LTC Residents and Workers Face Tragedy

J.Adderton, BSN, MSN

The earliest U.S. coronavirus deaths occurred in late February when residents at a Seattle nursing home began falling ill. Since then, the virus has spread like wildfire through the nation’s nursing homes. On Sunday, April 19th, ABC News reported at least 7,300 long-term care residents, in 19 states, have died during the COVID-19 outbreak. Because only 19 states have reported this data, the number of deaths is likely much higher.

Too Little Too Late

On April 2, 2020, the Center for Disease Control (CDC) issued new recommendations to help slow the spread of the virus among some of our most vulnerable patients and healthcare workers in long term care (LTC). But, COVID-19 continued to surge in LTC facilities across the nation, suggesting the CDC recommendations were not stringent enough or came too late. Here are just a few examples:

Canterbury Rehabilitation & Health Care Center in Richmond, Virginia, reported on April 17th, at least 46 residents died of COVID-19, which is one-fourth of the facilities population. Testing was not available to the facility until March 30th and the state only had an estimated supply of 300 kits.

On April 17th, officials in New York released information showing at least 14 nursing homes in New York City and surrounding suburbs have recorded more than 25 coronavirus deaths. At least 55 deaths are reported at the Cobble Hill Health Center in Brooklyn.

In New Jersey, almost two-thirds of the state’s LTC facilities have reported coronavirus outbreaks and more than 1,500 deaths tied to nursing homes. One of the homes was overwhelmed by the number of resident deaths and an anonymous tip led to 17 bodies being found in the facility’s morgue, which was designed for only 4 bodies.

Both Residents and Workers High Risk

Residents in long term care often require assistance with bathing, feeding, turning and other daily living activities that require close contact with the workers caring for them. The level of personal care needed puts both residents and workers at increased risk for infection. In early April, a McKnight’s Long-Term Care News Flash Survey showed 48% of respondents had workers missing work due to either having COVID-19 or experiencing symptoms. Workers and residents in LTC also face challenges that are both unique and common among all of healthcare.

Chronically understaffed, poor staffing ratios and ill-prepared for staff to be off work after acquiring COVID-19 or coming in close contact with someone who has tested positive.
Many already had a history of safety violations prior to the coronavirus outbreak.
Provide services to residents who are older adults who are immunocompromised due to age or chronic illness/disease.
Late in requiring workers and residents to wear masks.
Some facilities initially required a worker or resident to test positive for COVID-19 before requiring masks.
Poor staff to resident ratios.
LTC facilities designated as lower priority for COVID-19 testing than hospitals.
Difficult to isolate residents with symptoms due to common eating/recreation areas and semi-private rooms with double and triple occupancy.

A combination of these factors, among others, have allowed the spread of COVID-19 despite efforts to slow the spread.

Overlooked Workers

Workers in long-term care have been largely overlooked as COVID-19 plays out. Like other healthcare settings, virus tests and protective gear have been limited in many facilities. Staff in nursing homes are also less likely to receive the same level of training as those working in a hospital. In addition, many employees are poorly paid and work several jobs to make ends meet. As a result, the virus may be spread from one facility to another and even to the worker’s home.

Creative Solution

Park Springs Life Plan Community in Stone Mountain, Georgia, has found a creative way to slow the spread. The facility’s leaders asked staff members to volunteer to live on campus to avoid carrying the virus into the facility from home. Sixty workers took the bold step and volunteered. Only four staff members and one resident at the facility have tested positive for the virus and all have fully recovered.

Let Us Hear from You

Do you work in a long-term care facility or have a loved one that is a resident?

If so, what insight would you like to share on the high rates of COVID-19 in nursing homes?

Resources

‘They’re Death Pits’: Virus Claims at Least 7,000 Lives in U.S. Nursing Homes

LTC Residents and Workers Face Tragedy

Too Little Too Late

Both Residents and Workers High Risk

Overlooked Workers

Creative Solution

Let Us Hear from You

About J.Adderton, BSN, MSN

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