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Opening Up Nursing Homes / Assisted Living

Brett

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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 :rolleyes:
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?

I am sorry you or your loved ones are suffering.
My mother's assisted living facility in Northern Virginia allows outdoor visitation (6' social distance) so we can talk with her in person. They also allow unlimited "Facetime" video sessions. She appears to be doing OK --- if there was not a coronavirus pandemic then things could probably be better.
 

Cornell

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@Monykalyn Thank you for saying this. As we can see by looking through the MONTHS of threads on TUG , everyone has different opinions on their risk tolerance and what's "worth it" to them. I will speak to my mother's case . She lives in assisted living. She is not particularly social so really doesn't mind not eating meals in the dining room & doesn't enjoy participating in the community social events. But she wants to see her family. In her case, one on one visits with her family members are low risk because she isn't "out and about" in her community. Additionally, my family feels comfortable & confident that management in her community is doing an amazing job with their C19 prevention strategies. And if I hear one more suggestion of "virtual visits", I might just scream. They are NOT the same.
 

bogey21

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I live in a CCRC and very much disagree with Monykalyn's post. The large majority of us don't feel like living shells. I note that even in good times there are those who are near death and have no quality of life but that is always going to be. I don't know of any of my fellow Residents experiencing depression but concede there could be. I don't know of any who have lost the will to live but again concede it could happen. Our problem here is not rapidly losing weight. It is gaining weight due to good food, rich deserts and reduced physical activity. Again there may be outliers that I don't know about. At age 85 I'm one of the young ones here. The average age of move ins is 83. I'd say the majority of those I talk to are between 90 and 100 years old and I don't know of any who don't agree with me. I concede that not having vists from family does bother some but most seem to understand. We have had no Residents with COVID-19 to date. Give me life. It will take longer than we like but his will pass...

George
 

Brett

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I live in a CCRC and very much disagree with Monykalyn's post. The large majority of us don't feel like living shells. I note that even in good times there are those who are near death and have no quality of life but that is always going to be. I don't know of any of my fellow Residents experiencing depression but concede there could be. I don't know of any who have lost the will to live but again concede it could happen. Our problem here is not rapidly losing weight. It is gaining weight due to good food, rich deserts and reduced physical activity. Again there may be outliers that I don't know about. At age 85 I'm one of the young ones here. The average age of move ins is 83. I'd say the majority of those I talk to are between 90 and 100 years old and I don't know of any who don't agree with me. I concede that not having vists from family does bother some but most seem to understand. We have had no Residents with COVID-19 to date. Give me life. It will take longer than we like but his will pass...

George

Good !! ;)
 

davidvel

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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 :rolleyes:
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?
This is completely inaccurate. They are free to leave at any time. If they or their family who is in control of their healthcare wants to eschew the skilled care, they can leave and move right in with their family, likely a hospice for many. This is their right. Not locked in. Not in jail.

But if they want to stay, they have to abide by the current rules of those facilities, which recognize that 90% or more of COVID deaths have occurred in these places, and others that live there may not want to play Russian roulette for an in person visit with family.
 

PigsDad

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But if they want to stay, they have to abide by the current rules of those facilities, which recognize that 90% or more of COVID deaths have occurred in these places, and others that live there may not want to play Russian roulette for an in person visit with family.
I've seen reports in the range of 30-50% of Covid-19 deaths were from elderly care facilities, but never anywhere close to 90%. Do you have a reference for this claim? Thanks.

Kurt
 

jackio

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MY MIL was in independent living and despite their great efforts to control Covid, she contracted the virus. It brought on a recurrence of atrial fibrillation. She ended up staying 8 days in the hospital and ultimately had a pacemaker inserted. She was frail to begin with, and the hospital stay left her too weak to walk around her apartment, so she was sent to rehab. That's when the s***show started. She has not seen any family members in person since the first week in March, except for a drive by 92nd birthday parade where they brought her to a day room to look out the window.
In the rehab they have so far lost 2 pairs of her hearing aids, so she cannot communicate either on the phone with family, or with the staff members who repeatedly insist she is doing fine.
She had had a urinary catheter inserted upon hospital discharge, which was never communicated to family members, and although they said they have tried to remove it without success (they say she cannot empty her bladder on her own) a few times, we had to demand that they order a urology consult. The woman has never had a bladder problem in her life. The call to make the appointment was not made until a week later when I called to find out the date. The appointment was in July. I promptly called the MD office and changed it to this Thursday with a PA. They don't return phone calls in a timely manner, and we get the run around. They do not follow through on planned team meetings with the family, and when they do, most of the team members do not show up.
We ask for supervisors to contact us with sporadic results.
Believe me, if family members were allowed to visit, none of things would have gotten out of control. We would have been on top of everything and saw that things were followed through.
My SIL finally contacted the NY state ombudsman who got involved. Miraculously, she got an email from the facility director that she would be contacted and the concerns would be addressed.
We cannot pull her out until the catheter issue is addressed. After that she can return to her apartment or to any one of her children's homes with outpatient PT until she becomes stronger.
This facility was one of the highest rated on Long Island, which was why it was chosen. A patient is supposed to leave rehab in better shape than when they enter. I am afraid that this will not be the case with my MIL.

Sorry for the long vent...thank you...
 
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Cornell

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@jackio Wow, what a tough story to read. Vent away - sometimes it feels good. I hope that your family gets some resolution for your MIL sooner than later. You bring up a VERY important concern that my family has -- when family is "locked out" you lose that regular monitoring / vetting of your loved one's care and circumstances. It's distressing. I have heard many stories like yours , where communication has been woeful with family members.
 

geoand

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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.
I think they don’t want to try it because they would have to rely on visitors to follow the protocols. They don’t want to bring Covid in.
 

Brett

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I think they don’t want to try it because they would have to rely on visitors to follow the protocols. They don’t want to bring Covid in.


right, the strict protocols with visitors is likely to continue for quite a while. We're lucky to be able to visit my mother in her assisted living garden patio area - albeit with supervised social distancing
 

MULTIZ321

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Cornell

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Hi Cornell,

You hace mentioned that your mom is very hard of hearing. Here is a link about something you can get for her that would greatly improve communication with her.

.


We would use these all the time with veterans who needed help before we could get them hearing aids.

Best Regards.

Richard
Richard - I cannot thank you enough for this suggestion! I'm running this by my occupational therapist sister.

My mom has hearing aids but doesn't wear them. ** sigh **
 

MULTIZ321

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Richard - I cannot thank you enough for this suggestion! I'm running this by my occupational therapist sister.

My mom has hearing aids but doesn't wear them. ** sigh **
If the headphones don't work out, you can use earbuds, that fit into the Ear Concha Bowl. The earbuds plug into the same port the headphones plug into and are included with the kit..

Best wishes


Richard
 

normab

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She had had a urinary catheter inserted upon hospital discharge, which was never communicated to family members, and although they said they have tried to remove it without success (they say she cannot empty her bladder on her own) a few times, we had to demand that they order a urology consult. The woman has never had a bladder problem in her life.

Wow, so sorry to hear of the issues your MIL is dealing with, alone. I just wanted to share my story of a catheter related to my Dad (who is 97 right now, in memory care). This Story is pre-Covid but it relates directly to the catheter issue after a hospital stay which included a pacemaker insertion. Maybe it can help you a bit...

Last year when he was 96 he was in the hospital for about a week and a half where he had a new heart valve, followed by the pacemaker. He also left the hospital with a catheter. He went to a rehab where they just continued the catheter. He never had an issue before this. Apparently though, as people get older, the surgeries and the anesthesia can shock their system and it takes a while before the bladder muscle works again.

Six weeks later, he still had the catheter, and the urologist, who is probably 35 years old, told me many people his age have catheters. Really? I had to ask the doctor to put him on some Flomax and prostate shrinking meds. I felt that this doctor didn’t care because my dad was old.

The biggest problem was that my dad was living in an assisted living facility, and he couldn’t take care of the catheter. The facility charged extra to take care of it for him, but they were NOT doing a good job either. His room stank of urine, and they didn’t even rinse out the overnight bag; it was horrendous.

I was fed up, and found a different, older urologist and took my dad to see him. Within two weeks my dad was off the catheter. But overall, he was eight weeks with a catheter.

I realize that in your current situation it’s very difficult, because you can’t see your mom, and you can’t just take her to a doctor. However I would fight to have another urologist (that you can choose) review the situation and see what they can do. There’s no reason for her to be catheterized for months....Also, does she have a PCP who is a geriatrician who can help here?

By the way, when I discussed this with my dad’s PCP a month later After he was off the catheter, he said it’s not uncommon for there to be age prejudice among the younger docs. His PCP is actually a geriatrician, so he specializes in people who are elderly and he really knows the different issues that the elderly have.

I wish you and your MIL the best. She is lucky to have you and your Sil fighting for her. Even the best facilities can’t fight the battles you can for your loved one.
 

jackio

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Normab, thank you so much for your reply and sharing your dad's story.

As a follow up, we got Mom to the urologist's PA. She, in turn, called the dr. in to consult at that visit. The PA called the rehab who told her that they had tried to remove the catheter 4 times (urine trials) and Mom was unable to void, so it was re-inserted. They did not provide the dates.
I had asked them several times prior to this, as did my SIL, to give us the dates of these urine trials and they were unable to furnish them. I, too, requested Flomax and they reluctantly put her on it. The urologist scheduled 2 tests including a cystoscopy to be done on 6/30.

So a few days ago, the oldest brother (who is the healthcare proxy) got a call from the rehab social worker that mom is off the catheter and is voiding on her own. No incontinence at all.

What?? They were insistent that they were NOT going to remove the catheter one more time due to fear of damaging the urethra from so many insertions. Then all of a sudden they did it? And there was no difficulty at all in her voiding?

SIL called Mom, who told her that they NEVER removed the catheter while she was there. Not once, and certainly not 4 times. Mom gets a little confused sometimes but I know she would remember a catheter insertion FOUR times. She finally has her hearing aids so she is able to communicate on the phone and let us know a bit of what is happening there.

The team meeting is scheduled for Tuesday, and we told Mom if she can walk herself to the bathroom and back, she can return to her apartment (we will get an aide in a few hours a day). She said she is working on it.

So we cancelled the urology follow up testing for now, since there does not seem to be a problem. We just want her out of there at this point.

I am glad it worked out for your dad and I hope he stays well. Thank you for your good wishes. Jacki
 

Cornell

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Heartbreaking and touching . Resourceful lady .

The facility my mom works at employs lots of local high school kids . Many are my daughter’s friends . We get the “inside scoop” from the kids on how my mom is and what she’s up to as they deliver meals to her .

My mom , who has always been clever , said about a month ago “Tell Charlotte to get a job here so I can at least see my granddaughter “.

(Charlotte is my daughter)
 

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I was going to give this it's own thread but, it seems to fit here. ;)

Will you be their pen pal?

Nursing home 'overwhelmed' by positive response to pandemic pen pal program

There’s nothing better than getting a letter. Increased loneliness and isolation are two heartbreaking consequences of the coronavirus pandemic, inspiring one network of care homes in North Carolina to proactively promote a pen pal program for residents.

The care center is still seeking letter-writing buddies for the #VSCPenPals project; those interested can learn more about potential partners on the Victorian Senior Care site.

 

critterchick

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I’m angry, too. My 98 year old dad was living in an independent living facility in Connecticut when COVID hit. He moved in in January (DH and I came in from LA to help). I had to cancel my March trip and never saw him again. He went to the hospital after a fall in early June (that didn’t injure him; but they wanted to be sure) and never came out. It was two weeks of hell for us as harried residents effectively dismissed him as an old man with dementia (he was old, but his confusion stemmed from not properly taking his thyroid medication) and one catastrophe after another ensued, culminating in watching him draw his last breath on a Zoom call. He was buried without ceremony and now the facility is on us to clear out his belongings because somebody wants his apartment. All from 2500 miles away with businesses running on shortened loads.

My dad was a physician (retired, but kept his license current) and I know that the MD part of his brain appreciated the seriousness of the situation. But he asked me on every phone call when I was coming to see him again (he lost my mother in 1973 and stepmother in 2018 to cancer so was desperately lonely). He had finally come into the light with a social life with the other residents and they continued to have lunch after the outside world was shut out. Then the facility told them they couldn’t do that (they were in a large room sitting 6 feet apart and only took of their masks to eat), so they were shut in their apartments without contact with anybody except for meal deliveries and health visits. That isolation was deadly to him and he slipped back into the grief from which he was just recovering.

He probably didn’t have a lot of years left, but they were set to be contented years, with new friends, activities galore and a gorgeous brand new facility. COVID robbed him of those years as surely as if he’d contracted it. I know that many COVID deaths occur in nursing homes, but there has to way for residents to maintain regular human contact.
 

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@jackio Wow, what a tough story to read. Vent away - sometimes it feels good. I hope that your family gets some resolution for your MIL sooner than later. You bring up a VERY important concern that my family has -- when family is "locked out" you lose that regular monitoring / vetting of your loved one's care and circumstances. It's distressing. I have heard many stories like yours , where communication has been woeful with family members.
Also family helps with cares in many cases too, and relieves a chronically short staff. Many of the staff I know miss the families too- remember these homes are in a community that the families know each other “outside” the facility.
I think they don’t want to try it because they would have to rely on visitors to follow the protocols. They don’t want to bring Covid in.
it’s going to get in anyway unless you have staff locked in a bubble and no resident is allowed to leave even for emergencies. It. Will. Eventually. Get. In. Good and regular testing will make outbreaks able to be obtained. After 3 months of covid free homes it’s hit one, they’ve got a ward just for covid and so far 9 residents have passed. Of note these are all people I’ve been following closely and would see in person each week (way back before March lockout) as I was following them closely due to declining nutritional status. Nearly all were in hospice before covid. I’m sure the damn virus accelerated things, and I’m also grateful the home has special rooms set aside where family can be with them at the end. The family has to assume the risk and wear a mask at all times, cannot come out of the room and when ready to leave must be escorted out the door near the room (at end of hall by an exit door).
That isolation was deadly to him and he slipped back into the grief from which he was just recovering.
Yes I’m afraid this is being repeated way too often. I’m very sorry about your loss! 90’s and still in independent living!
 

Cornell

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I’m angry, too. My 98 year old dad was living in an independent living facility in Connecticut when COVID hit. He moved in in January (DH and I came in from LA to help). I had to cancel my March trip and never saw him again. He went to the hospital after a fall in early June (that didn’t injure him; but they wanted to be sure) and never came out. It was two weeks of hell for us as harried residents effectively dismissed him as an old man with dementia (he was old, but his confusion stemmed from not properly taking his thyroid medication) and one catastrophe after another ensued, culminating in watching him draw his last breath on a Zoom call. He was buried without ceremony and now the facility is on us to clear out his belongings because somebody wants his apartment. All from 2500 miles away with businesses running on shortened loads.

My dad was a physician (retired, but kept his license current) and I know that the MD part of his brain appreciated the seriousness of the situation. But he asked me on every phone call when I was coming to see him again (he lost my mother in 1973 and stepmother in 2018 to cancer so was desperately lonely). He had finally come into the light with a social life with the other residents and they continued to have lunch after the outside world was shut out. Then the facility told them they couldn’t do that (they were in a large room sitting 6 feet apart and only took of their masks to eat), so they were shut in their apartments without contact with anybody except for meal deliveries and health visits. That isolation was deadly to him and he slipped back into the grief from which he was just recovering.

He probably didn’t have a lot of years left, but they were set to be contented years, with new friends, activities galore and a gorgeous brand new facility. COVID robbed him of those years as surely as if he’d contracted it. I know that many COVID deaths occur in nursing homes, but there has to way for residents to maintain regular human contact.
I don’t even know what to say but that is just awful and sad. I’m so sorry .
 

critterchick

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I don’t even know what to say but that is just awful and sad. I’m so sorry .

Thank you. It had to have been a nightmare for him and there was nothing my brother (who is also in LA) and I could do to make it any better for him.
 

Panina

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I’m angry, too. My 98 year old dad was living in an independent living facility in Connecticut when COVID hit. He moved in in January (DH and I came in from LA to help). I had to cancel my March trip and never saw him again. He went to the hospital after a fall in early June (that didn’t injure him; but they wanted to be sure) and never came out. It was two weeks of hell for us as harried residents effectively dismissed him as an old man with dementia (he was old, but his confusion stemmed from not properly taking his thyroid medication) and one catastrophe after another ensued, culminating in watching him draw his last breath on a Zoom call. He was buried without ceremony and now the facility is on us to clear out his belongings because somebody wants his apartment. All from 2500 miles away with businesses running on shortened loads.

My dad was a physician (retired, but kept his license current) and I know that the MD part of his brain appreciated the seriousness of the situation. But he asked me on every phone call when I was coming to see him again (he lost my mother in 1973 and stepmother in 2018 to cancer so was desperately lonely). He had finally come into the light with a social life with the other residents and they continued to have lunch after the outside world was shut out. Then the facility told them they couldn’t do that (they were in a large room sitting 6 feet apart and only took of their masks to eat), so they were shut in their apartments without contact with anybody except for meal deliveries and health visits. That isolation was deadly to him and he slipped back into the grief from which he was just recovering.

He probably didn’t have a lot of years left, but they were set to be contented years, with new friends, activities galore and a gorgeous brand new facility. COVID robbed him of those years as surely as if he’d contracted it. I know that many COVID deaths occur in nursing homes, but there has to way for residents to maintain regular human contact.
I am so sorry for your loss. Real life situations like yours need to be told and heard. Our elderly have been in a way the forgotten whether in a facility or at home yet we hear little about it.
 
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