Visiting regulations for practical visits in nursing homes revised

Visiting regulations for practical visits in nursing homes revised

**Berlin - The Commissioner for Care advocates for pragmatic visiting regulations in nursing homes during the pandemic, urging a balance between safety and resident well-being. According to Andreas Westerfellhaus, certain rules may be excessively strict, particularly concerning mask-wearing and visiting bans for children, and should be eased.

Westerfellhaus emphasizes the importance of preserving visiting privileges even during limited outbreaks, likening a facility-wide closure to a hasty and inappropriate reaction. He acknowledges the confusion that masked individuals can cause for cognitively impaired residents, suggesting exceptions when maintaining a sufficient distance and briefly removing masks during greetings is appropriate for recognition purposes.

Some facilities have enforced visiting bans on children, a measure that Westerfellhaus states lacks scientific backing. He advises against visiting with multiple children from different households but concedes that a cautious visitor who minimizes contacts beforehand should be permitted to visit one child.

Additionally, Westerfellhaus expresses concerns over restrictive hygiene practices, such as storing birthday gifts in basements, deeming it unjustified based on the latest knowledge of infection risks. He encourages thepermission of gift and flower deliveries during the holiday season, further suggesting that visitors be allowed to visit residents in their private quarters rather than group rooms.

For improved managing of visits, Westerfellhaus and the Robert Koch Institute (RKI) have developed a guideline, to be distributed to facilities and made available online. The guideline advises advance notice for visits to home management and clarification on whether a rapid test would be beneficial, especially during the Christmas season. Overwhelming staff with visitors can quickly become unmanageable, he warns, urging visitors not to leave staff ill-prepared with large crowds or unnecessary testing demands.

Reflecting on the challenges faced by nursing home management during the pandemic, Westerfellhaus acknowledges their difficult situation, stating that isolating residents as during the first lockdown must not occur again. However, he emphasizes that nursing homes risk being cast under scrutiny for adopting overly permissive visiting concepts and experiencing outbreaks as a result. The guideline aims to offer pragmatic solutions for the benefit of residents, visitors, care staff, and management.**

Regarding recommendations on visiting rules, infection prevention, resident activities, and staff duties, the following essential points have emerged based on the latest information as of 2025:

- Masking: Visitors and residents are strongly advised to wear masks, with N95 respirators or higher-level masks suggested for visits with isolated residents.

- Testing: Rapid COVID-19 tests for visitors are no longer mandatory but are still strongly recommended to minimise transmission risk.

- Physical contact: Physical contact between visitors and residents, regardless of vaccination status, is permitted without distancing; however, physical distancing is encouraged during large indoor gatherings, especially in poorly ventilated areas.

- Symptom Screening: Active symptom screening of residents, visitors, and staff remains essential for effective infection surveillance.

- Resident isolation and group activities: Residents in isolation should avoid communal dining and group activities. Close contacts may participate in group activities while wearing masks but should not partake in communal dining for 10 days post-exposure.

- Staff vaccination and masking: Although mandatory masking requirements have been lifted for nursing home staff who have not received the 2024-2025 COVID-19 and influenza vaccines, it is still essential to encourage vaccination and the appropriate use of personal protective equipment (PPE).

These pragmatic rules aim to strike a balance between safety and quality of life for nursing home residents while taking ongoing COVID-19 risks into account, relying on masking, symptom surveillance, and careful management of communal activities and visits. Nursing home staff and management play crucial roles in effectively implementing these guidelines to safeguard vulnerable populations.**

1. The latest information suggests that nursing home residents and visitors should wear masks with N95 respirators or higher-level masks for visits with isolated residents.
2. Rapid COVID-19 tests for visitors are no longer mandatory but are still strongly recommended to minimize transmission risk.
3. Physical contact between visitors and residents, regardless of vaccination status, is permitted without distancing, but physical distancing is encouraged during large indoor gatherings, especially in poorly ventilated areas.
4. Active symptom screening of residents, visitors, and staff remains essential for effective infection surveillance.
5. Residents in isolation should avoid communal dining and group activities.
6. Close contacts may participate in group activities while wearing masks but should not partake in communal dining for 10 days post-exposure.
7. Although mandatory masking requirements have been lifted for nursing home staff who have not received the 2024-2025 COVID-19 and influenza vaccines, it is still essential to encourage vaccination and the appropriate use of personal protective equipment (PPE).
8. Pragmatic rules aim to strike a balance between safety and quality of life for nursing home residents, taking ongoing COVID-19 risks into account.
9. Effective implementation of these guidelines is crucial to safeguard vulnerable populations in nursing homes.
10. Nursing home staff and management have a key role in enforcing these rules and ensuring resident well-being.
11. Science and medical conditions are integral to shaping these visiting and infection prevention regulations.
12. In some cases, it might be appropriate to make exceptions when maintaining a sufficient distance and briefly removing masks during greetings is necessary for recognition purposes.
13. Environmental science and climate change play a part in influencing the transmission dynamics of respiratory conditions, such as COVID-19.
14. Other chronic diseases, like cancer and digestive health issues, also pose significant challenges for nursing home management and residents.
15. Eye health, hearing, and skin-care are vital aspects of health-and-wellness that should not be neglected during the pandemic.
16. Workplace-wellness initiatives can help staff manage stress and mental health concerns, which are becoming more prevalent due to the difficulties faced during the pandemic.
17. Fitness-and-exercise programs are essential to maintain physical health, with activities tailored to the needs and abilities of aging residents.
18. Sexual health and autoimmune-disorders are often overlooked concerns but are still decisive factors in overall well-being.
19. Medical-counseling and therapies-and-treatments can help residents manage conditions and improve their quality of life.
20. Nutrition is crucial in maintaining a balanced diet for both staff and residents, essential for maintaining energy levels and overall health.
21. Aging brings about unique challenges, including weight-management and cardiovascular-health concerns.
22. Womens-health, mens-health, and familial health are important aspects of consideration in achieving a comprehensive approach to healthcare within nursing homes.
23. Well-being encompasses more than just physical health, with mental health, neurological-disorders, and environmental-science displacing prominence in understanding overall well-being.
24. In many cases, the interplay between science and finance is integral in providing adequate resources for industry and Medicare to support the necessary infrastructure, staffing, and innovations in healthcare.
25. The role of artificial-intelligence in healthcare will continue to grow, contributing to advancements in diagnostics, treatments, and disease management.
26. Lifestyle choices have a direct impact on long-term health outcomes, with proper data-and-cloud-computing essential in studying and managing chronic conditions.
27. Fashion-and-beauty, food-and-drink, and investing industries may appear unrelated but can impact health, introducing hidden risks like the use of CBD or potential allergens in skincare and food products.
28. Embracing a holistic approach to healthcare, addressing areas like mental health, relationships, pets, travel, cars, books, shopping, social-media, movies-and-tv, entertainment, music, climate-change, and environmental science contributes to an all-encompassing well-being strategy for nursing home residents.

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