Family Engagement

Can You Get Me a Screwdriver?

When I asked Dad the reason for his call, he cheerfully responded, “Well, we’re trying to figure out how to get out of here.” The “we” is my 92-year-old dad and his fellow residents in a locked memory care unit where they’ve been very well cared for and almost entirely free of COVID-19 but without the support and distraction of outside visitors for months.

Dad went on to say that he hoped I could somehow supply him with a Phillips-head screwdriver. He explained that he could crack the window in his room open a little but to open it fully (enough to escape), he would need to remove a bracket in the casing – installed, no doubt, to prevent escape. This was a problem easily solved, in the view of my ever-practical dad, if only he had a proper screwdriver.

This was Dad’s response to the COVID-19-induced cabin fever experienced by so many, especially residents in long-term care facilities. Dad is seldom happier than when he’s solving problems. Rather than causing anguish, rage or depression, the COVID “lockdown” inspires him to get creative and think of ways to fix the problem. By the end of our call, he sounded lucid and content, having agreed that it’s wonderful to be able to visit by phone and Skype and, besides, it’s all we’ve got at the moment.

I’m grateful that Dad’s personality and current mental state allow him to accept the limitations of the moment and that the facility where he lives is very well managed. Many family members and friends are not as fortunate and are struggling to stay in touch with loved ones they’re not allowed to visit and may not be able to assess adequately by phone.

Planetree’s guidelines for preserving family presence

Open visitation policies, which have been upended by COVID-19 restrictions, are central to the philosophy and practice of Planetree International, a healthcare organization driven by a mission to provide high quality, patient-centered care. Through certification and consulting, Planetree partners with hospitals and long-term care facilities around the world to “inspire caregivers to make patients true partners in their care, meet their human needs and improve outcomes.”

Planetree has issued detailed guidelines for preserving “family presence” through this time of restrictions, which are available for free download on the organization’s website. The basic principles described in the guidelines, with practical implementation advice, include:

  1. Assess the need for restrictions to family presence based on current factual evidence. Continually reassess as conditions evolve.
  2. Minimize risk.
  3. Communicate what to expect proactively and with compassion.
  4. Establish compassionate exceptions.
  5. Support meaningful connections to minimize feelings of isolation.
  6. Inform and educate.
  7. Enlist family as partners for quality and safety.
  8. Enhance discharge education and post-discharge follow-up.

Planetree presents the guidelines, Preserving Family Presence During Challenging Times: Principles and Practical Strategies, in a webinar available with slides and other related webinars and resources on its website.


Susan Carr Susan Carr is a medical editor and writer specializing in patient safety and engagement. In addition to curating the EngagingPatients blog, she produces publications for the Betsy Lehman Center in Boston and the Society to Improve Diagnosis in Medicine. Susan lives and works in Lunenburg, Massachusetts.

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