It was the darkest of times for Gabrielle, a 96-year-old resident of a nursing home in the foothills of the San Gabriel Mountains. Each dawn during the pandemic brought another day of loneliness and anxiety.
“She was having feelings of being abandoned,” remembers her daughter Denise Bogan. “And sometimes she would cry … it was completely traumatic.”
Gabrielle was one of the 250,000 California residents in long-term care nursing homes. Like many other residents, she suffered as state and county public health officials periodically denied access to family and friends during the height of the pandemic. The on-again, off-again closures had a “devastating” impact, according to a taxpayer-funded report released last fall.
The prolonged shutdowns led to residents "experiencing cognitive impairment, severe feelings of isolation, malnutrition and depression," the report found. It concluded that a new approach is needed during any declared emergency.
The study spurred San Diego Assemblymember David Alvarez (D-80th) this year to author AB 2075, also known as the Resident Access Protection Act. This would allow access to chosen support providers who aren't nursing home employees as long as they follow the same safety protocols required of the staff.
Last month, Alvarez told the Assembly Health Committee that “residents suffered an incalculable loss due to prolonged visitation restrictions.”
The bill has passed the Assembly’s Aging and Health committees and is now before the Appropriations Committee. It is supported by AARP, Essential Caregivers Coalition, the Long-Term Care Ombudsman,and California Advocates for Nursing Home Reform (CANHR).
“Visitors provide just as much support, if not — in some cases — more support to the wellbeing of long-term care facility residents than the paid staff,” said Tony Chicotel, the lawyer for CANHR. He had argued against the closures during the pandemic shutdowns.
This legislation would not just apply to when a pandemic occurs, but go into effect with any health emergency declared by state or local officials. Included would be natural disasters, bioterrorism emergencies, chemical and radiation emergencies, power surge failures and blackouts.
Second chance
This is the second statewide bill proposed on this subject. Former Assemblyman Adrin Nazarian (D-46th) proposed the first in 2022. However, it died amid opposition from organizations representing state and county public health officials. That defeat led to the study Alvarez used as the basis of the current bill.
Most of the groups that opposed the 2022 legislation are working to defeat this one as well. They include the Health Officers Association of California (HOAC), representing the physician health officers of 61 counties and cities statewide, and the County Health Executive Association of California (CHEAC), representing the state's local health departments.
The public health officials said even if designated support providers are trained, it won’t be at the same level as the training nursing home staff receive.
The staff of nursing homes are regulated by state agencies and “may be trained in the use of personal protective equipment in a way that the public generally is not,” said Dr. Cameron Kaiser, speaking for HOAC.
Kaiser, who works as a deputy public health officer in San Diego County, added that creating a law guaranteeing access would have “unintended consequences (because) we don't know what the next pandemic will potentially bring.”
CHEAC’s Betsy Armstrong said the bill doesn’t square with current “public health guidance and measures.”
The San Diego County Department of Public Health refused KPBS' request for comment, citing the “pending legislation.”
Chicotel said the officials are not taking into account the benefits of having support providers and underestimating the risk coming from nursing home staff.
The support providers offer “companionship and psychosocial support, along with daily living tasks, such as eating, dressing, and hygiene support,” among other things, Chicotel said.
Chicotel went on to say that first-hand accounts show “public health departments didn't understand that staff in these situations are actually more dangerous than visitors because the staff go from resident to resident to resident throughout the day.”
'Care went down'
Denise Brogan said her mother, Gabrielle, contracted COVID-19 from a nursing home staffer.
“There were beautiful people that worked there that cared deeply about her,” Brogan said. “It's just when the pandemic hit, and they no longer let in this essential part of her care team, then the care went down. And she went down. And so did a whole bunch of her friends.”
Lynn Dedrick’s now deceased mother, Petey, lived in an Encinitas nursing home. Petey had Alzheimer's and “couldn't remember the pandemic," Dedrick said. "She thought I had forgotten about her.”
The forced separations exacerbated her mother’s condition, Dedrick said. “You keep trying to explain what's happening and, and you know, but they can't remember the more recent things, right? They just know that you're not there.”
Dedrick hopes something good can come from what her family experienced.
“I don't want anyone else to go through what we did,” she said. “And I think that anyone who's been in a similar situation, gets it.”
