Visiting a person with dementia in a care home during coronavirus

Keeping connected with someone living in a care home has been much harder during the pandemic. As we come out of lockdown restrictions, read our advice on what to expect from a visit to a care home and how to prepare.

If you have a question or concern that isn’t covered here, speak to the care home manager. See also the ways Alzheimer’s Society can provide support.

Types of care home visit that may be allowed

The government publishes national guidance on visiting care. Read the current guidance for:

It is not compulsory for any family visitors or the resident to have had the COVID-19 vaccine for any visits to go ahead. However, the guidance  strongly recommends that everyone who is offered a vaccine takes up this offer under the  national vaccination programme. Two doses offer the best protection. 

The type of visitors each resident should be able to have are listed below.

Named visitors 

Every care home resident can have named visitors who can visit regularly.

The government has now removed restrictions on the number of ‘named visitors’ that a resident can have in England. There is now no limit. There is also no nationally set limit on the number who can visit in a single day. The care home will decide how often visits can happen and how long each visit can be.

Visitors must have a rapid flow test before every visit and be negative (uninfected) beforehand. All visitors are advised to keep physical contact to a minimum and those aged 11 and over will be required to wear PPE. 

Physical contact like handholding is acceptable if hand washing protocols are followed. Close physical contact – such as hugging, is riskier, but will be safer between people who have had both their vaccine doses, and if it is a quick hug.

An ‘essential caregiver’ 

An essential caregiver is someone who can provide the person with practical, emotional or mental support in close contact with them. For example, the caregiver might help with tasks such as washing, dressing or encouraging the person to eat. Or their close relationship with the person means they can manage challenging behaviour more easily than care home staff can.

Any resident can have an essential caregiver, not just residents with the greatest needs. The essential care giver can visit in all circumstances, unless they or the person they are visiting test positive for coronavirus. This includes if the care home has an outbreak of coronavirus.

This visitor will have to use the same PPE as care home staff.  They will need to take a minimum of two rapid lateral flow tests a week. This should include: 

  • one rapid lateral flow test – on the same day as a PCR test 
  • one rapid lateral flow test – three to four days later.

In exceptional circumstances, more than one essential care giver may be allowed.

Other visitors 

Other visitors will not need to be tested but will have to visit outdoors, inside a pod or behind a screen. If there is a coronavirus outbreak within the home, then visits will be allowed only for essential carers or for exceptional reasons and for those visiting residents at end of life.  

You will need to wear PPE during your visit. There is government guidance for care home workers on the type of PPE that is required for different scenarios. This guidance is also relevant to visitors. Ask the care home to guide you on the appropriate PPE for the situation.

Visiting policies

Each care home manager will develop their own visiting policy. They will work to support visits safely, while focusing on each resident’s needs. Local public health staff can offer advice and support.
 
The manager will look at the following specific aspects:

  • The rights and wellbeing of residents – tailored in a person-centred way to the circumstances of each individual.
  • The benefits of visits to the person, and their individual risk from coronavirus.
  • Where and how visits will happen – based on the home’s layout.
  • Measures in place to control infection (PPE, social distancing and handwashing).

Ask your home about its visiting policy and how it supports the wellbeing of people with dementia including guidance for visitors. The home should also agree on a visiting plan with you as part of the person’s care plan.

In most cases, you will need to book your visit in advance. 

When you won’t be allowed to visit a care home

If any residents or staff have had coronavirus, visiting will stop until at least 14 days after the last person had coronavirus symptoms. An exception will be made for essential caregivers and for visiting someone who is nearing the end of their life. It may also be possible for outdoor or screened visits to continue subject to a risk assessment.

You also won’t be allowed to visit at all for any of the following reasons:

Government guidance states that visiting must be supported and enabled whenever it is possible and safe to do so. Blanket bans on visitors are not acceptable. If care home visits continue to be a challenge for you and the person with by dementia, let us know by sending an email to [email protected]

Our dementia advisers are here for you.

Testing for coronavirus

The care home is likely to have set up a special area for rapid testing on arrival for visitors – to test for coronavirus. This will probably have a waiting area and a one-way system. Hand hygiene and social distancing will also 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.

Alternatively, rapid flow tests can be done outside the care home. This can be either at a testing site (where you can get a test without having symptoms of coronavirus) or in your own home. You can get tests for home use at some test sites, in some pharmacies, or by ordering online. 

PCR tests, needed for essential caregivers and processed in a lab, will be organised by the care home.

After a negative rapid 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. 

After a positive rapid 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 PCR 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 this result comes back positive, everyone in your household will need to self-isolate unless they are exempt from having to self-isolate, for example if they are double vaccinated or under 18.

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

These visits are encouraged so that the resident can see a wider range of family and friends.

With outdoor visits, these must take place outside of the care home building. Being outside reduces the risk of coronavirus being spread. You can read more about other steps to keep the person you are visiting, safe and well

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.

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
  • the area will be thoroughly cleaned between visits
  • expect the space to be well ventilated.

For both outdoor and screened visits, the home may restrict the number of visitors at each time. You will need to wear PPE during the visit. But you should not need to have a virus test first.

Your reunion

When you get to visit the person with dementia, your reunion may 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 hairstyle and perfume/aftershave that the person associates with you may help them to remember.

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. 

How can I keep in touch if I can’t visit the care home?

Whether or not you are able to visit the care home, staff there should keep you updated regularly on the person you care about. 

Some homes have websites or social media groups to support relatives. Make sure the home has your up-to-date contact details and knows the best way to get hold of you.

You may have already been using technology to keep in touch with the person from a distance. We have more about staying in touch from a distance on our page about keeping someone safe and well.

Can I visit a person out of their care home?

Spending time with friends and family out of their care home is important for many residents. Some people will also have visits out, such as to a day centre, included in their care plan.
 
The latest guidance on visits out in England now allows most trips out without the need for the resident to isolate on their return to the home.

These visits should be individually risk assessed, so talk to the care home manager. They could include:

  • spending time with friends and family - including overnight stays 
  • medical appointments (including planned but not overnight hospital stays but not unplanned ones)
  • other activities to maintain the person’s health and wellbeing –such as going to a day centre or place of worship.

To keep safe, you and the resident will need to test negative beforehand. The type of test you need will depend on which type of visitor you are (as set out above). See our guidance about keeping safe and well.

Your risk is much lower if you have both had two COVID-19 vaccinations. Public transport and crowded spaces are also best avoided

There is similar guidance in Wales and Northern Ireland.

Visiting at the end of life

There have always been exceptions to the rules for visits to someone who is nearing the end of their life. They need not be limited to the very end of life but could be within their final months or weeks.

If you are visiting someone who is near the end of their life, the home should communicate clearly with you and involve you in all planning decisions. You will need to have a rapid test before each visit, which must be negative for the virus (not infected). You should then be able to visit indoors.

Dementia Connect support line
Our dementia advisers are here for you.
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