Nursing homes in the time of COVID

Being a senior living in a skilled nursing facility under normal circumstances can be a challenging proposition, but in the time of coronavirus, it has become much more difficult. To be sure, there are distinctions between residing in an independent/assisted living home and residing in a skilled nursing home.

Senior citizens living in independent/assisted living homes, while facing the concerns and constraints of coronavirus, are still able to move about and interact with others while maintaining social distancing and mask protocols. If they reside in a facility like Hillcrest Royale, they can have breakfast and dinner in a dining room prepped for social distancing with staggered service times. At OakView Health Center, there are several acres of grounds for residents to enjoy and visit with family in a safe environment.

However, the individual in a skilled nursing facility, who often suffers from a debilitating disease, has far fewer options available to them. Since their health is generally more fragile, greater measures are required to ensure the maintenance of their physical safety. Although meeting that need is crucial, it is important also to consider the impact physical restrictions caused by coronavirus remediation have on emotional and psychological needs. Nursing homes certainly do their best in providing physical care, but those constraints also preclude meaningful time spent or physical touch essential to health and wellbeing.

Visiting with family members in a skilled nursing environment has its challenges. I spoke recently with a Conejo Valley resident whose father is in skilled nursing, and she relayed to me the challenges of visiting him. 

She is not allowed to enter into the facility; she can only see him through a glass window and talk on the phone. Unfortunately, he has a hard time holding a phone owing to his condition. She is not allowed to sit with him or hold his hand because of liability concerns, even though she is happy to take the same precautions staff take. She is not allowed to bring him food he likes, lovingly prepared by her, because outside food, or even restaurant take out, is not allowed due to coronavirus. These rules leave her father frustrated and despondent, stripping him of the things that bring him joy in life.

For the nursing home patient, even going on a basic doctor visit can be enormously difficult. Upon returning to the facility, as a precaution the individual is placed in isolation for 14 days. Already limited in the opportunity to engage in human companionship, they are now put in isolation where for two weeks the only time they see someone is when the staff brings food, takes away the tray, or sees to some other physical need. Long hours of isolation are not good for emotional wellbeing.

Another local resident described that he has not seen his mother in weeks because of the facility’s restrictions. Before coronavirus he used to visit his mother at least twice a week; now he wonders if she understands why she has not seen her son for so long.

To be sure, skilled nursing facilities are doing the best they can while following California Health Department guidelines, but unfortunately those guidelines are primarily concerned with protecting the physical wellbeing of the patients to the detriment of the emotional wellbeing of our elders. 

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