{"id":4102,"date":"2020-04-21T12:32:22","date_gmt":"2020-04-21T16:32:22","guid":{"rendered":"http:\/\/www.healthinaging.org\/blog\/?p=4102"},"modified":"2020-04-23T16:22:13","modified_gmt":"2020-04-23T20:22:13","slug":"during-the-coronavirus-crisis-things-to-consider-if-someone-you-care-for-is-in-long-term-care","status":"publish","type":"post","link":"https:\/\/www.healthinaging.org\/blog\/during-the-coronavirus-crisis-things-to-consider-if-someone-you-care-for-is-in-long-term-care\/","title":{"rendered":"During the Coronavirus Crisis: Things to Consider if Someone You Care for is in Long-Term Care"},"content":{"rendered":"

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If you are caring for someone who lives in a long-term care facility, you may have questions about their care and well-being during the\u00a0coronavirus crisis<\/a>. You\u2019ve probably wondered whether it would be safer to take them out of the nursing home and move them into your home.<\/p>\n

We put some of the questions you may be asking to Sharon K. Inouye, MD, MPH, Director, Aging Brain Center, Milton and Shirley F. Levy Family Chair Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center.<\/p>\n

\u201cThese are very difficult and individual decisions for each family. There is no right or wrong situation, just a balance of the specific considerations,\u201d says Dr. Inouye. \u201cI had to consider this for my own mother. Ultimately, we were unable to move her out of her facility because our home was not set up for her safety (too many stairs, lack of adapted bathrooms, narrow hallways that would not permit her walker).\u201d<\/p>\n

Dr. Inouye noted other hazards at her sister\u2019s home (who lives closest to her mother). Her children who are home from school might pose an exposure risk. Her family also has pets who could create fall risks.<\/p>\n

\u201cThe facility where my mother lives has outstanding infection control processes and procedures in place, with a highly trained staff. So, with difficulty, we made the decision to keep her in the facility. Five weeks later, after one documented case of COVID-19, my mother remains safe without any additional cases. This turned out to be the right decision for our family, but it was a very difficult one\u2014and obviously, had more cases emerged, it might have shifted the equation for us,\u201d Dr. Inouye said.<\/p>\n

Questions to Consider<\/strong><\/p>\n

What kind of care does the person you\u2019re caring for need? <\/strong>Can you meet their needs in your home environment? If they need skilled nursing or 24-hour care, this could be taxing for your family, says Dr. Inouye\u2014especially if you\u2019re working (even remotely) or if children or other family members have care needs, too.<\/p>\n

Some\u00a0people\u00a0in long-term-care facilities need\u00a0help with eating, dressing, toileting, managing medication, and other activities. Others, especially those with dementia or Alzheimer\u2019s disease, need more help. The pandemic does not change those considerations.<\/p>\n

How safe and accessible is your home?<\/strong>\u00a0Few homes are designed to minimize tripping and falls,\u00a0which put the person you care for\u00a0at higher risk for injury. If you have stairs, consider whether they can safely access needed areas of the house. Bathrooms should be fitted with grab bars next to the toilet and in the shower.<\/p>\n

Think about exposure sources.<\/strong> Do you have family members who go to work or have regular contact with others who may be exposed to the virus? You can\u2019t guarantee that your home environment is safer than a long-term care facility where professional staffers use personal protective equipment (also known as \u201cPPE\u201d) and infection control procedures.<\/p>\n

Also, consider whether all members of your household are able to maintain the recommended hygiene practices<\/a> of frequent handwashing and cleaning of household surfaces to reduce infection risk.<\/p>\n

What conditions at a long-term care facility might make you consider removing someone?<\/strong> \u201cIf there are documented cases at the facility, and inadequate infection control processes (such as not enough protective equipment), then you might want to consider moving your loved one,\u201d says Dr. Inouye. However, she notes that if the facility can provide adequate infection control, your consideration may be different.<\/p>\n

How can you make sure that the person you care for will be allowed back into a facility once you\u2019ve removed them during this crisis? <\/strong>\u201cThis is a difficult area and there are no guarantees,\u201d says Dr. Inouye. She advises that you learn in advance what the criteria are at the facility. If the person you care for is able to get tested to show they are negative, then they may be allowed back. However, as she notes, such testing is often unavailable in many areas. Bottom line: Find out in advance what the policies are at the specific facility.<\/p>\n

How will a move impact your family?\u00a0<\/strong>It\u2019s\u00a0important to\u00a0consider the\u00a0impact\u00a0of a move\u00a0on\u00a0other\u00a0family members\u00a0who will take on new\u00a0responsibilities, even if they won\u2019t be involved in direct care.\u00a0Changing roles\u00a0can be a\u00a0stressor.\u00a0If you\u2019ll be making the decision to bring the person you care for into your home, everyone in your family should feel\u00a0they were informed in advance. This can\u00a0reduce stress for the entire family.<\/p>\n

Questions to Ask the Management of the Long-Term Care Facility<\/strong><\/p>\n