Nursing homes prepare for increasing numbers of infections with rapid tests and infrared thermometers. But who is actually allowed in?
BERLIN taz | The residents, including those with dementia, have got used to the fact that the nursing staff in the home wear masks. “It has become everyday life,” reports Kristina Baumstark, director of the “Haus im Schelmenholz” senior citizens’ center in Winnenden.
It is now part of everyday life that employees at reception measure the body temperature of the visitors, contactless, with an infrared thermometer in front of their foreheads. And the new tests are coming soon. “I hope that we can organize the procurement of the rapid tests in the next few weeks,” says Baumstark.
The senior citizen center is one of thousands of nursing homes in Germany in which a compromise has to be found – between the needs of the residents and the requirements for infection protection in the second wave of the corona pandemic. Rising numbers of infections in the country are currently again leading to “sometimes disproportionate restrictions on visits to nursing homes,” says David Kröll, spokesman for the Biva-Pflegeschutzbund in Bonn.
The Schutzbund advises relatives and those in need of care and fears a repetition of the momentous isolation of home residents like in spring. Homes had imposed general visits and exit bans, a precautionary measure as mass outbreaks of Covid-19 had occurred in some nursing homes, in which dozen of residents died. The frail senior citizens became lonely due to the general ban on visits. “After all, relatives take on a lot when they visit, for example helping with food and drink, which then disappeared,” says Kröll.
20 rapid tests per resident
The Biva-Pflegeschutzbund recommends taking legal action if you cannot resolve a conflict about a visit ban with the home management or home supervisory authority and in contact with the health department. He refers to a ruling by the Minden Administrative Court in which the judges lifted the isolation of a nursing home resident due to a lack of authorization and questioned the content of a corona protection ordinance.
“We definitely don’t want general visitor bans again,” says Baumstark. The senior center is prepared. “We are better equipped now. There is enough protective clothing, gloves, FFP2 masks, ”says the house manager. If one of the residents in the 135-bed house were to test positive, she could be isolated from the others and cared for by caregivers in protective clothing. The district of the home records more than 50 new infections per 100,000 inhabitants, which is why the body temperature of the visitors is measured at the entrance as a precaution.
The home has applied for 20 of the new rapid antigen tests per resident per month, says Baumstark. The contingent of 20 tests must be enough for a resident, her caregivers and her visitors. Specially trained nurses will then swab the throat area of the visitors at reception. The result of the rapid antigen test can be read after 20 minutes.
Tests should be carried out, for example, if the symptoms are unclear or if a visitor has had contact with those who tested positive or if nurses look after someone who is positive, explains Baumstark. If you come to visit frequently, a weekly smear is provided for.
The relatives only meet the residents in the room or outside, but not in the common room. Since Corona there have been no cross-residential events in the senior citizen center. “You have an enormous responsibility,” says Baumstark. She is happy that with the Protestant Home Foundation she has a support behind her who runs several facilities and helps with decisions about infection protection.
“Limitations always create suffering”
The restriction of visits or even exit bans are always legally tricky. “With the visiting and exit bans in spring and summer, we were entering new legal territory. We were catapulted into a situation where there was no authorization and no qualification, ”says Ulrike Kempchen, lawyer at Biva. “We would like to see uniform national minimum standards for visiting regulations in the facilities.”
The visiting regulations have so far differed regionally, states the Schutzbund. In Berlin, residents can receive up to three visitors a day, masks must be worn in closed rooms. In Baden-Württemberg there is no mask requirement and a minimum distance of 1.50 meters for close relatives. In Hamburg, a maximum of three hours of visits per week and resident for a maximum of two people are permitted in the interiors of the care facilities, physical contact of a maximum of 15 minutes per visit is permitted. In addition, the homes have special rules.
The federal government’s representative for care, Andreas Westerfellhaus, has now announced a nationwide “handout” for visiting concepts in care homes, in cooperation with the Federal Ministry of Health and the Robert Koch Institute. Every restriction always creates suffering. Kempchen says: “I see surveys where residents are quoted saying that I want to decide for myself what I’m going to die of and I don’t want to live in isolation.”