Vision for long-term care regulations needs new focus

Look through my eyes

Shakespeare taught us, “The eyes are the window to your soul.” What happens when our vision is cloudy? Can we “see” each other? I’m certainly no Shakespeare, nor would I ever pretend to be. What I will offer, however, is when something is taken away, we certainly appreciate it more. It shouldn’t take the absence of that something for you to have an appreciation for it. This month has taught me that tenfold. I thought I had an appreciation through COVID, but I have gained an even deeper understanding, and that, my friends, is a silver lining.

This column, while it stems from my personal journey of eye surgery, reminded me of how each of our lenses is very different. If you could see through someone else’s eyes, could it change your perspective? My lingering question is, will it change your perspective enough to entice action?

For years I thought when those older than me complained about sight problems they were overexaggerating. After all, I’ve had “bad” vision since second grade. I now appreciate I did not really understand. A detached retina later and two hours of surgery at the Wolfe Eye Surgery Center taught me it could be much worse, not so much the inconvenience or the loss of vision, but it’s the feeling of uncertainty and loss of self that really scared me. Who am I if I can’t see, if even only for a short period of time? I suddenly (or over 47 years) actually have a much deeper understanding of how physical changes impact us in emotional ways. Frustration and self-pity can do very strange things to us, regardless of age.

And yet during this time of pandemic paralysis, age continues to be an unfair governing factor in how one lives. Let me explain. Despite the fact that most residents of long-term care are vaccinated, other people’s vaccination status, COVID status, employment status, and overall being directly impacts our residents’ ability to see friends or, in some cases, even leave their room. As a leader in this field, I keep telling myself there has to be a better way.

In other words, today if you, regardless of your vaccination status, were possibly exposed to someone who tested positive, you would not be allowed to see friends or family unless you qualified for what someone else defines as a compassionate care visit. Would you stand for that? Would you allow it? Would you ignore it? Fight it? My hunch is you wouldn’t sit by and let it happen.

In the long-term care world, did you know we are still forced to adhere to guidance that says just that for those living in nursing home settings? Technically, a resident would have to qualify for a “compassionate care visit,” as defined by The Centers for Medicare and Medicaid to have a visitor, even if there is just one case of potential exposure. If we, as leaders, push the limits, there is a chance we will face deficiencies or even fines. The vision remains cloudy. We, better than most, understand the risks and need for the appropriate use of personal protective equipment. We think about all potentially infectious diseases every day, we talk with our teams, provide education, and audit for appropriate use every day. My hope is those making the decisions around visitation for those living in nursing home settings will see what this is doing to all of us.

We need visitation guidelines to change now for those living in licensed areas. Here in Webster County, we are now testing employees twice a week because our county’s positivity rate is over 10 percent. Decisions matter, and there is no “end” in sight. The people living here should not be punished any longer; they have faced enough.

I’m confident my personal sight will return to normal, maybe even better than normal soon. My hope is we start to really see guidance and regulation differently for long-term care. My greater hope is that we all continue to truly see and understand each other; it shouldn’t take any more loss to appreciate the circumstances we are all living and working in.

Julie Thorson is the president and chief executive officer of Friendship Haven in Fort Dodge.


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