Senior Living Facilities
COVID-19 is here, and it’s doing exactly what we thought it would. After watching China and Italy and gathering data from their outbreaks, we were told what would inevitably happen here in the US.
Many people would get it, healthcare systems would become overwhelmed, and mortality would ensue, particularly for those ages 65 and older. Knowing this, we could’ve been more prepared. We could’ve done more on the front end to prepare, especially in our senior living facilities.
Long-term Care Facilities
Unfortunately, we waited, and we’re seeing the toll of that right now. The number of long-term care facilities with COVID-19 cases is now over 400, per a report from NBC News yesterday. For some perspective, this number is a significant increase from 146 only one week prior. But there’s no official word yet on how many total individual cases at these 400+ facilities, or which facilities these are exactly.
What Does the CDC Say?
The spokesperson for the CDC declined to answer these questions, to protect the anonymity of those affected.
The majority of these cases are coming from the hardest-hit states, like New York, Washington, New Jersey, and California. But we know that nearly 300 of the affected facilities are within those states, leaving the remaining 100+ divided up between the remaining states. The only other way to narrow it down being media headlines, which have highlighted individual outbreaks among nursing homes and retirement communities. One can google the subject and find multiple recent reports of deaths and confirmed COVID-19 cases among senior living facilities nationwide.
Release of Guidelines
It wasn’t until March 13th that the Centers for Medicare and Medicaid Services, or CMS, released guidelines advising what measures senior living facilities should take to prevent the spread of COVID-19 to its residents. It based these guidelines on the newest recommendations from the CDC at the time. The emphasis seems to be on minimizing people going in and out of the facilities. Doing so reduces the chances of the virus coming in. And if you think about it, this is a strategy that should’ve already been implemented.
Restricted Acces and Limited Mobility
Senior living facilities have the blessing and the curse of being microcosms. Unlike a larger, porous community, they usually have restricted access, and often the residents aren’t very mobile. This makes them perfect places for minimizing contact with new infectious agents. But, once something makes its way in, they quickly become a breeding ground for things like COVID-19 because there are so many people living in close proximity. Colds and flu run through senior living facilities affecting a disproportionately large number of residents when compared to the general population. So, the emphasis has to be on keeping it out.
Incubation Time and Asymptomatic Cases
But this can be difficult with COVID-19 because of the delay in the onset of symptoms. It can take two weeks from exposure to symptoms, or the person may never develop symptoms at all. Since the person is infectious during this whole time, they can be spreading the virus without knowing it. What was discovered is that workers and visitors were bringing COVID-19 into senior living facilities, along with residents who might venture out into the community or vacation.
Personal Protective Equipment
These new guidelines restricted visitation, starting immediately after its issuance. The only exception to this being compassionate cases like the end of life. If a resident is dying, visitors must wear Personal Protective Equipment, or PPE, and can only enter the one room. Another thing these guidelines aim to do is restrict all non-essential personnel and volunteers from entering. Trimming down to bare minimum staff prevents the constant revolving door and narrows down who needs to be actively screened. Screening measures like taking temperatures is to take place among workers and residents. While this isn’t perfect, it will help in isolating those cases that are symptomatic.
Distancing
Group dining and activities are all canceled as well. This makes sense, as everyone’s been advised to participate in social distancing measures. These can be difficult to achieve for people who live in close quarters or communal settings. So, avoid eating together, and any activity in which it’s challenging to maintain a minimum of 6 feet distance from others.
Sanitation
In addition to the above recommendations, instructions for how to properly sanitize have been issued. Facilities are required to place an alcohol-based hand sanitizer in every room and commonplace. They are also to ensure that sinks are equipped with adequate soap and hand towels so that residents and workers can practice proper hygiene measures to prevent the spread of COVID-19. Tissues and facemasks are to be made available to people who are coughing and ensure they have adequate PPE available in areas where resident care is given. Additionally, they are to provide hospital-grade disinfectant and clean high-traffic surfaces with it. This is because the virus has been proven to survive on inanimate surfaces for days at a time.
Minimize Exposure
On top of these recommendations, the CDC has issued checklists to help facilities comply. All senior living facilities should be following them. It can be quite scary for residents, as they don’t necessarily have control over whether their facility is taking the proper measures. They rely on the workers doing so. The caveat is that they are also the most likely individuals in the facility for spreading the virus. Regardless of one’s confidence in their facility, though, staying in their rooms as much as possible can only help minimize the chance of exposure.
Morbidity
The way that senior living facilities respond to this pandemic can have a significant impact on the overall mortality rate that COVID-19 has in America. Senior citizens are most at risk and are more likely to have underlying health conditions that can make the virus a killer. Following the newest guidelines is the best protection against it. Anyone who has concerns about their or their loved one’s safety should ask their facility what they’ve implemented and if it’s being followed. While many of these life-saving measures may not have been implemented immediately, it’s better late than never.
