Reopening Long-Term Care Facilities ‘an Absolute Necessity’

By Judith Graham

Thursday, March 4, 2021 (Kaiser News) – For almost a year, nursing homes and assisted living centers have been mostly closed to visitors. Now it’s time for them to open up and relieve residents of the crushing isolation, according to a growing number of long-term care experts, caregivers, consumer groups and doctors.

This story was also broadcast on CNN. It can be reposted for free.

They are calling on federal health authorities to ease visitation restrictions at long-term care facilities, replacing guidelines in place since September. And they want federal and state authorities to grant special status to “essential caregivers” – family members or friends who provide critically important, practical care – so that they have the opportunity to care for relatives in the near future. the need.

Richard Fornili, 84, who lives in a nursing home in St. Marys, Georgia, supports a policy change. He hasn’t seen any of his family since last summer, when a granddaughter, her husband and two children stood outside his window and called him on the phone. “The depression and the feeling of loneliness affecting my fellow citizens is terrible,” he said. “That our loved ones come back to see us is an absolute necessity for our well-being.”

“At this point, residents are more and more likely to die from isolation and neglect than from covid,” said Jocelyn Bogdan, program and policy specialist at the National Consumer Voice for Quality Long-Term Care, citing de new data linking covid-19 vaccination to declining covid-related deaths. Her organization has started a petition calling for nursing homes to reopen safely and essential caregivers to have unrestricted access to their loved ones.

Since the end of December, when vaccinations began, cases of covidus among nursing home residents have fallen by 83%, while deaths have fallen by 66%, according to an analysis by the KFF. As of Monday, 4.6 million residents and staff of nursing homes and other collective facilities had received at least one injection of the Pfizer-BioNTech or Moderna vaccine, of which more than 2 million had received a second dose.

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Vaccines have “changed everything” and nursing homes are now among “the safest places in your community in terms of covid,” said Ruth Katz, senior vice president of public policy at LeadingAge, an association representing more than 5,000 non-profit retirement homes. , privacy centers and senior housing providers

LeadingAge last week called on federal authorities to expand the number of visits in a letter to senior White House officials, the Centers for Medicare & Medicaid Services and the Centers for Disease Control and Prevention. In an email, the American Health Care Association, which represents more than 14,000 long-term care providers, also urged CMS and the CDC to review its advice on visits. AARP, the nation’s most powerful seniors lobby, rang with a letter noting “a critical need” for further recommendations.

Long-term care facility medical directors are also stepping in while issuing a cautious note in the new guidelines on resuming joint activities and visiting long-term care facilities. With new covid variants in circulation and a significant number of staff and potential visitors still unvaccinated, “we recommend a measured and phased approach,” said Dr Swati Gaur, chair of the infection advisory committee for AMDA. – the Society for Post-Acute and Long-Term Care Medicine.

Establishments that reopen to family members should do so “carefully,” she said, by arranging tours, screening these visitors for symptoms and ideally requiring a negative covid test before entering; limit the number of visitors to a facility at any time; send them to sites reserved for visitors and not to residents’ rooms; and requiring the use of masks and gloves, among other precautions.

No one wants to see covid outbreaks reoccurring in long-term care facilities, said Gaur – the site of nearly 173,000 covid-related deaths, or about 35% of the country’s total.

The CMS ordered nursing homes to lock up almost a year ago, on March 13, as the coronavirus pandemic accelerated and the CDC said no one except parents performing end-of-life visits, should only be allowed. In September, new recommendations allowed outdoor visits, as long as safety precautions such as physical distancing were in place and indoor visits, as long as an establishment was covid-free for 14 days and the positivity rate for covid cases in the surrounding community was less than 10%.

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Federal recommendations apply to nursing homes. States regulate assisted living and other group care facilities, but tend to follow the CDC’s lead. In practice, long-term care facilities vary widely in the way they implement recommended policies.

In addition, federal authorities have recommended that parents be able to make “compassionate” visits when a resident is in emotional distress, grieving the loss of friends or family, losing weight or losing weight. ‘adapting poorly to the recent loss of family support. But many nursing homes continue to refuse such visits and law enforcement needs to be strengthened, the AARP observed in its letter.

Melody Taylor Stark said her request for a compassionate visit with her husband, Bill Stark, was denied in October, when her congestive heart failure worsened. Bill, 84, a resident of Huntington Drive Health and Rehabilitation in Arcadia, Calif., For five years, was later hospitalized with pneumonia. Stark said she was only allowed a 15-minute visit with him on November 17 after returning to Huntington – the last time she saw Bill before his death on November 22. The Huntington Drive administrator did not respond to a request. for comment.

The Essential Caregivers Coalition, of which Stark is a member, is calling for every long-term care resident to be able to nominate one or two essential caregivers who can enter and leave facilities regularly to provide convenient care to loved ones, as they do. did before the pandemic. As the anniversary of the lockdowns approached, the coalition staged email blasts and letter-writing campaigns to federal and state authorities, a roving signage campaign in more than a dozen states and gatherings in several state capitals. The campaign slogan: Isolation Kills, Too.

Mikko Cook, 49, of Ventura, Calif., Is one of the group’s co-founders. Her father, Ron Von Ronne, 77, has advanced Alzheimer’s disease and lives in a 200-bed nursing home in Albany, New York. Before the pandemic, Cook’s brother visited him almost every day.

“The house was sorely understaffed and when my family came in to take care of him, my father’s sheets were soiled. He wouldn’t have showered. The bathroom was never clean. But they would take care of that, ”Cook said.

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After the lockdown, Von Ronne went more than three months without seeing or speaking to family members. Over the past year, he has almost stopped communicating, has been assaulted by another resident and has lost nearly all of his personal belongings, which have been misplaced or stolen, Cook said. Von Ronne has since had two outdoor visits with relatives and three short visits to family members’ homes over Christmas and in January and February.

Mary Daniel, 58, founded another activist group, Caregivers for Compromise, after getting a part-time job in July at her husband’s assisted living center in Jacksonville, Fla. – the only one way for her to see it. Steve Daniel, 67, has early-onset Alzheimer’s disease, and she had come every night before the pandemic.

After stories about him went viral, Daniel started Facebook groups in all states for caregivers who wanted better access to their loved ones. The Caregivers for Compromise chapters of Connecticut, Florida, Illinois, Kentucky, North Carolina, New York, Pennsylvania, Tennessee, Texas and West Virginia are now actively involved in the Isolation Kills campaign, Too.

“We are getting impatient: the quality of life of our loved ones is deteriorating every day. My husband has been vaccinated and he wants to come out and feel the sunlight on his face. It’s time to open up and let him live the time he has left with freedom, ”said Daniel. “You can’t protect people like him forever, from everything.”

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