As we all know by now, long-term care (LTC) facilities present an ideal setting for the spread of the novel coronavirus and the ensuing high levels of fatality. The senior residents in LTC facilities are immunocompromised and especially at risk of dying from COVID-19 as they often suffer from co-morbid health conditions like diabetes, obesity, and heart and lung disease. Moreover, the caregiving staff is constantly exposed to such infectious conditions, increasing their susceptibility to the infection.
Therefore, professionals who work in LTC facilities should have the required knowledge of the transmission dynamics and a sufficient backup plan to protect their facilities and reduce the levels of mortality. In March 2020, the World Health Organization (WHO) shared new guidelines to protect the residents, staff and healthcare workers in LTC facilities. These guidelines state the steps to be taken by LTC facility owners, administrators and directors to protect their facilities.
However, at present these facilities are being threatened by a high COVID-19 mortality rate. A recent report published in the NY Times shared that one-third of U.S coronavirus deaths are linked to LTCFs and nursing homes.
Source: https://www.nytimes.com/interactive/2020/05/09/us/coronavirus-cases-nursing-homes-us.html
In fact, as of May 7, nearly 25,000 LTC residents across 33 states succumbed to COVID-19.
To help reduce further mortality, in this post we have compiled, as a reminder, the best practices for LCTF owners and administrators for reducing COVID-19’s spread.
- Continue mass testing people for the disease
It’s been over three months since the first COVID-19 case was reported in the U.S. and it has seen several improvements in its testing capacity. However, experts share that the country still lags behind in tracking all the cases. Testing for the virus in one of the key measures recommended by the Trump administration, most of the states are facing a shortage of test kits.
Social distancing is next to impossible in LTC facilities. That’s because close contact between healthcare workers and residents inevitable. This makes consistent testing for the virus critical. But what can you do in the absence of rapid and ubiquitous testing measures? Learn to recognize the symptoms early!
For residents
- Assess the health status of any new resident when admitting and watch out for respiratory symptoms of COVID-19 including fever, cough, and shortness of breath.
- Examine the current residents twice daily for fever (≥38°C) and any of the symptoms shared above.
- If you find any such cases, report them immediately to the IPC focal point or the clinical staff.
For employees
- Ask your employees to report and stay at home if they experience symptoms, such as fever or any sort of respiratory illness.
- Check on employees with unexplained absences to determine their health status.
- Do a temperature check for all the present employees before they enter the facility.
- If you see an employee exhibiting the aforementioned symptoms, immediately ask them to leave or remove them from service temporarily, and refer them to their healthcare provider.
- Monitor the movement of your employees and their contact with the LTC residents, especially those with COVID-19.
- Use the WHO risk assessment tool to identify employees who have been at high risk of exposure to COVID-19.
- Amp up your staff support
Prohibiting senior care aides and nursing staff from working second jobs can significantly reduce the spread of the virus. Improve the staff support by converting these part-time positions into full-time and increasing their pay.
Further, protect your staff and healthcare workers from the anxiety and stress associated with the pandemic. Monitor them for symptoms and offer them a paid sick leave, rest, and recuperation, if they aren’t feeling well. They should also be offered mental health and psychosocial support to prevent excessive worries or anxiety within the LTC facility.
- Stress the use of PPE
In the U.S., LTC facilities have become a priority for PPE and testing. Thus, though these senior care centers have struggled to obtain personal protective equipment (PPE) like masks, gloves and isolation gowns in the past, the Federal Emergency Management Agency (FEMA) is coordinating PPE shipments to 15 thousand nursing homes and LTCFs across the country.
It’s common for aides to enter and leave the residents’ rooms without the use of proper PPE. Train and encourage your staff to use sufficient PPE within the facility. For instance, cleaners and support staff handling soiled bedding and laundry should wear appropriate PPE and perform appropriate hand hygiene before putting on and after removing PPE.
Further, the leadership and staff should be trained on how to reconfigure their facilities, thus separating infected individuals from the ones who haven’t tested positive. Offering them effective infection-control training will go a long way in limiting the needless deaths and lower the infection risk borne by the frontline healthcare workers.
- Exercise source control
If a resident shows symptoms of or is diagnosed with COVID-19, here are a few source control measures you should take to prevent further transmission.
- Immediately isolate the resident and place a medical mask.
- Notify the local authorities and appropriate public health authorities about the case.
- Patients at a high risk of contracting the disease like those over 60 years of age or with underlying comorbidities should be isolated and cared for in a health facility.
- Staff attending to such residents contact and droplet precautions. The residents’ room should be clearly marked at the entrance by placing IPC signs, indicating droplet and contact precautions.
- Dedicate separate medical equipment for managing resident(s) with suspected or confirmed COVID-19. The equipment should be disinfected before reuse.
- Restrict the sharing of personal devices, namely books and electronic gadgets.
The proper supplies and appropriate actions should at least help the owners, administrators and staff at LTC facilities protect their facilities amid the COVID-19 pandemic.
Amie Clark is the co-founder, senior editor, and visionary behind The Senior List. She loves to share her insight about topics related to senior living and caregiving with innovative eldercare products and services for their well-being. Her background in social work, especially with seniors and their families, has equipped her with the required knowledge and determination to express her thoughts and share best practices with others. You can connect with her Twitter at @seniorlist.
