During her first time outside in more than six months, Doreen Bible basked in life’s small pleasures: The warmth of the sun on her face, the cool air passing over her skin, the sounds of birds chirping and residents chatting with old friends they hadn’t seen in over a year.
“People were reaching up to the sky, trying to embrace the sun. Being outdoors was something,” said Bible, a 61-year-old resident of Castleview Wychwood Towers, a long-term care home run by the City of Toronto. “It was healing mentally and physically.”
The home had been in lockdown since March 2020 to stop the spread of COVID-19. It and other Ontario care homes, once at the centre of a “horrific humanitarian disaster,” have cautiously started to reopen as almost all residents and staff are fully vaccinated, said palliative care Dr. Amit Arya.
The province announced some additional changes Tuesday, allowing residents and their caregivers to hug and touch, and to leave their homes for essential reasons like exercise, buying groceries or visiting the pharmacy.
Impact of vaccines
The impact of vaccines on eradicating COVID-19 from long-term care homes is “nothing short of a miracle,” said Arya, the palliative care lead at Kensington Gardens, a not-for-profit care home in Toronto.
In Ontario, nearly 3,800 long-term care home residents and 11 staff members have died of the disease and more than 22,000 cases in the homes were reported over the course of the pandemic, according to the most recent provincial data in May. But with the vast majority of long-term care residents vaccinated, only a handful of homes have outbreaks of more than two cases. Those that do have outbreaks are reporting fewer than 10 cases, most involving staff.
The provincial changes mean the residents are no longer confined to their rooms 24 hours a day, a feeling Bible described as “like being a caged animal.” She said it stripped away her usual optimism, replacing it with anger and sadness.
She passed the hours by reading and talking on the phone with her children and grandchildren, who she hasn’t seen in over a year. In the summer, Bible was allowed outside for an hour at a time, but that ended in September when the second wave hit long-term care.
Bit by bit, bright spots are returning to her days.
Recreational activities, music and physiotherapy and communal dining have started up again, though residents and staff still must wear personal protective equipment and maintain physical distancing where possible.
“That is something, to sit in a dining room and eat like a human being,” Bible said.
The residents each enjoy meals at their own tables that are spaced apart, something that allows them to move beyond the “dark place” that Bible says held them captive for months on end. Tomorrow, her unit will be celebrating Cinco de Mayo.
“Little things are starting again,” Bible said. “And when you’ve had nothing for a year, that’s the pleasure. We learned to enjoy little things each day, every day. I hope the world has learned that, too.”
‘A purpose to live’
Nelson Ribeiro, the director who oversees the 10 long-term care homes run by the city, said there’s a renewed sense of optimism among residents now that some restrictions are lifting.
“It gives them meaning again, a purpose to live, a sense of appreciation,” Ribeiro said.
About 97 per cent of residents are vaccinated, along with 81 per cent of staff, according to a recent city report. They are now anxiously waiting for the rest of society to be vaccinated, and for the province to loosen some restrictions.
Ribeiro said it’s time to allow fully vaccinated family members to visit fully vaccinated residents and he’s hopeful the province will announce changes later this week. Currently each resident can name two visitors who could be deemed essential caregivers and would then be allowed to visit.
The Ministry of Long-term Care did not answer questions from CBC News about lifting visitor restrictions.
“Some residents haven’t seen family members in person for a year. That’s significant,” Ribeiro said. “Being able to reunite them is really important.”
Improving quality of life
Arya, the palliative care doctor at Kensington Gardens says the province’s top priority should be improving quality of life for residents and loosening restrictions when it’s safe to do so.
“We have to look at infection control, but that can’t be everything,” he said. “For many people, it may be their last opportunity to celebrate their grandchild’s birthday, to sit outside and enjoy some ice cream in the nice weather.”
While the COVID restrictions saved residents’ bodies, Bible wonders about their minds and spirits, or “the whole package,” as she calls it.
“I’ve seen residents here with the lights out in their eyes,” she said. “They’re not the same. Mentally, they did not survive.”
As people get vaccinated and society reopens, she hopes those in long-term care aren’t forgotten.
“We need some quality of life — to laugh, to smile, to engage.”