COVID-19 in Nursing Homes - Learn More.

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Transitioning A Loved One Into a Nursing Home During the Coronavirus Pandemic

Nursing homes and assisted living centers should offer a safe place for your loved one, whether he or she is your parent, a family member, or a friend who needs guided rehabilitation or to make a senior care facility their future residency. It is normal for you to have questions and be concerned as a quarter of all nursing home residents will experience abuse during their residency and the coronavirus pandemic has brutally targeted the elderly nursing home population.

As you begin your research, schedule a virtual tour of a facility, or speak with an administrator, review these questions to guide your learning about the home’s staffing, environment, and infectious disease outbreaks.

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An altered mental status is a difficult condition for nursing home residents to manage on their own, especially when symptoms can present slowly and brushed off for age-related memory loss, stress, medication side-effects, lack of sleep, or other conditions like dementia. Delirium, sometimes referred to as “sundowning” or “psychosis”, is one of those conditions that if misdiagnosed or treated with overmedication, can worsen quickly with irreversible outcomes including long-term cognitive impairments.

Delirium has been defined by The American Delirium Society (ADS) as a state of confusion that comes on very suddenly and lasts hours to days. If a nursing home resident becomes delirious, they may have hallucinations, disorganized thinking, difficulty understanding daily tasks, and inability to pay attention and be unaware of their environment or trust of the people in it. Delirium affects nearly 18% of long-term care residents and has a staggering 40% one-year mortality rate.

Nursing homes have been known to manage residents with disruptive behaviors in less productive ways, and many things can make delirium (and other mental conditions) worse, such as:

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What kinds of social distancing measures are nursing homes taking at this stage of the pandemic?

CMS guidelines have eliminated all communal meals and activities to limit residents’ contact with each other and allow facilities to repurpose communal spaces (like activity rooms) to spread residents out. Likewise, CMS is prohibiting visitation by family and friends, advocates and non-essential health care providers. The only exception is for “compassionate situations,” including but not limited to end-of-life visitation. Visitors making compassionate visits will be required to wear personal protective equipment, comply with other safety measures and refrain from physical contact. Finally, a person exhibiting any respiratory symptoms whatsoever will not be allowed to visit.

Facilities should already be following longstanding CDC guidelines for infection prevention. Here are some questions that can guide your inquiry into whether they currently comply with the rules.

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