Just eight months ago, no one would have predicted that COVID-19 would impact our health and lives so dramatically. And no population has suffered more than the elderly in nursing homes. According to one analysis, as of May 22nd, 42% of all COVID-19 deaths had taken place in nursing homes and assisted living facilities (based on the direct reporting of 43 states and extrapolated data for non-reporting states ).
Perhaps that does not sound overly excessive when you consider that the elderly population living in nursing homes are at increased risk for contracting and dying from COVID but consider this. The 2.1 million Americans who live in these facilities represent only .62% of the U.S. population. And, by state, up to 80% of deaths can be linked to elderly residents in nursing and residential care facilities. In New Jersey, one in ten residents had died of the novel coronavirus as of mid-May. These numbers were certainly not helped with some states directing nursing homes to accept infected patients from hospitals.
COVID-19 has served to shine a bright light on the severe cracks in the preparedness of care facilities. Many were understaffed before the novel coronavirus. Senior care facilities often offer low pay, and many are chronically short of basic supplies and the personal protection equipment (PPE) needed to deal with an infectious outbreak. When it comes to protocols, some nursing homes even lack a basic plan to control infection. While the pandemic brought sharp focus to these deficiencies, they are nothing new. One reporter shared that prior to 2020, an average of nearly 388,000 nursing home residents died of infections every year.
For the families who lost a loved one in a care facility to COVID-19, it is hard to calculate the mental anguish and devastation of a loved one passing away suddenly, especially when more could have been done. With family members often barred from visiting, the loss is particularly acute.
For those who still have family members living in care facilities, there is understandable concern about what the future holds. The question of whether it makes sense to move a loved one out is one with which many families continue to wrestle. One piece of good news is that federal regulations allow a resident to leave a facility at any time. Before you make that decision, though, there are a few things to consider:
What does your loved one want? As concerned as you may be, it is important to understand what your loved one wants to do. Have an honest discussion and observe how well he or she integrated into the community and setting.
What is the nursing home’s policy? While you can bring your loved one home for a time, returning may not be so easy. Some nursing homes treat the departure as a discharge and may require being placed on a waiting list before returning. Also, leaving the facility may result in the loss of insurance coverage under certain policies. If the plan is to move a resident out permanently, be aware of any notification requirements or fees that may apply if those requirements are not met.
What is the cost/benefit? Carefully weigh the pros and cons. Take a hard look at your loved one’s care facility to assess its strengths and weaknesses. Consider that any move from familiar surroundings can be disorienting and difficult for an elderly person, especially one with cognitive difficulties.
What care does your loved one need? Take a hard look at your loved one’s daily care requirements. Consider diet, medications, activities of daily living, behavior management, and safety. If you are considering bringing your loved one home, be realistic about your own capability and time you can devote. Consider what supplemental care you may need and the availability/cost.
Is there a plan “B?” If you do decide to move your loved one out and that move is not successful for some reason, what is your next recourse? If you want to leave the door open to return to the facility, having that conversation before making the decision can help ease their way back.
In the wake of COVID-19, many nursing homes have been forced to take a hard look at their own protocols and capabilities to work on addressing these issues, but change takes time. If you are uneasy about your loved one remaining in a care facility, it is a good idea to make your own assessment of your loved one’s quality of care and consider exploring other options. This is not an easy determination to make so take the time to arrive at the best decision for you and your loved one’s unique circumstances.