First Hand View
Covid19 has affected the world dramatically, everything that we still had suddenly changed. We must adapt to a new normal that adds stress, uncertainty, and worries. One major area that has COVID19 has effect has to be in nursing homes in many aspects in the way it's run and family visits to name a few. This area is holding a strong place in my heart, I have been working in nursing homes now for about 8 years. Through my 8years in nursing, I work many areas in assisted living, long term, and memory care units as well as being involved in many different positions from starting off as a CNA to eventually going into activities, then moving on as a social services assistant, and eventually currently being offered the Director position in activities in Memory Care.
Working in a nursing home I have seen firsthand the changes COVID19 has brought to Nursing Homes. According to IDPH, there have been 31,995 cases of COVID19 and 4,888 total deaths due to COVID19. My job for instance which is Thrive of Lake County (previously known as Winchester House) has had 34 cases and 7 deaths. (Long-Term Care Facility Outbreaks COVID-19 | IDPH. (2020, October 16)
According to the National Center for Biotechnology Information Search database “Nursing home residents have been the most affected by COVID-19 in many countries (1), representing as many as half of all deaths for COVID-19 in a number of European countries, over three quarters in Canada and around 40% in the USA,” Below is a chart taken from NCBI show how COVID has affected residents in a nursing home in different countries. (Inzitari, M., Risco, E., Cesari, M., Buurman, B. M., Kuluski, K., Davey, V., Bennett, L., Varela, J., & Prvu Bettger, J. 2020, July 11).
Visit Restrictions & Their Impact
One huge dilemma that COVID19 has brought to nursing homes is the restrictions to visits of loved ones in nursing homes. My job currently has made changes during these past months, that allow family visits outside for 15mins 2x a week. However, before this change during the beginning of the Outbreak, there were no visits allowed unless a resident was declared activity dying. Even with this some residents who weren't showing symptoms of activity dying passed away with no family members around.
In an article written by Roger Lowe for e UsAgainstAlzheimer’s had a survey conducted found families stating that due to COVID19 the restrictions made it very hard to access the health of their loved ones. The survey found that “More than 9 in 10 of these caregivers said they were unable to see their loved one because of virus-related visitation restrictions in the long-term care communities. More than two in three (68 percent) said their stress levels were higher than before the COVID-19 pandemic, with widespread concern (85 percent) about their inability to know/accurately assess health status (85 percent).” Loved ones also face symptoms of sleep problems (41%), difficulty concentrating (36%), vigilance/being ‘super alert’ (33%), trouble experiencing positive feelings (31%), loss of interest in activities (31%), and irritable/angry behavior (25%). (Lowe, R. 2020, October 19).
Along with this the survey also identified how many residents in a nursing home are testing them. The survey conducted on caregivers of loved ones in nursing homes stated 47% said that their loved one the nursing is being tested. About 35% said that their loved one wasn’t being tested, and 18% said they were unsure if they were or not. (Lowe, R. 2020, October 19). Currently, at my job, everyone including staff has to be tested once a week, before it was twice a week.
Less than half (47 percent) of these caregivers said their loved one in a nursing home or long-term care community had been tested for COVID-19, with a third (35 percent) saying no test has been done and 18 percent saying they did not know. (Lowe, R. 2020, October 19).
Loneliness
Along with families of loved ones in nursing, residents in nursing homes are facing a new dilemma due to COVID19. This includes loneliness, according to an article written by Joyce Simard MSW, Ladislav Volicer MD, Ph.D. loneliness is common in older adults, about 22% to 42% of the resident population has a feeling of loneliness compared with 10% for the community population. Due to COVID, these numbers can rise due to restrictions the article states “Group activities have been canceled and, in many facilities, residents are eating in their rooms, as all communal dining has been stopped. Although prohibiting group activities will decrease the risk of spreading the COVID-19 infection in nursing homes, it significantly increases the isolation and resulting loneliness of residents.” (imard MSW, J., & Volicer MD, Ph.D., L. 2020). According to Priya Chibambaram's article “Residents in nursing facilities are at risk of being diagnosed with psychiatric disorders, with nearly 40% having experienced symptoms of depression” Again COVID19 will only dramatically raise these numbers due to isolation away from families.
At my job this is very similar, group activities were removed, residents eat in rooms, and one on one activities or independent activities were added. We have changed back to dining room meal but six feet apart and group activities but six feet apart with a mask. However now every time we get a case; we must quarantine the residents for two weeks which means no group activities or dining room meals.
Overall, it important to note the effects of COVID19 on our elderly society. They must not be forgotten. It's important to make them feel loved especially during these tough times. This can be done by daily phone calls or even video chats or by simply sending care packages.
Work Cited
- Long-Term Care Facility Outbreaks COVID-19 | IDPH. (2020, October 16). IDPH. https://www.dph.illinois.gov/covid19/long-term-care-facility-outbreaks-covid-19
- Inzitari, M., Risco, E., Cesari, M., Buurman, B. M., Kuluski, K., Davey, V., Bennett, L., Varela, J., & Prvu Bettger, J. (2020, July 11). Nursing Homes and Long Term Care After COVID-19: A New ERA? PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353831/
- Lowe, R. (2020, October 19). COVID-19 Impacts Increasing on People Living with Alzheimer’s in Nursing Homes and on their Families. UsAgainstAlzheimer’s. https://www.usagainstalzheimers.org/blog/covid-19-impacts-increasing-people-living-alzheimers-nursing-homes-and-their-families
- Simard MSW, J., & Volicer MD, PhD, L. (2020). Loneliness and Isolation in Long-term Care and the COVID-19 Pandemic. Https://Www.Jamda.Com/Article/S1525-8610(20)30373-X/Pdf. https://secure.jbs.elsevierhealth.com/action/cookieAbsent?code=null
- Chidambaram, P. (2020, March 14). Data Note: How might Coronavirus Affect Residents in Nursing Facilities? KFF. https://www.kff.org/coronavirus-covid-19/issue-brief/data-note-how-might-coronavirus-affect-residents-in-nursing-facilities/
Thank you for your post. I know that the restrictions for visitation is for safety purposes, but I cannot imagine how residents in nursing homes feel. Some residents may not understand these restrictions and may wonder why their family does not visit. This breaks my heart. I am glad that your particular facility allows for small visits twice a week. Even though this is extremely low minutes for visitation, I am happy that people are at least allowed to visit. I am curious how this visitation protocol will occur during the winter. It will be too cold for the residents to go outside to visit with their families. Does your facility have a new protocol in mind?
ReplyDeleteThanks,
Taylor Wise
I really enjoyed reading your post. Despite the deaths from COVID-19 on the nursing home population I believe learning about the isolation and visit restrictions was truly heart wrenching for me. For some families they'd visit their family member everyday, so I could only imagine how hard this was on the mental health for both parties. As we've learned mental and physical health go hand in hand. With that being said do you believe the increased loneliness had an impact on the immune systems of those in the nursing homes? As social workers what suggestions can we over to both abide COVID guidelines but allow for that intimate interaction between family members despite phone calls? I would suggest maybe window visits or hand made cards to show time spent to display and outward sign of love and care.
ReplyDeleteIt is so sad and frustrating to see how keeping people safe has also isolated them and impacted their well-being. Lack of intimacy and interaction are so harmful to people, but to individuals that are institutionalized and away from their family, the experience must be much more painful. I am glad that socially distanced activities are resuming to some extent and that family members are allowed to see their loved ones. I recall at the start of a pandemic, a young woman visiting her grandparent and showing her engagement ring through the window. It seems we have to get creative and find ways to maintain contact and demonstrate care without physically being in the same room. Taylor does bring up an interesting point on visitation in the winter. I wonder what would be a good option.
ReplyDeleteThis was a really interesting read. I do not have any direct experience with this population, but have done research on Alzheimer's disease and know the importance of socialization and connectivity for elderly and older adults suffering with memory problems. During the pandemic it has been so terrible to see nursing homes, such an essential place of care for so many elderly adults and their families, have cases of the virus spread, and individuals within the homes lose their lives. Not only that, but it sounds like individuals really suffered because of the separation that they were subjected to not only from the other people in the nursing homes, but also from their families. It is such a double-edged sword because you have firsthand seen deaths at your facility due to COVID-19, but at the same time have seen the deep loneliness that your patients feel due to the requirements of the pandemic. Care packages and technology are great resources and I hope people use them as much as they can. Like you said, we definitely cannot forget about our elderly population during this time, thank you for your post!
ReplyDeleteGreat post! During the pandemic a lot of COVID-19 cases were individuals have die. The nursing home population have a lot of visitors restrictions and isolation because of the pandemic. It's very sad that patients are not allow to see their family due to the pandemic. The patients might understand the circumstances but others might not.
ReplyDeleteFamilies and patients emotional and mental health might be a concern at this time. During this difficult times we must ensure that our love ones are well taken care of but also we must focus on our own well-being.