Opening Up Nursing Homes / Assisted Living

[Cornell]

I've mentioned in some of my comments that my mother lives in an assisted living facility. Her "campus" has all levels of care - fully independent living, skilled nursing, memory care, etc.

We have obviously not seen my mother since early March. This week one of my sisters inquired w/the director to see if they had any idea on timing or the logistics of when we can start having family visits. We were given a "non-answer" answer.

I'm curious if any of you have first-hand experience with situation now and if you've heard anything on your end. I don't envy the administrators of these places - it is going to require a lot of thoughtful planning.

 

[Monykalyn]

As Covid-19 lockdowns are lifted, uncertainty at nursing homes only deepens

As some states relax restrictions, at nursing homes and assisted living facilities, which account for roughly one-third of all U.S. coronavirus deaths, there is not yet a return to normal.

www.statnews.com

Cornell-at this point I don't think anyone knows. Testing must be in place for visitors/vendors/resident/staff first, which means the rapid testing needs to be available. The guidelines are leaving it up to states on how to move through the phases as well-all NH in a state move forward through all phases at same time or by regions? For example-in my state my particular region has had a case in an Assisted living but no nursing homes, the nursing homes affected are in different region. The AL has had no further cases for weeks now. Can we start moving through phases or do we need to wait for rest of state to catch up? Part of the challenge is vendors/visitors/contractors move through the community and possibly to multiple centers as well. Obviously we have to be tested (and looks like frequently). The home also MUST have adequate PPE for ALL staff and visitors at all times-that can be a roadblock as well. Again my particular region actually has adequate PPE but the harder hit areas may not. Do we allow Assisted living to loosen restrictions first? Most tend to have their own "apartments' so if an outbreak were to happen it is easier to "lock down" a bit quicker there, plus staff size/resident size tend to be smaller.
One of the companies I contract with had a town hall zoom meeting on this yesterday. This is brand new, but gut feeling from calls to department of health (state and local) is it will be at least -at least-July before even first phase is fulfilled. And I am in MO where outside of St Louis and Kansas City-have been relatively lucky (not the right word I know!!) in that we were never overwhelmed nor even close to it.

I really really hope you can get to visit your mom soon. I wouldn't be surprised if you have to show proof of negative test, ask family to limit visitors to one or two to keep "pod" small and having family agree to keeping your "pod" small in the community (ie you voluntarily keep quarantining as much as you are able) at first. This is getting harder by the day on so many of our residents. I get that we needed to be super cautious in the beginning-but as we got a handle on what was happening in the community-not sure why they couldn't continue communal dining, activities etc when cases in the community were low, and no cases in local hospitals or nursing homes happened. I know some of my homes are relaxing the strict social distancing and having communal activities with small numbers of residents who are able to keep physical distance.

Yesterday the feeling was we won't even know how to move forward and what will be in place and happening until mid June. It is a complicated process and I am hoping that those of us who don't go out of a defined region will be allowed back in soon, vs having nursing homes across the state be in lockstep.

 

[Monykalyn]

Nursing Home Reopening Recommendations for State and Local Officials | CMS

www.cms.gov

Has the link for the guidelines on opening.

 

[Cornell]

@Monykalyn Super helpful info -- thank you so much!

 

[pawolf]

@Cornell, my mom lives in a nursing home about five minutes from my house. I too haven't been able to see her since early March. We (me, my sister, and my brother) had a call with the staff today. They are setting things up so we can visit with her using a phone with us on the outside, and her on the inside by one of the lobby windows. We've tried Skype a few times, and continue to use it, but given all she's been through, she doesn't really understand what is going on. Hopefully this will work better if she can see us 'in person', even if there is a pane of glass between us. They are also looking at how they can safely set up visits in the courtyard, with us both in the same space but with distance between us. And I assume masks and/or other PPE. It's tough, to say the least.

 

[Cornell]

@pawolf My social worker sister started the dialogue with the director today. We are hoping that with some nicer weather coming there could be some physical visits in an outdoor space. Who knows. We just wanted to get this discussion going.

My mother has mild dementia. She absolutely knows what's going on but her symptoms present themselves in lack of executive function. She looks out her window and sees the residents in Independent Living out walking , driving, etc and that really bugs her.

I am the youngest of 5 kids. Fortunately us siblings all work well together in regards to my mom's care. My uncle (her brother) suggested today that we pull my mom out of assisted living so that she can resume "normal life". He has zero idea as to what that would entail.

 

[Brett]

I've mentioned in some of my comments that my mother lives in an assisted living facility. Her "campus" has all levels of care - fully independent living, skilled nursing, memory care, etc.

We have obviously not seen my mother since early March. This week one of my sisters inquired w/the director to see if they had any idea on timing or the logistics of when we can start having family visits. We were given a "non-answer" answer.

I'm curious if any of you have first-hand experience with situation now and if you've heard anything on your end. I don't envy the administrators of these places - it is going to require a lot of thoughtful planning.

We plan to visit my mother at her assisted living facility in a couple of weeks on her birthday --- but with 'social distance". She will be inside the facility and we will be outside in a patio area.
Everyone in the facility (residents and staff) has been tested but not us

 

[pawolf]

My sister and I had a 'window visit' with my mom today at the nursing home. Unfortunately, it was one sided. My mom has dementia and has suffered three strokes over the past year. She'll be 95 in June. She looked good and it was so nice to see her in person again. But she wasn't able to open her eyes today to see us or communicate at all. The staff member who was with her tried so hard, but nothing seemed to work. We'll try another window visit but at a different time to see if we can catch her when she's more alert. I felt bad for my sister; she was pretty sad when we left. She used to visit my mom and spend time with her almost every day.

 

[davidvel]

It would seem to me that these facilities should be the last opened, given that most of all COVID19 deaths have been people living in them.

 

[elaine]

Her "campus" has all levels of care - fully independent living, skilled nursing, memory care, etc.

same for my Mom in north Florida (not Covid 19 hot spot). She is in indep apt. She can now leave "campus" to go to Dr. appts, etc., but she's not supposed to go to grocery, etc. They implemented pharmacy/grocery shopping service for them in April. They still bring all meals to door. No social gatherings. They can now walk outside without mask. Must wear masks indoors. No visitors for indep. residents.

 

[normab]

Dad is 5 minutes away in memory care. They locked down quickly per our governor’s recommendation. In addition to calling him several times a week, I’ve been able to have a couple of Skype calls with him. My siblings are also periodically calling him. And they had a parade where we drove by and called out to him.

The Skype calls are good because I can see how good he looks, at 97, and he is hanging in there. He can’t really see me with his bad macular degeneration, but he sees me in a blur. It’s as good as it will get for now. Could you do something like this?

I think when we get to phase three we may actually get to see him. But not sure if we can take him out then....this has been tough on all of us, and even worse on our loved ones.

hang in there.

 

[bogey21]

I've mentioned in some of my comments that my mother lives in an assisted living facility. Her "campus" has all levels of care - fully independent living, skilled nursing, memory care, etc.

I live in a CCRC with the same levels of care. We have been on severe "Lockdown" for a couple of months. So far it has worked. Two Employees came down with COVID-19 but tracking has proven they didn't spread it. No Residents have contracted it. Management has started to loosen up some of the extreme restrictions internally but visitors are still now allowed. Just today the City of Fort Worth came in and tested every employee. My guess is that within a week all Residents will be tested...

The track record of the Assisted Living Facility your Mother lives in is the key. My opinion is that if the Assisted Living Facility your Mother is in has a track record similar to that of my CCRC, she is safer there than being exposed to the outside world. Now if a lot of Residents are coming down with the virus, that is a different story...

George

 

[bogey21]

same for my Mom in north Florida (not Covid 19 hot spot). She is in indep apt. She can now leave "campus" to go to Dr. appts, etc., but she's not supposed to go to grocery, etc. They implemented pharmacy/grocery shopping service for them in April. They still bring all meals to door. No social gatherings. They can now walk outside without mask. Must wear masks indoors. No visitors for indep. residents.

Similar to policies at my CCRC including meals at my door...

George

 

[elaine]

No covid at moms facility. All workers being tested this week-surprised didn’t happen sooner.

 

[Panina]

This is currently on BBC News website.

 

[BJRSanDiego]

We have family in a rest home - - one in independent living and one in skilled nursing.

These facilities need to CONTINUE to be shut down. 50 to 70 percent of the deaths are occuring in rest homes. We don't have a cure and we don't have a vaccine. And we have 1.5 million infected people with an additonal 20,000 more infect each day.

Although these people feel trapped, I think that we need to continue with the shutdown.

We "see" our relatives once every 2 weeks. We all wear masks and we stay at least 6 feet apart. We can't go in to the facility but we talk through open windows or from the parking lot to the balcony.

 

[Patri]

I just sent that image of the tent to the corporate office of my DH's center. It is cruel to keep people separated for what could end up being six months. I know of one residential home that now lets family visit in a courtyard, with everyone wearing masks and keeping a distance. And just every two weeks. But physical presence can be so meaningful to mental health.

 

[bogey21]

It is cruel to keep people separated for what could end up being six months....But physical presence can be so meaningful to mental health.

I disagree. I am 85 years old and live in a pretty much "Locked Down" CCRC. I don't think it is cruel at all. Would you prefer that I get infected and die? No way that I feel abandoned. I communicate with my Son, Daughter and Ex-Wife 3 or 4 times a week via email and phone. Others here use Skype and Zoom. I don't want to speak for all my fellow Residents but I think they pretty much agree with me...

George

 

[Brett]

I just sent that image of the tent to the corporate office of my DH's center. It is cruel to keep people separated for what could end up being six months. I know of one residential home that now lets family visit in a courtyard, with everyone wearing masks and keeping a distance. And just every two weeks. But physical presence can be so meaningful to mental health.

I agree with Bogey, it's not "cruel", the policy is meant to keep people alive.
I visit with my mother at her assisted living facility in the garden courtyard - with 6 feet 'social distancing'

 

[Cornell]

The retirement community where my mother has been doing a fantastic job. Now that testing has become easy to do , we received an update that they have tested 800+ staff members and residents. Only one positive -- from 2 weeks ago from a staff member.

Seriously so grateful for the incredible job that they have done keeping these residents safe.

Unfortunately, though, I will not be able to see my mother any time soon.

 

[TravelTime]

The retirement community where my mother has been doing a fantastic job. Now that testing has become easy to do , we received an update that they have tested 800+ staff members and residents. Only one positive -- from 2 weeks ago from a staff member.

Seriously so grateful for the incredible job that they have done keeping these residents safe.

Unfortunately, though, I will not be able to see my mother any time soon.

Since they have tested all the residents, why don't they allow visitors to have a test and you can go visit with 24-72 hours of the test, assuming you have been quarantining since you took the test? They could also make those visits outside with 6' distance and wearing a mask. I can't see how covid could get in if no one has it and all visitors are tested and follow safety precautions. Just wondering.

 

[davidvel]

Since they have tested all the residents, why don't they allow visitors to have a test and you can go visit with 24-72 hours of the test, assuming you have been quarantining since you took the test? They could also make those visits outside with 6' distance and wearing a mask. I can't see how covid could get in if no one has it and all visitors are tested and follow safety precautions. Just wondering.

Because they can't confirm all those conditions, including whether someone has 100% quarantined, including not living with anyone, etc. Because you could have just contracted COVID before you test, but not yet showing up. Because you could have contracted COVID the day you went to get tested, and your test is negative, but a few days later you are contagious. Because the tests have varying levels of accuracy. Because you'd have to do all this testing, with perfect timing, and none of the above issues, everytime you go to visit.Because you could have coronavirus on your person, clothes, phone or otherwise introduce it, even if you aren't ill with COVID. Because masks and 6' can't stop all transmission.

Because most all of the people in these homes will become severely ill and/or die if they contract COVID.

 

[easyrider]

My foster mom caught covid 19 at the nursing home she went to after being released from the hospital for heart attack. She has recovered from covid but sitting in that nursing home all by herself has caused dementia. We were able to talk to her through an open window but the new guidelines keep the window closed. Now we have to use a phone at the window.

In her condo that she lived in for 40 years she has a bunch of friends that met up every day. Now, no visitors for the last few months. It is really a bummer to see her go through this. She is next in line to leave this nursing home to go to a dementia care nursing home. Even though she will be moving to something maybe better, it will be the same thing or a worse situation regarding visitors.

Bill

 

[Cornell]

@easyrider I’m so sorry to read this. Horrible situation.

 

[Monykalyn]

Because they can't confirm all those conditions, including whether someone has 100% quarantined, including not living with anyone, etc. Because you could have just contracted COVID before you test, but not yet showing up. Because you could have contracted COVID the day you went to get tested, and your test is negative, but a few days later you are contagious. Because the tests have varying levels of accuracy. Because you'd have to do all this testing, with perfect timing, and none of the above issues, everytime you go to visit.Because you could have coronavirus on your person, clothes, phone or otherwise introduce it, even if you aren't ill with COVID. Because masks and 6' can't stop all transmission.

Because most all of the people in these homes will become severely ill and/or die if they contract COVID.

Right so in this scenario never again once you get confined to a nursing home will you ever be allowed to see your family in person ever again. No more communal dining ever again. No more trips to the store or other outings. WE MUST KEEP THEM SAFE AT ALL COSTS! Doesn’t matter if that is effectively PRISON! They are alive right? No longer allowed to HAVE a life but at least the shell is breathing
I had a resident die last week from depression for just his reason, he’s DEAD because of the lockdown. No amount of coaxing, antidepressants or anything could bring back his will to live. I have at least 60% of the residents in my homes (plural) starting now to rapidly lose weight because they are sick of dining in their rooms and bored to tears despite the outstanding efforts of staff to do room and individual activities. The weight loss and resulting malnutrition will just further weaken their immune systems, but hey! Not a DIRECT covid death so no matter!
Yes I’m angry. Unless you can see the big picture keeping our family locked away forever is NOT the answer. A vaccine is probably at least a year away from being effective and widely available and no guarantee it will be 100% preventative. So the 101 year old who longs to see her son and grandkids should just hang on that long?