Asymptomatic in SNFs/ALFs?

[anashenwrath, ASN, RN]

Hi all,

Hospice RN seeing COVID+ patients exclusively. So far, all my patients have been at SNFs or ALFs, all are geriatric with lots of comborbidities and usually dementia. One thing I'm noticing is how mild symptoms seem to be: mild cough, a few days of low-grade fever, poor PO intake and increased lethargy. I've only had one patient that needed supplemental O2 and one who developed really significant pain (she had a hx of chronic pain and I think the virus just amplified it).

Don't get me wrong, these patients are still dying super fast. Usually within days of coming on service. I've had to move my "actively dying" goalposts, bcs the s/sx I usually look for for active dying aren't there. People are still rousable, maybe even eating a little bit and then the next day they are gone.

I read an article about that SNF in Washington that had that terrible outbreak, and it said most of their patients were asymptomatic.

Is this something others in LTC are seeing? It's hard bcs I have so many families who are reading about these distressing symptoms, and then when their loved one isn't experiencing them, they start getting hopeful that it means they might recover. It's heartbreaking. I feel like having more experiences to speak to will help me support them.