFuC71gNK1xYhizYXkE
@TexasHHSC, "The harm from [the #EssentialCarePartner ban] goes far beyond emotional damage. It has also led to newly low standards of care in many facilities, charge some patients, their relatives & doctors."

Written re: CA, this applies to TX NHs also https://twitter.com/CANHR_CA/status/1276268828457005058?s=20
This is #sad. I hope @TexasHHSC responds better than DPH in this instance—even though it's late & after more NH residents have died & suffered harm from #isolation than from covid—it would beat allowing MORE residents to die of isolation & suffer neglect https://twitter.com/LouiseAronson/status/1281258751714947075?s=20
@TexasHHSC, @LouiseAronson writes in the @nytimes:

"Since late February, the stories from NHs & ALFs have been appalling: people dying of neglect...starving to death; defeated people lying in bed or staring out windows with no hope of reprieve..." https://twitter.com/LouiseAronson/status/1270080825967521794?s=20
@TexasHHSC, Surely Texas can figure out how to protect the elderly from coronavirus without imposing another very real health threat—isolation.

#EssentialFamilyCaregiver #VisitationSavesLives #EssentialCarePartner #NotJustAVisitor #eldercare https://www.wsj.com/articles/isolating-the-elderly-is-bad-for-their-health-11595261640
Isolating the Elderly Is Bad for Their Health

Quarantining elderly residents alone in long-term care facilities to protect them from Covid-19 makes them stressed and lonely, with potential negative effects on cognition, memory and immunity.

https://www.wsj.com/articles/isolating-the-elderly-is-bad-for-their-health-11595261640
@TexasHHSC, perhaps this could be a model for allowing #EssentialFamilyCaregivers inside Texas #nursinghomes. This JAMDA article is by a facility medical director in Cincinnati 👇

https://www.jamda.com/article/S1525-8610(20)30430-8/fulltext

#EssentialCarePartner #eldercare #NotJustAVisitor #MoreThanAVisitor
@TexasHHSC, please see this valuable perspective from @NishaOttawa, a Pediatric ID + IPAC physician working in LTC.

"There appears to be an ageist resistance to 'essential visitors' in LTC that belies social supports as a main determinant of health."

https://ottawacitizen.com/opinion/thampi-covid-19-lessons-from-pediatrics-for-the-long-term-care-sector/wcm/aa9907e7-6ece-415a-bf3d-d376db440ae5/
@TexasHHSC, please see this valuable perspective from @NishaOttawa, a Pediatric ID + IPAC physician working in LTC."There appears to be an ageist resistance to 'essential visitors' in LTC that belies social supports as a main determinant of health." https://ottawacitizen.com/opinion/thampi-covid-19-lessons-from-pediatrics-for-the-long-term-care-sector/wcm/aa9907e7-6ece-415a-bf3d-d376db440ae5/
@TexasHHSC, please see this valuable perspective from @NishaOttawa, a Pediatric ID + IPAC physician working in LTC."There appears to be an ageist resistance to 'essential visitors' in LTC that belies social supports as a main determinant of health." https://ottawacitizen.com/opinion/thampi-covid-19-lessons-from-pediatrics-for-the-long-term-care-sector/wcm/aa9907e7-6ece-415a-bf3d-d376db440ae5/
@TexasHHSC, please see this valuable perspective from @NishaOttawa, a Pediatric ID + IPAC physician working in LTC."There appears to be an ageist resistance to 'essential visitors' in LTC that belies social supports as a main determinant of health." https://ottawacitizen.com/opinion/thampi-covid-19-lessons-from-pediatrics-for-the-long-term-care-sector/wcm/aa9907e7-6ece-415a-bf3d-d376db440ae5/
@TexasHHSC, please see this valuable perspective from @NishaOttawa, a Pediatric ID + IPAC physician working in LTC."There appears to be an ageist resistance to 'essential visitors' in LTC that belies social supports as a main determinant of health." https://ottawacitizen.com/opinion/thampi-covid-19-lessons-from-pediatrics-for-the-long-term-care-sector/wcm/aa9907e7-6ece-415a-bf3d-d376db440ae5/
@TexasHHSC, this is the link to Minnesota's policy that distinguishes between #EssentialCaregivers & casual visitors (no link in 1st tweet). PLEASE consider it when writing Texas guidelines allowing #EssentialFamilyCaregivers inside NFs.

Thank you!

https://www.health.state.mn.us/diseases/coronavirus/hcp/ltccaregiver.pdf
@TexasHHSC, this is an excellent example of how #FamilyCaregivers could safely be allowed in NFs to provide #EssentialCare.

Please read this 5-step plan from the Registered Nurses' Association of Ontario:

#EssentialCarePartner #MoreThanAVisitor https://twitter.com/RNAO/status/1287757304511832064?s=20
#TeamTexasHHSC @TexasHHSC, know that “We may have the same numbers of people who...died from loneliness, social isolation, dehydration & malnutrition as actually died from COVID-19 itself."— Dr. Samir Sinha, director of geriatrics at Mount Sinai Hospital https://www.pri.org/stories/2020-07-28/isolation-may-be-greater-risk-covid-19-residents-canadas-nursing-homes
Isolation may be a greater risk than COVID-19 for residents of Canada's nursing homes

Canada's nursing homes were hit especially hard by the coronavirus. To protect residents, provincial governments issued lockdown measures and shut out families. But some experts argue that confinem...

https://www.pri.org/stories/2020-07-28/isolation-may-be-greater-risk-covid-19-residents-canadas-nursing-homes
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