It was a clear, breezy Thanksgiving afternoon in upper Palolo Valley, and seated in his wheelchair on the leaf-shaded terrace of his nursing home, Thomas Takeuchi, 93, was singing in a strong, melodic baritone as his family cheered him on with laughter and praise.
Takeuchi has had vascular dementia for 20 years, said his wife, Lillian, but he remembered all the words as he harmonized on “You Are My Sunshine” with his son, John Takeuchi, a music teacher at Kalakaua Middle School, who had brought along his wife, Annie Takeuchi, and a bright-red ukulele.
Although the visit looked and felt like a comfortable routine on the comfortable lanai of Palolo Chinese Home, it had been at least a year and a half since the Takeuchis, like families throughout America, had been able to visit their loved one in a care home in person.
“We’re so grateful to be together on Thanksgiving,” said Lillian Takeuchi, her fine, dark eyes filling with tears.
She is in her 80s and resides with another son and his wife but has visited her husband every day via Zoom and FaceTime, in occasional holiday drive-bys, and — at last — in person after the federal Centers for Medicare & Medicaid Services relaxed its guidelines for long-term care homes and similar facilities effective Nov. 12.
The new guidelines say visitation is now allowed for all residents at all times, without advance scheduling or limits on the frequency or length of visits; outings by residents also are allowed.
“Our residents and their families are ecstatic to be reuniting, just in time for the holidays,” said Eric Batalon, fund development, marketing and communications manager at Palolo Chinese Home, which has 93 residents.
Managers at other care facilities also provided positive responses about admitting visitors after 20 months. But they also are keeping precautions, such as masking, temperature checks and coronavirus questionnaires, in place and restricting visitors to no more than one or two at a time “because it’s not over yet,” said Suzie Schulberg, president and CEO of the Arcadia Family of Companies, which has a total of 500 senior residents.
The company operates the Arcadia on Punahou Street and 15 Craigside in Nuuanu, both offering a mix of independent-living, assisted- living and licensed nursing facilities.
“We’d like for people to remember that while things are opening up, we’re not out of the woods,” Schulberg said, “and we continue to be very vigilant regarding infection prevention.”
At same time, she added, “we need to live, and after the social isolation that hit our residents so hard, with depression, anxiety and further cognitive decline,” the revised guidelines are “welcome news.”
The reopening is going well at Arcadia, Schulberg said. “The energy is high and positive; employees, too, can start to enjoy being with our families again,” she said.
She noted that 99% of residents and employees are vaccinated at Arcadia, and while nonvaccinated people can now enter under the new guidance, “it’s also dependent on whether the resident wants them to come.”
Schulberg said Arcadia continues to recommend outdoor visits. Batalon said Palolo Chinese Home also encourages meeting outside rather than indoors.
“Visitors are coming in, families are making plans to take residents out for the holidays — it’s lifting up spirits,” said Czarina Tabilas- Palmeira, community life director at Maunalani Nursing and Rehabilitation Center, which has 100 residents.
Prior to Nov. 12 but after vaccinations became available, the facility allowed limited visitation, outdoors in the courtyard, with one person at a time, she said.
While under the new guidelines facilities can’t ask for proof of vaccination or a negative COVID-19 test, Tabilas-Palmeira said she’s found “the majority of visitors volunteer that information because they want their loved ones safe.”
“We are still following the governor’s mandate of having everyone wear face masks,” she said. “But what has made a big difference is now the residents can receive a hug from their loved ones. The power of touch goes a long way — you can see it in their faces.”
She added that one resident couple is looking forward to celebrating their wedding anniversary with their children, and “our oldest resident is 102, so you can imagine how hard it was to have that 18-month wait.”
A spokesman for the state Department of Health told the Honolulu Star-Advertiser that CMS guidance applies directly to federally certified skilled-nursing facilities but that state- licensed care homes also should follow it.
As for outings, the revised guidance says that “facilities must permit residents to leave the facility as they choose” but remind the resident and their companions to follow all recommended infection prevention practices — including wearing a face covering or mask, physical distancing and hand hygiene — and screen them upon return.
“If community transmission goes back up, we may have to pivot again,” Schulberg said. “But at least the residents will have had Christmas.”
They were also having some shots of normal daily life, Batalon and Tabilas- Palmeira said.
Although their institutions’ staff, volunteers and families had energetically and creatively stepped in to provide engagement and activities via iPads and smartphones, they said, nothing could replace physical presence.
Despite Thomas Takeuchi’s dementia, “he still reacts, still comes back, when the family is here and through music,” Batalon said. “And there are so many stories like this, with all our residents.”
Lillian and Thomas Takeuchi celebrated their 61st wedding anniversary Nov. 4. They have eight children, and as they sat on the lanai set among the green ridges of the Koolau, they leafed through a laminated booklet containing photos of some of their many grandchildren surrounded by hand-drawn rainbows, flowers, hearts and clouds.
“Every day is Thanksgiving for us,” Lillian Takeuchi said as her son wheeled her husband around the lanai to take in the view.
The new federal guidelines can be viewed at 808ne.ws/cmsrev.
