As COVID cases drop, nursing homes feel like a new normal
But while most residents of long-term care homes are now fully immunized, most other Americans are not, which means there are still plenty of opportunities for the virus to reenter facilities. The threat is compounded by reluctance to vaccinate among many long-term care workers. And there are unknowns about the effectiveness of vaccines in protecting long-term care residents as a specific group.
“It’s good to be optimistic,” says Jennifer Schrack, associate professor of epidemiology of aging at the Johns Hopkins Bloomberg School of Public Health. “But we still have to be diligent. It’s a new disease. We don’t know how it’s going to behave. We don’t know how the variants will behave… Just because you’re vaccinated doesn’t mean you can’t. not get it. “
This puts long-term care facilities across the country in a delicate interim phase. A return to a semblance of normality is now possible, but not without the maintenance of security measures. How careful facilities need to be is “the million dollar question,” says Schrack, who predicts confusion and stumbles are inevitable.
Beach balls in the garden
The Jewish Home Family includes a nursing home and an assisted living facility, where community activities that were either severely restricted or completely canceled during the pandemic are resuming. Almost all residents, except palliative care patients, and about 75% of staff are fully immunized against COVID-19.
Residents can now eat among themselves in the dining rooms, take exercise classes in the boxing gymnasium or rehearse for the next annual musical, The Lion King, which had to be postponed last year.
Infection control protocols are still in effect, including wearing masks, social distancing where possible, and capping the number of people participating in each activity, per federal guidelines. But these activities represent some of the first socializing opportunities residents have had in months.
“In many ways, we’re coming back to ourselves,” says Silver Elliott, who calls the coming months of programming at the Jewish Home Family “Project Welcome Home”.
The past year’s toll on residents is clear, she says: “Cognitive decline is significant and it breaks my heart.” Her facility’s activities are focused on ending isolation and overhauling restrictive environments as quickly as possible, while remaining cautious.
The Holly Heights Nursing Center in Denver takes a similar approach. Now that the majority of residents and staff at the facility are fully immunized, bingo and exercise classes are back on the agenda, as are some group meals. But precautions, such as masks and social distancing, continue.
And where possible, the center continues to follow federal recommendations for hosting activities outside, where the coronavirus is much less likely to spread. On a particularly hot day in early March, Executive Director Janet Snipes jumped at the chance to detonate beach balls and invite residents to pass them around the garden, soaking up the sun.
“It was a lot of fun,” Snipes said. “After such a devastating year, you could see that spirits were starting to improve.”
Punch for visitors
In many establishments, visits are also resuming. New recommendations this month from the Centers for Medicare & Medicaid Services (CMS), which regulate the more than 15,000 nursing homes in the United States, represent the most dramatic steps towards reuniting residents with their loved ones since nursing homes were first closed to guests in March 2020.
Citing widespread immunizations and declines in COVID-19 infections, CMS said that “the facilities should allow indoor visitation at all times and for all residents. [regardless of vaccination status]. “There are exceptions, including for residents who have COVID-19 or who are not vaccinated and in high-risk environments.
Fully immunized residents can choose to have close contact with visitors, the recommendations say, including touching and hugging while wearing a face mask and washing their hands before and after. The CMS recognized “the toll that separation and isolation have taken” on residents and said “there is no substitute for physical contact”.