May 26, 2020
How COVID-19 Spreads in Nursing Homes
The coronavirus has pulled back the curtain on longstanding problems in nursing homes. In 2014, the Inspector General for the U.S. Department of Health and Human Services had reported that more than one in five seniors in skilled nursing facilities experienced “adverse events.” These included poor medical care, patient neglect, and inadequate infection control, which frequently sent residents to the hospital.
Now, some nursing homes have become COVID-19 hotspots. This has contributed to disproportionate numbers of deaths among people over age 70, who may also have weakened immune systems that make them more susceptible to the virus or underlying medical conditions that increase their mortality rate.
Anthony Chicotel, a staff attorney with California Advocates for Nursing Home Reform, discussed what he’s seen in nursing homes in the months since the pandemic began.
Briefly, Tony, name the big three underlying problems you feel caused the virus to spread.
Chicotel: No. 1 is chronic understaffing to meet the needs of the residents and to perform all the basic functions required every day. No. 2 would be a tolerance for poor infection control practices. This flows from No. 1 because good infection control requires time, and it’s one of the things that gets cut when you’re pressed for time. No. 3 might be the practice of staff working in multiple facilities. Because they are often low-paid, it’s not unusual for them to work for two different companies that do nursing home care, or they might also work for an assisted living provider. This cross-pollination contributes to the spread of the virus among facilities. We’ve also learned that most of the staff who had the coronavirus have been asymptomatic.
The problems in nursing homes are not new?
Chicotel: I think we should’ve anticipated this. Coronavirus has brought all this out into the open but the Centers for Disease Control cites a a pre-pandemic study that found that up to 388,000 nursing home residents die each year resulting from poor control of infections such as Methicillin-resistant bacteria (MRSA) and urinary tract and respiratory infections. We’ve just accepted this staggering breakdown of infection control for a long time. I’m an advocate, and it wasn’t something I really focused on either. It’s been begging to be addressed in a significant way for some time.
Talk about infection control. In this pandemic, everyone is aware that hand washing is critical to stopping the virus. You cited a report by the Centers for Medicare and Medicaid Services (CMS) that 36 percent of long-term care facilities do not comply with hand-washing protocols and 25 percent do not comply with protocols for personal protective equipment (PPE). …Learn More
May 28, 2019
Cars Separate U.S. Retirees from Germans
Retired Germans spend more days outdoors than retirees in this country. But when older Americans leave the house, they stay out longer.
What makes the difference? The car. Americans love their automobiles and overwhelmingly rely on them, according to a new study by MIT’s AgeLab. If they’re going grocery shopping, they might as well run their other errands.
Only about half of Germans, on the other hand, say driving is their favorite way to get around. And they venture out more frequently, because they can walk – or bike – to the market, which tends to be closer to home.
As people age and recognize the inevitability of their limitations, they begin to think more carefully about whether they will be able to remain in their homes. To gain insight into this issue, the AgeLab surveyed older Germans and Americans to compare their retirement experiences and satisfaction with their lifestyles – the AgeLab calls it “residential mastery.”
This goal is achievable for seniors everywhere, if they can find a way to continue to live healthily in a particular cultural and social environment. “Americans may reach residential mastery by having access to a car, ride-sharing or taxi services, while Germans may reach residential mastery by having shops and amenities in walking distance,” concluded an article in the Journal of Environmental Psychology.
In the survey, retirees in each country were asked what they need and what their neighborhoods provide. Both Germans and Americans put the most value on living close to healthcare facilities and their family and friends, who can provide the day-to-day support they need. They agreed on 12 of 17 aspects of their lifestyles – affordability, places to sit and rest, cultural institutions, green spaces, etc. – as being critical to them. …Learn More
December 18, 2018
Holidays with Dementia in the Family
When my grandmother was spirited away by dementia and no longer recognized me, I stopped visiting her in the nursing home.
I didn’t understand this at the time but now think that I just wanted to remember her baking lemon cream pies or waving at me as she rode around on her lawnmower cropping the lot next to her Indiana farmhouse.
I wish I could get another chance and do things better this time. Regret is hard to live with.
Psychologist Ann Kaiser Stearns views the holidays as a precious time of year to make elderly family members feel they are loved and included in the festivities.
“People respond for as long as they live to smiles, to touch, to music, to kindness, to sitting in the sun, to pumpkin pies,” Stearns, a professor of behavioral science, said in an interview.
“We just need to remember that all of that nourishes an elderly person to whatever degree they have impairments,” said Stearns, who also wrote “Redefining Age: A Caregiver’s Guide to Living Your Best Life.”
Stearns encourages people to make an extra effort to connect with a loved one over the holidays and provides some tips:
Be patient. Take the extra time to sit down with your parent, aunt, or uncle and talk to them. Encourage them to reminisce. “Don’t do something if you don’t have the time,” Stearns said.
Be present. If grandma doesn’t remember you or something that happened in the past, do not argue with her or ask, “Why don’t you remember?!” She advised that it’s better to say, “Remember grandma, it’s your granddaughter from Baltimore.” When an elderly person repeats or forgets, connect with them where they are now, even if it means going through the same conversation again.
Stir sweet memories. Stearns said that her friend’s father, a former minister, has Alzheimer’s but the friend brings him to church anyway. When Stearns’ parents were old, they used to sit happily watching the squirrels in their yard while her father smoked cigars. It’s important to repeat rituals that are uplifting and have always brought meaning to their lives. …Learn More