The Centers for Medicaid and Medicare Services (CMS) recently released recommendations for state and local officials to gradually reopen nursing homes. The CMS recommendations guide officials to evaluate the feasibility to ease COVID-19 restrictions. State survey agency and state and local health departments participate in the decision-making process. CMS provides questions to answer to assess next steps.
Decision-making questions to answer
The key questions to answer are:
What is the COVID-19 case status in the surrounding community?
What is the COVID-19 case status in the nursing home?
Does the nursing home have adequate staffing?
Does the nursing home have access to adequate COVID-19 testing?
Is there universal source control (e.g., residents and visitors wear a face covering)?
Does the local hospital have the capacity to accept transfers from nursing homes?
Also, the recommendations include additional criteria for implementation, visitation and service considerations, and surveys that will be performed at each phase.
Easing COVID-19 Restrictions
AARP provides additional information about the next steps in reopening nursing homes. Fortunately, progress is already taking place in some states. For example, in Massachusetts, visits are allowed in some communities when scheduled in advance and must take place outside. Also, visits must include an employee. Additionally, only two people can visit a resident while wearing face masks.
In some ways, the new recommendations offer a glimpse into the new normal. It is likely that infection control procedures will continue indefinitely. The CMS recommendations only address protection for older adults and staff, not the effect of the COVID-19 restrictions. As a result, it is mandatory to implement plans that focus on the long-term effects of the COVID-19 quarantine.
Supporting Staff and Residents
We must address the effects of the COVID-19 quarantine on residents and direct care staff. Residents’ routines are disrupted. For example, residents cannot participate in group dining. Also, family and friends are unable to visit. As a result, residents are isolated. Furthermore, staff members work overtime to compensate for residents’ additional emotional needs. Also, staff members cope with exhaustion and compassion fatigue. Furthermore, direct care workers are not valued but are unquestionably invaluable.
Going Forward – the Next Steps
Now is the time to learn from the COVID-19 restrictions experience. We must support residents and staff to cope with the after-effects of the COVID-19 quarantine. Moreover, we must provide higher wages and more respect for direct care workers. Most importantly, they provide critical care and compassion to older adults in long-term care. As Julie Boggess’ blog emphasizes, “these workers and the residents they care for deserve better – much better.”
Kathy Dreyer, Ph.D., is the Director of Strategic Projects at AGE-u-cate® Training Institute, which develops and delivers innovative research-based aging and dementia training programs such as Dementia Live® and Compassionate Touch®, for professional and family caregivers; firstname.lastname@example.org