Preparing to visit a person with dementia in a care home during coronavirus

Many care homes closed to visitors in the early stages of the pandemic. Since then, as a friend or family member, you may have been able to see the person you care about face-to-face. The latest national lockdown makes visits harder again, but our advice here should help you prepare for visiting when this is possible.

What does the latest guidance for care home visits say?

The government issues guidance on care home visits in England. The most recent update recognises the continued risk from coronavirus to people who live in, work in and visit care homes. But it also recognises the impact on residents, including many with dementia, of not having visits for so long – especially indoor visits and close contact.

Before the January 2021 lockdown, it was getting easier for most care homes to open to visitors safely again. Homes are getting more help than they were with personal protective equipment (PPE) and regular testing for residents and staff. Infection control measures are also now well established. But what made visiting easier was the availability of rapid diagnostic tests (lateral flow tests) to detect coronavirus infection in family visitors. Now the vaccination of care home residents and staff against coronavirus provides more protection.

The January 2021 national lockdown has changed this. This new guidance states that visits should be outdoors or behind screens wherever possible. 

The only exception is when the person is approaching end of life, when an indoor visit will be supported. In all cases you will need to book your visit in advance.

This guidance as described below applies only until 8 March. Our information will be updated as this changes and when indoor visits supported by testing start again. 

(Guidance for care homes in Wales and Northern Ireland is broadly similar.)

For more about how care homes are making decisions about opening, see our advice on keeping in touch with a person with dementia in a care home.

The home should show you their general visiting policy. The home should also agree a visiting plan with you as part of the person’s individual care plan. The visiting plan should be person-centred – it should look at the specific risks to them from the virus, as well as the risks to their wellbeing due to not having visitors.

For a person with dementia, especially if they have struggled with remote contact, a lack of in-person visits (rather than virtual contact) may be making their dementia worse. It may also cause apathy, agitation and changes to their behaviour that might be challenging for them and other people. Talk to the home about the benefits to wellbeing that your visit could bring.

How do outdoor and ‘screened’ visits work in care homes?

With outdoor visits, these must take place outside of the care home building. You will need to stay at least two metres apart. Being outside and socially distanced reduces the risk of coronavirus being spread. 

Depending on the home, its layout and the weather, for an outdoor visit you might be supported to:

  • chat through an open ground-floor window or patio door
  • meet in a gazebo, under an awning or similar
  • meet in a garden or marquee (or similar) space
  • have a ‘drive-through’ visit – where you talk through your open car window to the person sitting two metres away.

These options may work for you, but the guidance does acknowledge that they will not be appropriate for many residents during the winter months.

A ‘screened’ visit is when you meet from behind a screen in a temporary outdoor structure (sometimes called a ‘visiting pod’) or a conservatory. In a ‘screened’ visit:

  • you speak to the person from behind a see-through plastic screen – similar to those seen in supermarkets now
  • the space will be thoroughly cleaned between visits
  • expect the space to be well ventilated.

For both outdoor and screened visits, family visitors are limited. The home will allow a maximum of the same two family members each time, where possible. You will need to wear PPE during the visit. But you will not need to have a rapid virus test first.

Visiting at the end of life 

Visits to someone who is nearing their end of life are exceptions to the rules on outdoor or screened visits. They need not be limited to the very end of life but could be within their final months or weeks. For end of life visits:

  • the home should plan and communicate clearly with you
  • you will need to have a rapid diagnostic test before each visit – and be negative for the virus (not infected)
  • you should then be able to visit indoors.

Testing for coronavirus

The care home will set up a special area for rapid testing on arrival for visitors – to test for coronavirus. This will have a waiting area, a one-way system, hand hygiene and social distancing will be in place. You will need to wear PPE during testing, provided by the care home.

Care home staff will give you the result 30 minutes after you do the test, so you will need to be patient.

After a negative test result

If you test negative (not infected) then the home should enable you to visit indoors straight away. You will still need to follow good hand hygiene and social distancing around the home. It’s natural to want to hold hands, have a hug or cuddle or possibly provide personal care. If so, you will be helped by staff to put on PPE to make such contact safer. (It will probably still feel strange wearing a mask, to both you and the person with dementia. You can ask about a visor, but these don’t offer as much protection from coronavirus as a mask.)

After a positive test result

If you test positive (infected) with the rapid test you will not be able to visit that day. Instead you will need to go home straight away, self-isolate and take a second different kind of test that the home will give you. You should take this second test and post it off. Follow the advice with the test, but if the result of that comes back positive, your household will need to self-isolate.

Our dementia advisers are here for you.

Your reunion

When you get to visit the person with dementia, your reunion may well be emotional. If it’s been a long time since they saw you – and if the person has memory problems, you may need to gently remind them who you are. Familiar aspects of your appearance such as clothes, a hair style and perfume/aftershave that the person associates with you may help them to remember. The home may also have shown the person photos of you together and talked to them about you, to help with this.

You may need to mention the virus to explain why you couldn’t visit before. Talking about earlier times you’ve enjoyed together may be a way of keeping the conversation more cheerful. Speak clearly and louder than usual to be heard through your face covering.

Don’t be surprised if the person’s dementia has got worse since you last saw them or if they seem low. They may improve with ongoing support, and their feelings for you remain, even if they seem hidden.

Try to be flexible and work with everyone as best you can. Before you leave, arrange the next visit. This will give you and the person something to focus on and look forward to.
 

Last updated 27 January 2021

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