Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Most of these facilities are managing the care of their very vulnerable residents with as much caution as possible. But there is no way for these care facilities to completely keep COVID-19 away from their residents.

The healthcare workers do their best to exercise caution, but with their residents coming back and forth from other medical facilities, being transferred in from lower care situations a virus can get introduced into the facility pretty easy. Add in the fact, that many of the residents have dementia and aren't always behaving in a rational, reasoned way towards the staff and other residents - that really complicates the situation.

Even in a home environment, the residents are vulnerable to becoming infected because their caregivers are in/out of the house and the person is at risk of infection every time they are taken to a medical facility to see a doctor.

My friend works in an admin capacity at a home health agency and a lot of staff are calling in sick because of exposure or illness. They're seeing multiple people a week, plus some have other jobs.

Even if you can afford a live-in, you have to give that person days off, so you have to hire backup help for those times, usually. The backup help usually rotates between many homes.

A live in caregiver can also quit at any time or die. In fact, often patients are sent to LTCs after a home caregiver gets too ill to provide care or dies.

A lot of patients also end up in LTC facilities because the home caregiver(s) aren't able to handle the patient anymore safely at home. Particularly true with dementia or Alzheimer's patients.

Absolutely. Also, a person can go from being frail but mobile to being completely bedridden or falling A LOT which could be too much for a home caregiver to manage alone. Things can go from being manageable to completely overwhelming very quickly.

There is a lot of neglect and over medication which is huge with falls.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
It makes sense.

First, Older people are more likely to die from this disease. So age seems like a strong reason for the deaths in nursing homes.

Additionally, it is difficult to practice any form of social distancing in a huge facility where nurses, cleaners, caretakers, cooks are constantly interacting with several people at the time. Additionally, a lot of employees in nursing homes pick up extra work at different facilities.

I think people will move towards finding much smaller facilities for their elderly loved ones.

+1 I think small facilities will become much more popular among those who can afford it (small facilities often do not have Medicaid beds).

Home care might become more popular, too, but it sometimes isn't an option. Even if you can afford aides, some people cannot safely be cared for in a home setting or by one aide/adult. Particularly true for dementia patients and people who have certain medical conditions where care can't easily be provided in a home setting (needs dialysis and isn't a candidate for home dialysis or needs certain therapies, for example).

Home care would be a nightmare right now. Can you imagine what it would be like to not have health care aids show up or what it would be like trying to deal with a frail patient whose regular physician has either reduced their office hours or has limited availability via Teledoc?

It is hard enough to provide home care during the BEST of times. Now just trying to find a facility that is taking new residents would be a nightmare.

My friend is an essential worker. He lives with his mother who has alzheimer's. He has to figure out a way to get care for her right now while he is working. The care workers can only work a limited number of hours and a lot are calling out right now because of possible exposure so he has numerous people coming in and out who his mom is unfamiliar with, which makes it worse. A lot of the new workers aren't able to deal with dementia patients so he is constantly getting emergency calls at work. It's really been a nightmare.

My heart goes out to your friend. He is truly in a terrible, terrible situation.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
It makes sense.

First, Older people are more likely to die from this disease. So age seems like a strong reason for the deaths in nursing homes.

Additionally, it is difficult to practice any form of social distancing in a huge facility where nurses, cleaners, caretakers, cooks are constantly interacting with several people at the time. Additionally, a lot of employees in nursing homes pick up extra work at different facilities.

I think people will move towards finding much smaller facilities for their elderly loved ones.

+1 I think small facilities will become much more popular among those who can afford it (small facilities often do not have Medicaid beds).

Home care might become more popular, too, but it sometimes isn't an option. Even if you can afford aides, some people cannot safely be cared for in a home setting or by one aide/adult. Particularly true for dementia patients and people who have certain medical conditions where care can't easily be provided in a home setting (needs dialysis and isn't a candidate for home dialysis or needs certain therapies, for example).

Home care would be a nightmare right now. Can you imagine what it would be like to not have health care aids show up or what it would be like trying to deal with a frail patient whose regular physician has either reduced their office hours or has limited availability via Teledoc?

It is hard enough to provide home care during the BEST of times. Now just trying to find a facility that is taking new residents would be a nightmare.

My friend is an essential worker. He lives with his mother who has alzheimer's. He has to figure out a way to get care for her right now while he is working. The care workers can only work a limited number of hours and a lot are calling out right now because of possible exposure so he has numerous people coming in and out who his mom is unfamiliar with, which makes it worse. A lot of the new workers aren't able to deal with dementia patients so he is constantly getting emergency calls at work. It's really been a nightmare.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
It makes sense.

First, Older people are more likely to die from this disease. So age seems like a strong reason for the deaths in nursing homes.

Additionally, it is difficult to practice any form of social distancing in a huge facility where nurses, cleaners, caretakers, cooks are constantly interacting with several people at the time. Additionally, a lot of employees in nursing homes pick up extra work at different facilities.

I think people will move towards finding much smaller facilities for their elderly loved ones.

+1 I think small facilities will become much more popular among those who can afford it (small facilities often do not have Medicaid beds).

Home care might become more popular, too, but it sometimes isn't an option. Even if you can afford aides, some people cannot safely be cared for in a home setting or by one aide/adult. Particularly true for dementia patients and people who have certain medical conditions where care can't easily be provided in a home setting (needs dialysis and isn't a candidate for home dialysis or needs certain therapies, for exam

Home care would be a nightmare right now. Can you imagine what it would be like to not have health care aids show up or what it would be like trying to deal with a frail patient whose regular physician has either reduced their office hours or has limited availability via Teledoc?

It is hard enough to provide home care during the BEST of times. Now just trying to find a facility that is taking new residents would be a nightmare.

I have home care for Mom now. Mom is still at risk as some of her caregivers work in nursing homes.

Yes. She probably sees the same doctors that the nursing home residents see, too. Plus, she's got healthy family members coming in and out of the house who very likely have less in the way of PPE than the staffed nursing homes do.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Most of these facilities are managing the care of their very vulnerable residents with as much caution as possible. But there is no way for these care facilities to completely keep COVID-19 away from their residents.

The healthcare workers do their best to exercise caution, but with their residents coming back and forth from other medical facilities, being transferred in from lower care situations a virus can get introduced into the facility pretty easy. Add in the fact, that many of the residents have dementia and aren't always behaving in a rational, reasoned way towards the staff and other residents - that really complicates the situation.

Even in a home environment, the residents are vulnerable to becoming infected because their caregivers are in/out of the house and the person is at risk of infection every time they are taken to a medical facility to see a doctor.

My friend works in an admin capacity at a home health agency and a lot of staff are calling in sick because of exposure or illness. They're seeing multiple people a week, plus some have other jobs.

Even if you can afford a live-in, you have to give that person days off, so you have to hire backup help for those times, usually. The backup help usually rotates between many homes.

A live in caregiver can also quit at any time or die. In fact, often patients are sent to LTCs after a home caregiver gets too ill to provide care or dies.

A lot of patients also end up in LTC facilities because the home caregiver(s) aren't able to handle the patient anymore safely at home. Particularly true with dementia or Alzheimer's patients.

Absolutely. Also, a person can go from being frail but mobile to being completely bedridden or falling A LOT which could be too much for a home caregiver to manage alone. Things can go from being manageable to completely overwhelming very quickly.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
It makes sense.

First, Older people are more likely to die from this disease. So age seems like a strong reason for the deaths in nursing homes.

Additionally, it is difficult to practice any form of social distancing in a huge facility where nurses, cleaners, caretakers, cooks are constantly interacting with several people at the time. Additionally, a lot of employees in nursing homes pick up extra work at different facilities.

I think people will move towards finding much smaller facilities for their elderly loved ones.

+1 I think small facilities will become much more popular among those who can afford it (small facilities often do not have Medicaid beds).

Home care might become more popular, too, but it sometimes isn't an option. Even if you can afford aides, some people cannot safely be cared for in a home setting or by one aide/adult. Particularly true for dementia patients and people who have certain medical conditions where care can't easily be provided in a home setting (needs dialysis and isn't a candidate for home dialysis or needs certain therapies, for example).

Home care would be a nightmare right now. Can you imagine what it would be like to not have health care aids show up or what it would be like trying to deal with a frail patient whose regular physician has either reduced their office hours or has limited availability via Teledoc?

It is hard enough to provide home care during the BEST of times. Now just trying to find a facility that is taking new residents would be a nightmare.

I have home care for Mom now. Mom is still at risk as some of her caregivers work in nursing homes.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The larger facilities would have a better ability to truly isolate the infected from the non-infected in quarantine halls or wings. They would also have a greater number of staff - some assigned to the non-infected units, some assigned to the infected units.

At the same time, there are quality of life issues at stake. We are talking about the long term isolation of the elderly from their family members and the rest of society until (and really even IF) a vaccine becomes available which might not happen.

I personally favor the approach of isolating the symptomatic sick people but allowing the folks without symptoms engage in group activities and, yes, even have (asymptomatic) visitors again. Life is too short and tomorrow is not guaranteed.

Staff are quitting and walking out at these facilities. They don't want to risk their lives working on a COVID wing for 14 dollars and hour and no PPE.

Turn over has always been high. That is not a new problem.

Anonymous wrote:Maryland just released, for the first time, cases and deaths from COVID in nursing homes. Like I said in the title, 22% of our cases and 50% of our deaths are from nursing homes.

My takeaways:

1. Those places are practically death sentences for old people and need radical changes.

2. We need to exclude those cases and deaths from the numbers as we think about reopening because they are not community spread. We know where they came from and the risk of exposure is to other residents and workers, not the general public. We need a completely different, separate policy response to nursing homes versus the rest of the community.

Outside of nursing homes, Maryland has 15,700 cases—roughly—and about 478 deaths. In MoCo, a county of 1 million people, we have about 2600 cases and 92 deaths outside of nursing homes.

This pandemic looks very different when you exclude nursing homes.

I feel horrible for the people in those places.

All the data is at Coronavirus.maryland.gov.

Anonymous wrote:

Anonymous wrote:The larger facilities would have a better ability to truly isolate the infected from the non-infected in quarantine halls or wings. They would also have a greater number of staff - some assigned to the non-infected units, some assigned to the infected units.

At the same time, there are quality of life issues at stake. We are talking about the long term isolation of the elderly from their family members and the rest of society until (and really even IF) a vaccine becomes available which might not happen.

I personally favor the approach of isolating the symptomatic sick people but allowing the folks without symptoms engage in group activities and, yes, even have (asymptomatic) visitors again. Life is too short and tomorrow is not guaranteed.

Staff are quitting and walking out at these facilities. They don't want to risk their lives working on a COVID wing for 14 dollars and hour and no PPE.

Anonymous wrote:The data is interesting. Nursing homes: 4406 cases. 476 deaths

Assuming people in nursing homes are over 60.

Standard MD data. Over 60 year old cases: 6465. Deaths. 735

Remove the nursing home cases so people over 60 not in nursing homes. 2059. Deaths. 259
12% death rate. Super high.
But what is weird is that suddenly the group over sixty only account for 10% of the cases. Maybe they don’t get out much or maybe they are more precautious. Who knows...

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Most of these facilities are managing the care of their very vulnerable residents with as much caution as possible. But there is no way for these care facilities to completely keep COVID-19 away from their residents.

The healthcare workers do their best to exercise caution, but with their residents coming back and forth from other medical facilities, being transferred in from lower care situations a virus can get introduced into the facility pretty easy. Add in the fact, that many of the residents have dementia and aren't always behaving in a rational, reasoned way towards the staff and other residents - that really complicates the situation.

Even in a home environment, the residents are vulnerable to becoming infected because their caregivers are in/out of the house and the person is at risk of infection every time they are taken to a medical facility to see a doctor.

My friend works in an admin capacity at a home health agency and a lot of staff are calling in sick because of exposure or illness. They're seeing multiple people a week, plus some have other jobs.

Even if you can afford a live-in, you have to give that person days off, so you have to hire backup help for those times, usually. The backup help usually rotates between many homes.

A live in caregiver can also quit at any time or die. In fact, often patients are sent to LTCs after a home caregiver gets too ill to provide care or dies.

A lot of patients also end up in LTC facilities because the home caregiver(s) aren't able to handle the patient anymore safely at home. Particularly true with dementia or Alzheimer's patients.

Anonymous wrote:The larger facilities would have a better ability to truly isolate the infected from the non-infected in quarantine halls or wings. They would also have a greater number of staff - some assigned to the non-infected units, some assigned to the infected units.

At the same time, there are quality of life issues at stake. We are talking about the long term isolation of the elderly from their family members and the rest of society until (and really even IF) a vaccine becomes available which might not happen.

I personally favor the approach of isolating the symptomatic sick people but allowing the folks without symptoms engage in group activities and, yes, even have (asymptomatic) visitors again. Life is too short and tomorrow is not guaranteed.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
It makes sense.

First, Older people are more likely to die from this disease. So age seems like a strong reason for the deaths in nursing homes.

Additionally, it is difficult to practice any form of social distancing in a huge facility where nurses, cleaners, caretakers, cooks are constantly interacting with several people at the time. Additionally, a lot of employees in nursing homes pick up extra work at different facilities.

I think people will move towards finding much smaller facilities for their elderly loved ones.

+1 I think small facilities will become much more popular among those who can afford it (small facilities often do not have Medicaid beds).

Home care might become more popular, too, but it sometimes isn't an option. Even if you can afford aides, some people cannot safely be cared for in a home setting or by one aide/adult. Particularly true for dementia patients and people who have certain medical conditions where care can't easily be provided in a home setting (needs dialysis and isn't a candidate for home dialysis or needs certain therapies, for example).

Home care would be a nightmare right now. Can you imagine what it would be like to not have health care aids show up or what it would be like trying to deal with a frail patient whose regular physician has either reduced their office hours or has limited availability via Teledoc?

It is hard enough to provide home care during the BEST of times. Now just trying to find a facility that is taking new residents would be a nightmare.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
It makes sense.

First, Older people are more likely to die from this disease. So age seems like a strong reason for the deaths in nursing homes.

Additionally, it is difficult to practice any form of social distancing in a huge facility where nurses, cleaners, caretakers, cooks are constantly interacting with several people at the time. Additionally, a lot of employees in nursing homes pick up extra work at different facilities.

I think people will move towards finding much smaller facilities for their elderly loved ones.

+1 I think small facilities will become much more popular among those who can afford it (small facilities often do not have Medicaid beds).

Home care might become more popular, too, but it sometimes isn't an option. Even if you can afford aides, some people cannot safely be cared for in a home setting or by one aide/adult. Particularly true for dementia patients and people who have certain medical conditions where care can't easily be provided in a home setting (needs dialysis and isn't a candidate for home dialysis or needs certain therapies, for example).

Home care would be a nightmare right now. Can you imagine what it would be like to not have health care aids show up or what it would be like trying to deal with a frail patient whose regular physician has either reduced their office hours or has limited availability via Teledoc?

It is hard enough to provide home care during the BEST of times. Now just trying to find a facility that is taking new residents would be a nightmare.