daughter kept from dying mother's bedside because of limits on long-term care visitors

when her mother developed alzheimer’s disease, louise savoie promised she would always be there for her.that was a promise savoie was unable to keep this weekend when 83-year-old thérèse savoie died at the montfort long-term care home. instead of sitting at her bedside, savoie watched her mother from outside her ground-floor window where she and her uncle kept a tearful vigil for much of the weekend. she is devastated that she was unable to be with her at the end.“it is inhumane. nobody should have to die alone and i shouldn’t have to be sitting outside her window watching her die,” she said.savoie’s story comes at a time when there is a growing call to let family members have more access to their loved-ones in ontario long-term care homes and other institutions. even as much of the province is opening up and some paid caregivers are allowed in long-term care homes, families remain largely banned.there are signs things could change soon, but no details. the province is finalizing a new visitors policy, associate chief medical officer of health dr. barbara yaffe said monday.since the pandemic lockdown began in march, long-term care homes have been restricted to essential staff and visitors. that does not include family members, although the province allows for exceptions when a resident is dying. but those guidelines — that accommodations should be “considered but are not mandatory” — are open to interpretation.in the case of montfort, a long-term care home operated by revera, staff told savoie that family members could only have a single 15-minute visit with a dying loved one.“you want her to die alone?” she asked, incredulously, when told of the rules.she notes that her mother had a single room and that the home allows “sitters” — paid caregivers — in. savoie said she doesn’t understand why she couldn’t be there.in the end, savoie had more than 15 minutes. she was there on saturday when a priest performed last rites on her gravely ill mother and was granted another short visit on sunday morning. but she spent most of the weekend outside her ground-floor window looking in, including when her mother drew her last breath on sunday afternoon. when her mother stopped breathing, savoie phoned staff inside the home to notify them.revera spokesman larry roberts said the management at each home determines how best to allow palliative visits, which are an exception to the province’s no-visitor rule during the pandemic. montfort put a 15-minute limit on them because it had been experiencing a serious outbreak of covid-19 and a staff member was required to supervise such visits, which meant visits had to be balanced with operational and staffing needs.he noted that savoie was given two 45-minute visits with her mother.“while this is a truly regrettable situation, the staff, working within the limitations placed on them by the pandemic, did what they could to help the family on what was a very sad day,” he said.“the unprecedented nature of this pandemic has required long-term care homes to alter their practices. we appreciate that restricting visitors is not easy for the residents or their families. it is also not easy for staff, who want to bring families together at all times, but particularly when a resident is nearing end of life. we look forward to a time when we can offer more visitation options.”dr. samir sinha, director of health policy research at the national institute on ageing, said there is nothing in the provincial guidelines that limits family members with dying loved ones to a certain amount of time.“this is an example of good policy and bad practice,” he said.long-term care homes, he said, are trying to do their best to protect people from covid-19, especially since their residents have borne the brunt of the illness in ontario. long-term care residents are 103 times more likely to die from covid-19 than other seniors.but he said a lack of clarity in the provincial guidelines and too strict an interpretation by the care home resulted in what he called a “travesty.”“i think it resulted in this family not having a good death,” he said.savoie’s story is not unique.“it is happening every day in homes across the province,” said sinha. he said the province needs clearer guidelines aimed at safe visiting.dr. amit arya, a palliative care specialist working in long-term care homes in the gta, said separating families from residents was done to stop the spread of covid-19 but it is causing its own serious harms, both to residents and their families. not only can family members provide comfort at end of life, he said, but keeping them away from their loved ones can result in distress and complicated grief that they might be dealing with for a long time.“we haven’t done a very good job of including family caregivers in the circle of care.” that should change, arya said.gilliann sloggett, a spokesperson for the ministry of long-term care, said the decision to restrict visitors to long-term care homes was not made lightly “as we know the tremendous hardship it poses for family. however, it was a critical and necessary decision to make. we look forward to a time when this restriction is no longer necessary.”thérèse savoie was a former civilian member of the rcmp who once helped crack a series of bank robberies through crucial fingerprint analysis, said her daughter. that was a high point in her career.the widowed mother of three became increasingly sick and unable to communicate in recent years with alzheimer’s. in april, she developed covid-19, but came through it with fairly minor symptoms and was no longer positive, said her daughter. at the end of last week, her systems began failing and she was placed on end-of-life care.savoie said she was able to calm and comfort her mother, even as she lost the ability to communicate. she still doesn’t understand why she was not allowed to be with her in the end.“it was my mom’s right to have me there.”as of monday, montfort no longer had an outbreak of covid-19.