Rest home resident Margaret Fitness (right) happy to be finally re-united with sister Colleen after several visits had to be cancelled. Photo / Supplied
For most of us, lockdowns ended together with the alert level system last year.
But for aged care residents, restrictions around where you can go and who you can see are still very real.
Aged residential care facilities across the country are still going into frequent lockdowns when Covid cases are detected and a wider spread is suspected.
Providers say they are following Government guidelines as well as keeping residents and staff safe - but also the need for lockdowns is easing.
However, Northland families and an aged care worker have countered with their concerns about the continuing practice that restricts whānau from visiting loved ones.
Julie Meehan's parents are in a Whangārei aged care facility - a place they chose themselves once it became clear they required care.
Her 82-year-old father was diagnosed with Parkinson's more than five years ago and now requires hospital-level care.
Parkinson's disease affects balance and coordination and causes uncontrollable movements, such as shaking and stiffness. Meehan's father lost the ability to walk during the pandemic and has difficulty talking now.
While Meehan lives in Palmerston North, she has family in Whangārei who after more than two and a half years still only get restricted visiting rights to see her parents.
"They have had numerous occasions where their appointments have been cancelled because the home is going into lockdown," she said.
Another family member from Auckland scooted around the outside of the facility to talk to Meehan's mother through the window.
Meehan said residents were not allowed outside in the "lively grounds" and on the "lovely courtyard" during the lockdowns.
"They're simply locked inside."
Nor could her mum and dad see each other because they are in different parts of the facility.
When Meehan is arranging to see her parents, she has to find a booking time when the limit of two visitors per one side of the hospital wing isn't maxed out.
This is only when the facility is not in lockdown. During an outbreak, visitors are generally not allowed.
Even though caregivers were doing the best they could during the lockdowns, Meehan says they don't have enough rostered staff or time to give residents the attention needed.
"There is no joy in these places. In many ways, it feels like my parents are in prison and it has robbed us of time with them."
Whangārei man Shane Burns says appointments to visit his aunt, Margaret Fitness, keep being cancelled.
He condemned the lack of clarity around the "impersonal" 60-minute time slots where visitors are asked to meet their family members outside of their rooms.
Fortunately, Fitness recently left the facility on an outing with her family.
Holly Attwood's grandad is also in aged residential care which has been "an absolute struggle" to visit since Covid hit.
She said her grandad hated life inside the facility where he spent most of his time in his room - except for when activities took place.
The situation in Northland is a reflection of what's happening nationwide, Aged Care Commissioner Carolyn Cooper says.
Providers were trying to take a risk-based approach as older people continued to over-represent in Covid deaths.
People aged 70 and older make up just 6.3 per cent of all Covid cases in New Zealand but 40.2 per cent of all hospitalisations and 83.4 per cent of all deaths.
Cooper believed that generally, providers were doing the best with the resources available to them but at the same time, residents had the right to have visitors.
"Families can't be replaced," she said. "It's hard to strike the right balance."
Cooper acknowledged isolation periods could cause "a great deal of distress" for aged-care residents and their families.
However, she said full-on lockdowns were not generally needed anymore.
"If staffing numbers are low, providers are concentrating them on the care of the residents."
A Far North health care worker, who the Advocate agreed not to name, questioned the strict lockdown rules imposed by aged care facilities.
In their workplace, residents of either the rest home or the hospital wing are required to stay in their rooms depending on where the Covid cases are detected during an outbreak.
All doors are closed, meals are delivered to the rooms and caregivers only enter the room in PPE.
"They can't see our faces; they can hardly hear us because of the N59 masks. That's all the interaction they get."
Visitors were not allowed except on compassionate grounds and recent relaxation of the rules meant residents who test negative are allowed to walk the hallways.
Covid-positive residents stay in their rooms an additional 24 hours after they return a negative test meaning they may surpass the seven-day quarantine all other Kiwis do.
The health care worker said some residents, particularly those with dementia, didn't understand why they were locked in their rooms.
"They know that no one is coming, they feel it."
The health care worker had witnessed residents crying and hyperventilating when lockdowns had been announced.
They agreed the rules were in place to protect older people and staff, and decisions by facility management came with the welfare of people at heart.
"I understand where the fear of Covid comes from. But you've got to accept it. You can't let people live like this," they said.
Staff were frustrated and stressed under lockdown conditions. Employees are asked to turn in colleagues who don't follow lockdown and PPE rules accurately.
"I considered quitting. I'm doing this job to put a smile on people's faces," the worker said.
Aged care, like other parts of the health sector, is under the pump because of severe staffing issues exuberated by chronic underfunding of health services.
Aged care nurses in Northland earn up to $20,000 less a year than hospital nurses and facility managers lose staff to better-paying jobs here and overseas.
Consequently, providers have to close parts of their facilities. This is amid a shortage of aged care beds, particularly in dementia units.
Cooper said, "We are facing major challenges across the health system and there is a need for urgent government intervention and a collaborative response from across the aged care and health and disability sectors to address these challenges."
She called on "robust mechanisms" to be put in place to monitor the experience of older people.
"At a time where health and disability services are being disrupted, we have a collective responsibility to measure the impact this disruption is having on older people.
"We must ensure older people are being supported and continue to receive the support they require in their day-to-day lives."
While aged care facilities juggle these problems, they are also obliged to follow Ministry of Health (MoH) guidelines around Covid-19 cases.
The regulations do not explicitly demand lockdowns and visitor bans during an outbreak.
An MoH spokesperson explained that aged residential providers work with the local public health (Te Whatu Ora Te Tai Tokerau) and Older Persons' Health teams to manage Covid-19 cases.
"Whether to temporarily close parts or all of the facility is determined by the scale of the outbreak and ability to safely staff the facility."
A group of residents who share facilities is often isolated as a "household" when one tests positive, the ministry said.
"The rest homes themselves would decide on what the visiting arrangements would be but there is no strict requirement to avoid visiting altogether at this stage.
"Generally, however, as part of the national strategy, cases and household contacts of cases should limit their interactions with the public while in the isolation window where possible."
Kamo Home & Village general manager Zoe Berry explained variations in visiting policies came down to the different nature of outbreaks.
Case numbers in the community as well as the risk of spread within the facility were taken into account.
"Sometimes when we find a positive case it takes several days to track who they have been in contact with. We have some staff who work in one area, and others across the facility.
"This is the crux for making a decision to go into health measure red or not.
"Visiting can vary in those times," Berry said.
When the facility isn't in health measure red or lockdown, visitors can book appointments from Monday to Friday and have to undergo a supervised rapid antigen test.
Precious staff resources had to be allocated to ensure all public health measures were being followed.
Berry said in the past they operated under a trust-based model so staff weren't required to welcome families into the facility but some didn't adhere to the visiting rules which gave cause for concern.
"The great majority of families have been amazing and absolutely understanding. We work as a team to keep the number of incidents low."
To enable as many visits as possible, they are restricted to an hour.
"Currently visits are in open well ventilated spaces as our residents bedrooms are small and unable to be ventilated well as we need to keep them warm. The warmer weather that spring will bring will see this change," Berry said.
There were not enough staff available at the weekends to facilitate visits. "The nurses are working on a skeleton roster. If you take them off to monitor public health measures then we take care of residents."
It was also about the preservation of the workforce who need to be protected in order to deliver care.
Berry said if families struggled with the visiting hours, they can approach the facility to arrange something suitable.
"We take isolating residents and restricting visiting extremely seriously because we understand the impact on the residents, the families and the staff.
"This is not an easy situation and not one that we take lightly."
It was about mitigating risks and Berry believes the facility had the balance right at this moment in time.
Outings were still happening unless the facility was in health measure red and staff, as well as residents, have learned to use video calls to talk to whānau.
"We have a fantastic team who have shown an incredible level of commitment to the residents."
With dropping community cases and the approaching end of the influenza season, visiting regulations could soon ease.
The latest news bites from around the region.