COVID-19: Quebec nursing homes seek to balance infection control with return to normal life

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Live music is back in the halls of the Idola St-Jean long-term care home.

Snow swirled past the windows of the Laval, Quebec residence on a recent afternoon as a singer, wearing a surgical mask and plastic goggles, launched into a version of ‘Just the Way You Are by Billy Joel. While most of her audience of four or five residents in wheelchairs ignored her – more occupied with dolls or a game – one woman smiled broadly, closing her eyes as she listened to music.

For much of the COVID-19 pandemic, scenes like this didn’t exist in long-term care homes across Quebec.

A year ago, Idola St-Jean was in the throes of a major outbreak of COVID-19, with dozens of workers and residents infected. Most activities have been canceled and Billy Joel’s singer – who is normally a recreation coordinator – has been reassigned to a position in infection control.

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Now, life in the long-term care home north of Montreal is slowly returning to normal, despite the continued presence of COVID-19.

Dr. Olivier Haeck, head of infection control for the Régie de la santé de Laval, says the combination of high vaccination rates among residents of long-term care facilities and the prevalence of a less severe strain of the novel coronavirus made it possible to ease the restrictions.

In a recent interview, he said the death rate for the fifth wave appears to be about 10 times lower than the first.

“(In previous waves) there was no talk of easing restrictions; it was clear,” Haeck said.

“Now we saw that people weren’t that sick – maybe they had a little cold, maybe no symptoms.”

Véronique Boulanger, nurse and infection control specialist, adds that Idola St-Jean had two deaths in the fifth wave of COVID-19 out of 62 patients. In previous outbreaks, nearly 50% of infected residents died.


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COVID-19 update: Where is Quebec in the fight against the virus?


COVID-19 update: Where is Quebec in the fight against the virus?

Close contacts of positive cases are usually asked to self-isolate for 10 days, but they may be allowed to leave their rooms after five if they agree to social distancing. During the first waves, when a negative PCR test was required, some residents remained isolated for weeks. Distant contacts, meanwhile, are not tested unless they develop symptoms.

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The Canadian Press was allowed to visit Idola St-Jean – including two rooms with COVID-19 positive patients. During a guided tour of the facility, Boulanger explained that the health authority is working to strike a balance between infection control and quality of life.

Most residents don’t wear masks, she said, but staff do wear N95s, goggles and, on COVID-19 wards, gowns.

In a COVID-19 wing, residents with the disease remained in their rooms – but with the doors open. A man, identified by a sign outside the gate as COVID-19 positive, sat at a coloring table, seemingly unconcerned with the virus.

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Another COVID-positive wing, with five cases, housed wandering cognitively impaired patients. Although it is almost impossible to enforce the sanitary rules by this clientele, Boulanger said that during previous waves, security guards and volunteers were posted outside the rooms in an attempt to encourage residents to stay. on the spot. Today, this is no longer the case.

Boulanger said the long-term care home has added a team of coaches who spend time with staff answering questions, leading drills and working with visitors and workers one-on-one. Many of these workers, Boulanger explained, are people whose jobs have been interrupted by the pandemic: nutritionists, activity coordinators and librarians.

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While the Omicron wave did not bring the same level of restrictions as the previous ones, it did bring some difficulties.

Lise Métras is a survivor, having already had COVID-19 at least twice. Her last fight, in recent weeks, deprived her of her hallway walks and visits from her four children. “Now I have started to walk; my daughter came to visit me and my son came, but I find it difficult,” the 81-year-old said.

“But it’s not just here. There are many places where it’s like that, and it’s for us, for our safety.

Métras, who wore a striped shirt and sported bright pink fingernails, agreed that more activities are available now than in previous waves. But she said she wasn’t interested in socializing or classes. What she wants is to be able to visit her family.

“I want to go out, see my grandchildren and great-grandchildren,” she said.

Today, it’s the weather, not the rules, that’s holding him back. “There is always something,” she says. “I find it very hard.”

Gisèle Lamarche, 94, lives in a COVID-19-free ward. She hasn’t found home life too difficult during the pandemic, but she said things are livelier now with more people around doing activities like knitting and bingo.

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But as for Métras, a return to normal requires a family outing, and for that she must wait for milder temperatures.

“I have four sons, and they push me in my wheelchair and take me to the park to see the greenery and the little ducks,” she said. “It will be nice to get some fresh air.”


© 2022 The Canadian Press

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