Opening nursing homes again

Information from this post comes from a Forbes Magazine article, “The Trump Administration may reopen nursing homes to visitors, but it must be very careful.” May 11, 2020.

The painful and isolating experience of living in a Covid-19 quarantine continues.  Until there is an adequate access to testing, until there is a proven treatment or vaccine, the common good will continue to call for restricted contact.

Howard Gleckman lays out political considerations that may underlie plans being set forth by the Centers for Medicare and Medicaid Services (CMS) and then says plainly, “If not done carefully, this would be folly, and could put residents, staff, and families at risk.”

The possible move on the part of the Trump Administration (thus, CMS) has surprised nursing home operators and their professional trade groups, LeadingAge and American Healthcare Association. These two trade organizations have also been working to create universal guidelines for their members, with the expectation that they would be not be finalized until late June or July.

“Facilities (Nursing homes) could begin allowing limited visits once they report no cases for 14 days. They could   increase access, as well as communal activities, if they go another two weeks without an active case.

“The problem, of course, is a facility (nursing home) may go weeks with no cases. But if a visitor brings COVID-19 in, it will spread like wildfire.”

“Residents are paying a severe price for being isolated in long-term care facilities. While we don’t know for sure, it is likely that they are suffering from more loneliness and depression. They also are at greater risk because their families are not able to advocate in person for them —an especially important role in the difficult environment COVID-19 when care is likely to go wrong.

“But it makes absolutely no sense to reopen facilities to visitors now. Nursing homes still don’t have enough coronavirus tests. Assisted living has even less. And tests often take many days to produce results. Absent immediate results—like those available to the White House staff—opening care facilities puts staff and residents at risk from visitors, while at the same time placing those visitors at risk.”

“Reopening also requires an ample supply of masks, gowns, and gloves for all visitors, and proper training in their use.  

“Nursing home and assisted living operators at horrified at the idea of reopening prematurely to visitors. Some are reluctant to have family members adding to what already is a chaotic situation, with staff shortages and jury-rigged efforts to isolate COVID-19 residents.”

“Facilities (Nursing homes), families, and state, federal, and local government need to work together to design a safe way for families to visit their loved ones. But this has to happen in a careful, well-considered, and properly timed way. And it should be based on careful benchmarks that all parties adhere to. The US has failed to establish coherent, enforceable protocols for much of its COVID-19 response. It would be a tragedy if it fails to do so when it comes to opening up long-term care facilities that have seen so much death already.”

Social Distancing, not Social Isolation

As the days of quarantine continue, Action Pact, a Culture Change training and consultant organization reminds us that although we practice social distancing, we do not want those living in nursing homes to experience social isolation.  Each week Action Pact offers resources for this very purpose. Here is a link for this week's issue.  Scroll  down the page to access this week's flyer.

Please feel free to share with persons who are Administrators or "Activity Directors" for use in the nursing home where they work.

Heroes

Last week I happened to be near our local hospital when I saw a nurse leaving the building after her shift.  I waved, smiled and said in a loud voice, “Thank you!” The nurse smiled and waved back.

A few days later I was in a Zoom event with individuals who have leadership positions in myriad aging community settings. In an interestingly and somewhat related conversation, one of the participants raised the subject of nursing home care providers being called heroes. He said that this appellation is a burden for hands-on individuals and upsetting to them. These labels put pressure on individuals, he said. “They tell me they are not heroes; they say, in fact, they are afraid many times as they carry out their work in the nursing home.” The implication was that being called a hero laid too heavy a burden for them in their eyes.

My take is a little different as I remember so many news stories paying tribute to a citizen hero. Almost universally, the interviewee denies that label of hero, saying they were just responding to the event at hand. Then there is a neighbor, a young man with a family, who is a police officer in a crime-ridden area of our greater metropolitan area. He absolutely loves his work. When I ask if he is ever afraid, his quick but smiling response is, “Every day.” One can be a hero and still be fearful. It’s probably the norm.

For those caregivers who cannot accept that they are heroes, there are other simple and direct ways to instill in every person on the staff the conviction of the nobility, dignity and sacredness of his/her work especially at this time. Yes, people are supposed to show up every day on time for work.  But is there a special smile or nod to greet the faithful staff who are there? A reminder or pat on the shoulder when we see someone going beyond mere duty to respond to a need? In staff meetings, do we acknowledge the stressful time we are in, and the spirit of generosity and sacrifice that these times call for, and then a thank you to the staff for meeting the mark in all this?  Building the self-image of any staff member, and thus deepening his/her self-confidence, is a great aid in furthering the mission of the community.

Finally, I hope the following is a given: Any compliments or other gestures of recognition must be truthful and must acknowledge actions that are aligned with the standards and values of the community. Otherwise it is fake. And employees can smell it a mile away!