The BulleTin • Sunday, June 20, 2021 A5
COVID-19 pandemic
‘Protected them to death’:
Elder-care rules under fire
BY MICHAEL RUBINKAM
Associated Press
Ben Lonergan/East Oregonian
Dr. Greg Jones, dentist for Fourth Street Dental in Hermiston,
speaks with a patient June 10 before an exam. Jones said he has
seen appointments rebound after dropping off in 2020 as a result
of the COVID-19 pandemic.
Patients put off
preventative care
during pandemic
BY JADE MCDOWELL
East Oregonian
HERMISTON — As newly
vaccinated patients are re-
suming their normal preven-
tative health care, some are
finding those appointments
they skipped during the pan-
demic have consequences.
Dr. Greg Jones, dentist
for Fourth Street Dental in
Hermiston, said he is seeing
some patients for the first
time in a long time.
“You could tell people had
put stuff off,” he said. “Cavi-
ties were a little bigger, clean-
ings had been skipped, some
broken teeth could have been
fixed sooner.”
He also saw signs that
people had been under ad-
ditional stress, including an
increase in cracked teeth, jaw
pain and other side effects of
people grinding or clenching
their teeth.
Jones said dentists in big
cities where people are more
cautious about COVID-19
still are seeing lower patient
volumes, but in rural areas,
appointments mostly have
rebounded after dropping off
in 2020. He said it wasn’t un-
common last year for people
to cancel an appointment at
the last minute because they
had been asked by the health
department to quarantine,
while other people decided
they weren’t comfortable
with the risk of going in to
the office.
“It was a little like a snow
day, where some people don’t
leave their homes and other
people drive around like it’s
no big deal,” he said.
In Oregon, health care pro-
viders were directed to only
provide emergency services
during the spring of 2020, to
help preserve personal pro-
tective equipment that was in
extremely short supply.
In a weekly survey of
13,000 dentists nationwide by
the American Dental Asso-
ciation, 76% of dentists said
their office was only open
for emergency patients and
18% said they were closed
completely on March 23,
2020. Those numbers slowly
shrunk over the year, and by
December, 39% described
their practice as operating
normally and 60% said they
were open but seeing fewer
patients than usual.
Jones said dentists al-
ready practiced many of the
guidelines for preventing
COVID-19 transmission
even before the pandemic,
including instrument steril-
ization and wearing gloves
and masks while working on
patients. But they have also
added new precautions, in-
cluding more frequent sani-
tization of the waiting room
area and temperature checks
when patients arrive.
Cancer screenings
One of the times delay-
ing preventative care can
have the most serious con-
sequences is when cancer is
involved.
Dr. Nattamol Hosiriluck,
a hematologist with Tri-Cit-
ies Cancer Center, which has
offices in Hermiston, said
she has seen a few cases of
people whose cancer is more
advanced after delaying a
routine screening, such as a
mammogram, because they
were trying to avoid catching
COVID-19.
“Right now, the queue is
really long to get a colonos-
copy, so if you delayed a colo-
noscopy I would say book it
down because it could be a
few months from now,” she
said.
Some cancers grow faster
than others, she said, but in
certain cases, not catching
something for an extra six
months could be fatal.
Hosiriluck said while can-
cer patients are in treatment,
they have a higher risk of se-
vere cases of COVID-19, so
she strongly encourages pa-
tients to get vaccinated before
treatment.
“If they’re not willing to get
the shot, I recommend care-
ful social distancing, because
they’re more at risk,” she said.
Eye exams
Some patients put off eye
care during the pandemic.
Dr. Michelle Monkman,
an optometrist with Vision
Pendleton, said they were
shut down for five weeks in
spring of 2020, then opened
to lower patient volumes.
Things have been rebound-
ing, however, as people who
have gotten vaccinated have
felt more comfortable com-
ing in.
Monkman said she hadn’t
personally seen anyone lose
vision because they hadn’t
caught something soon
enough after skipping ap-
pointments during the pan-
demic.
If people are wondering
whether to book an eye ap-
pointment, Monkman said,
“I think it’s time.”
Barbara and Christine Co-
lucci long to remove their masks
and kiss their 102-year-old
mother, who has dementia and
is in a nursing home in Roches-
ter, New York. They would love
to have more than two people in
her room at a time so that rela-
tives can be there, too.
“We don’t know how much
longer she’s going to be alive,”
Christine Colucci said, “so it’s
like, please, give us this last
chance with her in her final
months on this earth to have
that interaction.”
Pandemic restrictions are
falling away almost every-
where — except inside many
of America’s nursing homes.
Rules designed to protect the
nation’s most vulnerable from
COVID-19 are still being en-
forced even though 75% of
nursing home residents are
now vaccinated and infections
and deaths have plummeted.
Frustration has set in as fam-
ilies around the country visit
their moms and, this Father’s
Day weekend, their dads. Hugs
and kisses are still discouraged
or banned in some nursing
homes. Residents are dining
in relative isolation and play-
ing bingo and doing crafts at a
distance. Visits are limited and
must be kept short, and are cut
off entirely if someone tests pos-
itive for the coronavirus.
Family members and ad-
vocates question the need for
such restrictions at this stage of
the pandemic, when the risk is
comparatively low. They say the
measures are now just prolong-
ing older people’s isolation and
accelerating their mental and
physical decline.
“They have protected them
to death,” said Denise Gracely,
whose 80-year-old mother,
Marian Rauenzahn, lives in
a nursing home in Topton,
Pennsylvania.
Rauenzahn had COVID-19
and then lost part of a leg to
gangrene, but Graceley said
what she struggled with the
most was enforced solitude,
going from six-day-a-week vis-
its to none at all.
Rauenzahn’s daughters even-
tually won the right to see her
once a week, and the nursing
home now says it plans to relax
the rules on visits for all res-
idents in late June. But it has
not been not enough, as far as
Graceley is concerned.
“I believe it’s progressed her
dementia,” Graceley said. “She’s
very lonely. She wants out of
there so bad.”
Pennsylvania’s long-term care
ombudsman has received hun-
Ways you
can support
Thelma’s Place:
• Vehicle donations
• Cash donations
• Sponsorships
• Volunteer
CHILD CARE
AN INTERGENERATIONAL PROGRAM
Your support makes a difference!
Redmond: 541-548-3049
Day Respite and Support Groups
www.thelmasplace.org
Matt Slocum/AP
Angela Ermold, right, and her sister, Denise Gracely, hold a photo of their mother, Marian Rauenzahn, on
June 17 in Fleetwood, Pennsylania. Pandemic restrictions are falling away almost everywhere — except in-
side many of America’s nursing homes. “They have protected them to death,” said Gracely.
dreds of complaints about visit-
ing rules this year. Kim Shetler,
a data specialist in the ombud-
man’s office, said some nursing
homes’ COVID-19 restrictions
go beyond what state and fed-
eral guidelines require. Admin-
istrators have been doing what
they feel is necessary to keep
people safe, she said, but families
are understandably upset.
“We’ve done our darndest to
advocate for folks to get those
visitation rights,” she said.
“It’s their home. They should
have that right to come and go
and have the visitors that they
choose.”
A recent survey by National
Consumer Voice for Quality
Long-Term Care, an advocacy
group, found time limits on
visits remain commonplace,
ranging from 15 minutes to two
hours.
Rauenzahn’s Pennsylvania
nursing home has been limit-
ing most residents to a single,
30-minute visit every two weeks.
Federal authorities should
“restore full visitation rights to
nursing home residents without
delay,” Consumer Voice and sev-
eral other advocacy groups said
in a June 11 letter to the Centers
for Medicare & Medicaid Ser-
vices. Residents are “continuing
to suffer from isolation and de-
cline because of the limited vis-
itation permitted in the current
guidance,” the letter said.
Advocates also take issue
with federal guidance on how
nursing homes deal with new
COVID-19 cases. The guid-
ance says most visits should be
suspended for at least 14 days.
Some family members, admin-
istrators and advocates com-
plain that the recommendation
has led to frequent lockdowns
because of one or two cases.
“We’ve never had a real long,
lengthy period of time where
we’re able to have visitors,” said
Jason Santiago, chief operating
officer at The Manor at Seneca
Hill in Oswego, New York. He
said continued isolation is in-
flicting a heavy toll. “We’ve got
to do things that make more
sense for these residents, make
more sense for these families.“
While the federal govern-
ment recently eased restrictions
for vaccinated nursing home
residents, New York state has
not gone along. Those who eat
together in communal spaces
must remain socially distanced,
for example, and they have to be
masked and 6 feet apart during
activities, no matter their vacci-
nation status.
That makes crafts, bingo,
music — “a lot of what nursing
home life is about” — more dif-
ficult, said Elizabeth Weingast,
vice president for clinical excel-
lence at The New Jewish Home,
which runs elder-care facilities
in and around New York City.
“We prioritized vaccinating
nursing home residents and
that’s wonderful, but they’re not
getting the same liberties that
you or I have now,” said Wein-
gast, who recently published an
opinion piece calling for a loos-
ening of restrictions.
Her co-author, Karen Lipson
of LeadingAge New York, which
represents nonprofit nursing
homes, said the rules “force this
kind of policing of love that is
really, really challenging.”
With the virus infecting
more than 650,000 long-
term-care residents and kill-
ing more than 130,000 across
the U.S., nursing homes had a
duty to take precautions when
COVID-19 was out of con-
trol, said Nancy Kass, a public
health expert at Johns Hopkins
University. But she said she is
baffled by the continued heavy
emphasis on safety at the ex-
pense of residents’ quality of
life, given “we’re not in that
state of affairs anymore.”