Retirement and nursing homes relatives at least once a month, there are many who offered their support in doing everyday chores several times a week, some of them on a daily basis. For residents with cognitive or mental impairments, the presence of trusted persons alone can give them a sense of security and belonging. If their ability to communicate by speaking gradually deteriorates, it is very helpful if those close to them know how to interpret their facial expressions and gestures and translate them to the nursing staff. The subject matter of many complaints brought to the NPM’s attention shortly after the pandemic outbreak was visiting bans and restrictions in retirement and nursing homes. Whilst families at home were able to agree on whether and in how far they would practice social distancing with a view to the risk of infection with COVID-19, the residents of care facilities and their relatives were confronted with a fait accompli. Unclear legal basis for visiting bans Between the end of February and the end of April 2020, visits to care facilities in Austria were almost completely banned or conditional on special permit from the home management. Whether the legal basis for these restrictions was appropriate is more than questionable. In most cases, the requests for visiting bans were issued by the respective regional government which justified their actions with existing written recommendations of the Federal Ministry of Social Affairs, Health, Care and Consumer Protection. Vienna was the only Land to stipulate visiting restrictions in temporary regulation thereby removing the pressure from those facilities that had to implement the same. New media not a complete substitute for human relationships In the first few weeks of the pandemic, relatives were only allowed to say goodbye to the dying in person. In all other cases, strict measures were enforced to avoid the risk of infection and forbid visitors from entering homes. Only palliative and hospice wards were barely affected by these restrictions. To the credit of those responsible in the homes, it must be acknowledged that in the first few weeks after the outbreak of COVID-19 in Austria there was little knowledge of the already active regional spread of the SARS-CoV-2 virus and there was not enough PPE even for the staff. Much time and creativity were used to compensate for the negative effects. Residents were helped in using social media and video telephony to an extent never seen before. The staff often had to help out with laptops, tablets and smartphones. It became quite evident that digital media cannot replace physical closeness for those with poor eyesight or who are hard of hearing as well as those who are cognitively impaired. This is why a home in Vorarlberg encouraged meeting in the garden or through a window from the gym into the garden while observing social distancing at a very early stage. Some permitted visits from a distance, for example, on adjacent balconies or in the form of “fence visits”. One home in Tyrol organised postcards with enclosed reply envelopes for the residents to make easy contact. Regular caregivers in a home in Lower Austria wrote letters together with the residents and enclosed photos for the relatives. 37

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