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. Now that visits are supported again, read our advice on what to expect and how to prepare.

Being unable to visit and be with our families and the people we love has been one of the hardest aspects of this pandemic.

This has been especially true for people in care homes, and their friends and families who may not understand why you haven’t visited and be feeling lonely or low. 

Types of care home visit that may be allowed

The government publishes national guidance on visiting care homes in England. As part of its roadmap (plan to gradually ease restrictions) out of the latest national lockdown, the latest guidance for indoor visits has been effective since 17 May 2021. You can also see guidance for Wales and Northern Ireland.

It is not compulsory for any visitors or the resident to be vaccinated 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.  

Any contact the visitor is allowed will depend on the needs of the person they are visiting. The type of visitors each resident should be able to have are listed below.

Named visitors 

Up to five named visitors will be able to visit regularly indoors so long as they test negative (uninfected) before each visit and wear personal protective equipment (PPE) if aged 11 or over. They must avoid close physical contact with the resident such as hugging but can hold hands. One of the visitors can be under 18 and children aged under two need not be counted as one of the named visitors. More than two named visitors should not visit at the same time. 

Importantly, visitors must have a rapid flow test before every visit and be negative (uninfected) beforehand. 

An ‘essential care giver’ 

When the person has very high needs an essential care giver can provide the person with practical, emotional or mental support in close contact with them. For example, the care giver might help with tasks (washing, dressing, encouraging the person to eat) when their absence would pose a risk to the resident’s wellbeing. Or their close relationship with the person means they can manage challenging behaviour more easily than care home staff can.

The care home, family and resident will decide who counts as an essential care giver. This visitor will have to use the same PPE as care home staff. On testing, they will need to take a PCR test weekly plus a rapid flow test on the day and another rapid flow test three or four days later. They will need to test negative before each visit and results will need to be shared with the home.

An essential care giver counts towards one of the five named visitors above. 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 visiting will be allowed only for essential carers or for those visiting residents at end of life.

Visiting policies 

Each care home manager will develop their own visiting policy and will look to support visits safely, while accounting for 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 a visiting plan with you as part of the person’s care plan. 

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

When you won’t be allowed to visit

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 care givers and for visiting someone who is nearing the end of their life.

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

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.

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. 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.

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, the home is likely to allow a maximum of two visitors each time. You will need to wear PPE during the visit. But you will 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 in our page about keeping someone safe and well.

Trips out of the 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 some 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:

  • outdoor visits to parks, beaches or outdoor cafés – indoor visits (except to use the toilet) should generally be avoided 
  • medical appointments (but not overnight hospital stays)
  • 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). You should all follow the usual guidance outdoors on social distancing, hand hygiene and face coverings. Public transport is 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. 

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