A Word About Nursing Homes & COVID-19
Families have shared their anguish and frustration on the evening news as COVID-19 ravages nursing homes. In too many places staff and residents have both contracted this awful virus.
My heart aches for all of them.
For everyone’s safety, President Trump and the Centers for Medicare and Medicaid Services (CMS) have directed that all visitors, nonessential health care personnel and other personnel such as hairdressers or barbers be restricted from entering nursing homes nationwide with the exception for compassionate care, such as end-of-life. This has left families unable to see for themselves how their loved one is doing. For some, they struggle to get the information they want from the facilities.
Here’s something to consider and implement immediately. Your loved one needs to designate who their authorized representative is. If Mom has 4 children they can’t all get a call from the facility with an update. This would be precious time repeating information that must be used for providing care. There needs to be a family designee who then shares the update with the others.
Who should be contacted? Who has been named as the Health Care Power of Attorney in the event your loved one can’t make their wishes known? If a parent is remarried, who have they designated as the contact-the current wife? Or one of the children? It’s not up to the nursing home to settle long burning family feuds.
You can find information here on legal and financial considerations. If you aren’t sure how to start a conversation about what your loved one wants if they become ill, The Conversation Project has a wonderful resource specifically for COVID-19. You can download and print out the questionnaire here. The Institute for Healthcare Improvement offers resources for professionals who are engaging older adults in these conversations due to COVID-19.
It is easy to decide what actions someone else should do. The reality is that if you are over the age of 18, you need to complete a healthcare power of attorney and name someone in your medical records as authorized to receive your HIPAA protected information in the event of an emergency.
Remember that residents of nursing homes retain all the same rights as someone who lives in the community-including the right to privacy. Your loved one has the right to refuse your request for information.
If you are having difficulty reaching your loved one in a facility you can always contact the long-term care ombudsman in your state. Their role is to advocate for residents of long-term care facilities. There is an ombudsman in all 50 states, Washington DC, Puerto Rico and Guam. In Rhode Island, the long term care ombudsman’s office is located in the Alliance for Better Long Term Care. You can call that office at 401-785-3340. If you live outside of Rhode Island you can find your long-term care ombudsman information here.
Remember that the staff of these facilities are real people who are going through this crisis too. They worry about their residents, they worry about their own families and their own safety. Nursing home staff need to be cheered for too. Be gentle when you speak with them, they also weep with grief when a resident dies.