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States Prioritize Safety, Emotional Wellness With Expanded Senior Living Visits

Kara Lewis
By Kara LewisOctober 12, 2020

When coronavirus shutdowns swept the country mid-March, senior living communities faced some of the strictest visitor regulations. Due to factors like age and underlying health conditions, residents at these facilities are at greater risk for complications from COVID-19. Adults older than 65 account for 80% of virus fatalities, according to the Centers for Disease Control (CDC).

With this in mind, community staff and local, state, and federal regulators prioritized seniors’ protection and security. Yet as the virus stretches into its seventh month, senior communities and policymakers face a complicated question: How can they prioritize both safety and emotional well-being?

More than 90% of senior communities allow some type of visitation, according to an October survey of 1,513 A Place for Mom partners. Outdoor visits, designated visitor areas, and COVID-19 screenings are some of the many ways communities have balanced family and caregiver visits with resident health.

Essential caregiver policies go one step further. Recently adopted in Texas, Florida, Minnesota, Indiana, New Jersey, Michigan, Oklahoma, Missouri, and Ohio — with more states to likely follow — these new protocols expand visitation rules and allow for increased, in-person connection between seniors and select loved ones.

“If we can help with the emotional well-being of residents in our buildings, we want to do that,” says Patti Cullen, president and CEO of Care Providers of Minnesota, a long-term care association. “But we know we have to be safe.” Find out how senior living communities are managing these concerns, current visitation statistics, what role essential caregivers play, and how communities are combating loneliness with digital tools and creative, socially distant activities.

Who are essential caregivers?

Essential caregivers aren’t just any visitors. Rather, this classification describes visitors who were “very active” in caring for a resident prior to COVID-19 restrictions. In most cases, this involved daily visits. Seniors transitioning into communities will be able to designate an essential caregiver upon moving in, according to most state policies.

Argentum, a leading senior living organization, defines an essential caregiver as: “An individual age 18 or older who, prior to visitor restrictions, was regularly engaged with a resident to provide companionship and/or assist with activities. These individuals advocate for a loved one’s needs and support them in managing their health, health care, long-term care, and overall well-being.”

Why are essential caregivers important?

Research supports the essential nature of close connections among the elderly. Senior loneliness is as detrimental as smoking, obesity, inactivity, and excessive alcohol consumption, according to a 2017 study on the connection between close relationships and senior health in the American Psychologist Journal. Social connections have benefits that include:

  • Lower risk for infections
  • Less likelihood of contracting cardiovascular disease
  • Reduced cognitive and physical decline
  • Lower rates of cancer-specific mortality
  • Greater overall life expectancy

How many senior communities accept visitors?

In general, senior living facilities are allowing more visitors than during early stages of the pandemic. Policies vary depending on ever-changing local, state, and community guidelines. For example, in mid-October, Minnesota newly permitted indoor visits to assisted living facilities if a community hasn’t had a COVID-19 case in the last 14 days and the county positivity rate is less than 10%.

Caregivers were excited each step of the way when we expanded visitations. Just having an opportunity to sit face-to-face with Mom and Dad has been thrilling to family members. 

Patti Cullen, president and CEO of Care Providers of Minnesota

A Place for Mom’s recent survey of more than 1,500 communities’ visitation policies reveal:

  • 92% allow visitors in some fashion.
  • 39% allow indoor visits in designated areas.
  • 37% allow outdoor only visits.

What do essential caregiver policies mean for seniors and families?

Though these numbers show a majority of senior communities accommodate at least some form of visitation, essential caregiver visits differ in fundamental ways.

Cullen breaks down how essential caregivers may receive special permissions and considerations: “Let’s say you’re in a county that has a 10% or higher COVID-19 positivity rate. You can’t open your doors to visitors — besides for essential caregivers. Or, if you’ve had a positive case in your building in the last 14 days, you can’t allow just general visitors in, but you can allow essential caregivers. So, it really is a big difference.”

Additionally, essential caregivers can often visit an individual resident’s room, whereas other visitors may be relegated to common areas. While communities require six feet of social distance for general visitors, essential caregivers may come closer to a resident if their caregiving duties demand it — and if they wear more extensive protective equipment.

“Caregivers were excited each step of the way when we expanded visitations,” says Cullen, reflecting on the months-long process. “Just having an opportunity to sit face-to-face with Mom and Dad has been thrilling to family members.”

What protocols will essential caregivers follow?

While essential caregivers have enhanced visitation privileges, these come with necessary guidelines. In accordance with the CDC, senior living organization Argentum developed suggested requirements as part of their essential caregiver toolkit. Though specific protocols differ by state, in general, essential caregivers must:

  • Wear the facility’s mandated personal protective equipment (PPE), such as a face mask and eye protection, while in the senior living community.
  • Frequently wash their hands or use hand sanitizer.
  • Provide care in the resident’s room, restricting movement throughout the overall community.
  • Ensure 6 feet of social distance with staff and other residents.
  • Avoid outings with the resident, aside from necessary medical appointments.
  • Not visit if they feel sick, as well as inform the community if they develop COVID-19 symptoms within 14 days of visiting.

Cullen adds that caregivers should be flexible and understanding. Though states are currently expanding visitations, she cautions that regulations continue to evolve, often in unforeseen ways. Factors like a community or county spike in COVID-19 cases could change protocols. During virtual and in-person tours, ask how visitation policies are determined.

How assisted living communities facilitate virtual visits and combat loneliness

Even virtual connection can reduce loneliness, according to a study published in The Scientific World Journal. Though in-person visitations continue to expand in many states, families considering senior living should ask about ways communities facilitate virtual visits in the meantime. Many communities use FaceTime, Zoom, and other digital platforms to ensure residents feel connected to their loved ones.

Fellow seniors within a community may interact with each other using those tools as well to maintain friendships. Additionally, activities directors help beat loneliness and isolation with creative, engaging activities that follow social distancing recommendations.


Centers for Disease Control (CDC). “Living in or Visiting Retirement Communities or Independent Living Facilities.”

Husebø, A. M., & Storm, M. “Virtual visits in home health care for older adults.”

Kara Lewis
Kara Lewis
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