By Nancy Valko, RN, ALNC
Recently, two good friends of mine with physical limitations who had been waiting for over a year to enter a carefully chosen assisted living/long-term healthcare facility changed their minds about going. They found out that the facility had at least one resident with COVID-19. They are now staying at home with help from their sons, friends, and a paid caregiver.
And my 97-year-old friend Melissa with heart and mobility problems is adamant about staying at home to be cared for, primarily by her wonderful family. Recently, she developed a disturbing symptom, but instead of going to her doctor as usual, her doctor was able to come to her via a telehealth visit by computer. Melissa is happy at home and knows that other options like home hospice are available if necessary.
Are these three people overreacting about nursing homes?
In my opinion, the answer is probably no at this time.
Unfortunately, long-term health facilities for the elderly have become hotbeds for COVID-19 despite those residents being the most at risk during the pandemic. A number of staff at those facilities have also caught COVID-19, and some have also died.
Even worse, as NBC News reported April 25, 2020: “Three states hit hard by the pandemic—New York, New Jersey and California—have ordered nursing homes and other long-term care facilities to accept coronavirus patients discharged from hospitals.” (Emphasis added)
On May 6, 2020, the Wall Street Journal reported that New York nursing homes may have nearly 5,000 COVID-19 related deaths and the next day, the California Mercury News reported that “at least 41 percent of all known coronavirus deaths in California have occurred among residents and staff of nursing homes and assisted living facilities.” (Emphasis added)
And, unfortunately, these same people are usually dying alone due to restrictions for even family members in hospitals and nursing homes. Sadly, even funerals are changing with new restrictions for ceremonies and mourners.
According to an April 21, 2020 article “Nursing Homes Balk at COVID Patient Transfers from Hospitals” by the American Association for Retired Persons (AARP): “The American Health Care Association says discharged hospital patients should return only to nursing homes with separate COVID-19 units. Ideally, those units are staffed with employees with access to personal protective equipment. The federal Centers for Medicare & Medicaid Services (CMS), which regulates nursing homes, endorsed the idea of separate COVID units this month.” (Emphasis added)
I was personally shocked to discover that only 23 states publicly reported data for cases and deaths due to COVID-19 in long-term care facilities as of April 23, 2020.
However, the Trump administration has recently announced upcoming new regulatory requirements that “will require nursing homes to inform residents, their families and representatives of COVID-19 cases in their facilities. In addition, as part of President Trump’s Opening Up America, CMS will now require nursing homes to report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC).” (Emphasis added)
When my mother with Alzheimer’s disease was dying from cancer in 1988, there was no pandemic, and we cared for her at home as long as possible before placing her in a nursing home nearby for safety reasons. So I do know that nursing homes and other long-term care facilities can be wonderful and even necessary options.
But until this pandemic dissipates, we need all the essential information necessary to protect and advocate for the most vulnerable among us.
Nancy Valko has been a registered nurse since 1969 and currently is a spokesperson for the National Association of Pro-life Nurses (nursesforlife.org). She has also been a past president of Missouri Nurses for Life and past co-chair of the St. Louis Archdiocesan Respect Life Committee. In 2015, she received the People of Life Award from the US Catholic Conference of Bishops. She has served on medical and nursing ethics committees and give speeches and workshops around the country on medical ethics issues. Valko currently works as a legal nurse consultant (valkolnc.com) and volunteer.
This article has been reprinted with permission and can be found at nancyvalko.com/2020/05/08/covid-19-and-nursing-homes.