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For the short term, it is best if everyone considers that we are in a state of emergency.
The main point about this is that everything we all of us do just at the moment falls into one of only two possible categories: Helpful, and Unhelpful. It contributes to getting everyone through this crisis, or it makes it more difficult.
If what you are thinking of doing cannot be made to fit into the Helpful column, please don't do it, at least for now.
So, for example, ringing up the NH - good luck getting hold of anyone in authority at the moment anyway - and demanding information about another resident - yeah, that's going to happen - and how they're going to correct this situation...
Not helpful. Not even helpful in protecting the OP's own mother, come to that - because the new resident is already there, she is a fait accompli.
Sigh. Roll on universal testing, that's what I say. Anyone heard any updates on how long that's going to take?
I don't know the situation in LA, but expect that ALs will be pressured or even required to take in new residents.
Hospitals are having to release elderly patients before they usually would to open up healthcare resources for the flood of COVID patients. That means there has to be Skilled Nursing Facility space for them to go to to recover. And that means that the SNFs are going to have to open up space for them by discharging less frail residents to ALs (or a relative's home, if there's someone to care for them).
Depending upon whether or not we acted fast enough to 'flatten the curve' (in the absence of test results that would have guided the decision), we could be in for a situation where we will just have to do what we have to do. Old rules will no longer apply.
Absolutely. Nothing is “normal” during this pandemic and it’s going to be touch and go. The hospital probably needs the bed. In the Executive order President Trump signed last week CMMS regulations and rules may be relaxed in some areas to permit Medicare/Medicaid to waive time periods etc to get beds in an acute hospital opened up. Yes it’s scary but as CM said, at this time think to yourself whether it would or would not be helpful to call the facility as we are in a worldwide pandemic.
On the staff sickness issue - we are doing our best, I know I'm taking my temperature every morning, I assume everyone else is too, any warning signs we'll call in, I've no doubt we'll be told to stay home.
But how many times can they do that? Realistically, in not very much time the option will be between workers who might be carriers, or nobody.
Moreover, reducing staff numbers will further overload those carrying on, which will make them more vulnerable to infection.
We have to be clear-sighted about this. We are containing and delaying mass infection for as long as possible so as not to be overwhelmed by a sudden surge in case numbers. But it is not going to be possible indefinitely, and we had better think more about caring for people who are ill instead. Forget intensive care and aggressive therapy, I'm talking about relieving symptoms and (God willing) nursing them through it.
I would suggest 14 day quarantine, as well, in the room, with meals brought in. Certainly isolating and a problem, but otherwise she constitutes a danger to ALL there, including the staff they are dependent on. Call whomever is in charge and check on this. Unfortunately, at this time, at least here, even ombudsmen are on lockout.
I think the lady's arrival was probably agreed, arranged and paid for before the AL put its lockdown policy in place; and the least worst option available was to go ahead with admission.
You're going to call - what do you want them to say? Assuming that your mother's information is correct, what's your better idea of what everyone should do *now*?
Well my mom was in a nursing home, was transferred to a hospital for a NON coronavirus infection on Saturday. I have been visiting her every day except for Wednesday. When I called on Thursday they told me she had been discharged. I was completely confused and angry because they had not told me where she was being discharged. After about 10 minutes of scrambling around, they said she had been discharged to the nursing home she came from. I called the nursing home to make sure she was there, and she is. She no longer has a roommate as they put her in a private room due to the coronavirus scare. I am very angry at the hospital for not telling me she was being moved. I get the that we are in a health crisis and that things are a little crazy to say the least, but the hospital managed to call me five times to ask the same question regarding a local healthcare provider which I repeatedly told them she did not have one in this area because she is from a different city and I moved her to be closer to me but they can't manage to call me when she is discharged? My mom also has dementia so I don't see how they could legally do this. And please let me repeat I do understand that we are in a Health crisis. However mom is in the high-risk category and was being moved back to a nursing home so I'm just really disgusted that the hospital couldn't bother to tell me anything regarding that. The social worker was pretty flippant that I talked to oh, so I now have a phone call in to patient advocacy.
I would be calling administration and the Governor. These facilities are the HIGHEST risks of being infected and no one should be going in or going out... unless on hospice care. Period.
Ours is on total lockdown except for hospice. And has been PRIOR to the orders that came out.
https://youtu.be/G-HGTwY2XGw
This is a good video up to date from CDC about long term care facilities.
My mom was in a small nursing home in a small town and just passed at 101 two days ago. I was allowed in to say good bye as they too are under lock down. Signs on the door. Doorbells removed. Gown booties gloves and mask waiting for you as you enter. HOWEVER, upon entering I was not creeped for cough or fever. Maybe they trusted me to be well. Anyway, as I said my goodbye the nurse on duty said a few residents were “coming down with something tonight—fevers and flu symptoms but not “it” because she could tell the difference.” I then asked if residents had been tested and she said no, they don’t have any tests and the drs said unless they exhibit ALL THREE SIGNS testing not necessary. I was shocked. Some are in isolation already. I left immediately and have been on self quarantine. My sweet mom passed quietly after I got home so I’m thankful for that but I wasn’t given the option to choose whether or not to enter. Thoughts????
I live in New Orleans. It is really strange right now. Some of it does remind me of Katrina. My husband’s office is on Fulton Street in the Warehouse District and they sent everyone home last week. The entire firm is working from home. I am so thankful he wasn’t traveling. My husband travels a lot, here in the US and international travel too.
The cases of the virus are increasing in Jefferson Parish.
Awful about Lambeth House. Really sad about Dr. Lancaster. Sad about all of the deaths.
Did you see that church in Baton Rouge on the news for holding a service with 300 people? That was crazy.
My daughter is in Baton Rouge. She graduates from LSU this year.
Amite - Please pause to consider that you & your mom are fortunate that moms AL in Louisiana is remaining open. LA is fast approaching the overwhelmed critical stage for hospital availability, it’s at 392 cases & 10 deaths; once the testing #s come in over this weekend, its imho gonna go serious lockdown mode for cities along 10 and below. NOLA has double the rates of what Seattle has. Gov. Edwards presser on Wed. implied that was coming if social distancing didn’t happen. If you bank with H-Whitney, they emailed last nite that most locations are going closed lobby EOD today. Yesterday hubs & I drove to his office in CBD & then mine Uptown and door after door is locked & lights off with post-it or handwritten sign up. You could park anywhere on Poydras, in FQ, on Magazine. Last time it was like this was early post Katrina; it is eeerie. Restaurants who are still staying open, it’s only “takeout” & have doors propped open with a table blocking entry. Folks in NOLA who can shift to their place or camp on the coast or up country are doing it.
AL do not have to stay open, they can shut down with very little notice. AL, like IL, are not mandated by Medicare or regulatory agencies to provide for safe discharge / transfer like a NH aka skilled nursing care facility does. AL can decide to close. It’s AL and so the residents - in theory - can “do” for themselves with a bit of assistance. Facility can close their doors like manana and residents & their families have to just flat figure it out on their own. Also as AL is not skilled, staff do not have to have on hand the safety & sanitation (masks, spill bags, gloves) that a NH must. If AL can’t provide these, staff is gonna walk, they are not going to jeopardize their life, health, their family. Plus they can now go over to one of the hospitals and get a new job with a signing bonus.
The Lambeth House outbreak happened in the IL / AL section (23 cases with 4 confirmed Covid-19 deaths). The NH / SNc part (St Anna’s) only has 1 case which happened after the initial outbreak. What happened at Lambeth imo will put pressure other AL in Louisiana to seriously think about closing. Lambeth is pretty unique as it’s a very well off CCRC (buy-in abt 300k) and has partnered with Oschner for preventive care and research studies for IL, AL, NH, MC. It’s a well run facility with lots, lots of amenities & lots of staff. It puts out menus for its restaurant. It has $$$$ to pay for staff, it’s private pay & al la carte for care for AL, NH & MC services. It has its own foundation & does annual fundraiser/ auction..... it’s not a low profit margin AL or NH. But cause it’s IL/AL where Covid took off from, there not much the administration could have done as residents come & go. Lots of Lambeth residents have cars and drive; it’s a CCRC.
my point is, realize that all this is a balance. If folks panic pressure to IL & AL facilities, they can just shutter.
Central Florida here. The ALF where my father is is on lockdown too. They closed their dining room and are feeding residents in room. He is safe and taken care of and i have no intention of trying to visit. I am 64 with chronic diseases and sheltering at home. Everyone is doing the best they can. What will be will be. Good luck to us all.
North of Central Florida here. I work in an ALF in the Wildwood area. We have our facility locked down, too. Our residents have to take their meals in their rooms and when they come out for activities, we have to keep them 6 feet apart. The thing I've seen is they all have "some" dementia and understanding and remembering doesn't come easily to them anymore. We cannot hug them or anything other than speaking to them softly and every time they ask, we repeat why things are going this way. We also have to wear masks & gloves and that makes them very fearful. I've explained that it isn't that we think you're going to make us sick, it is that we don't want to chance giving anything to you that would make you sick. I also explain how we do go home to our families every day so we have to be extra careful to not bring anything into the facility. It is so sad to see the look of isolation on their faces. It's frustrating for the staff to watch this, but we have to follow the guidelines from the CDC and our corporate offices. We will get through this, and I just pray it doesn't take another month.
If the new resident is being admitted from a hospital, a discharge to a facility may have been in order to free up beds for a possible influx of patients due to the coronavirus. Most likely, the facility has protocols in place for new admissions given the knowledge of the reality of the population. If they are coming from home, I'm thinking the same protocols apply universally. While I can sympathize with your concern, how would you feel if it were your loved one who is in need of a higher level of care during this crisis.
I think we have to remember that sometimes a care provider is at the end of their rope by the time their loved one is admitted. I think if they are following precautions, and hopefully testing, I would be ok with it. Honestly, who knows who and how many people the nurses and other workers (still coming and going at the AL or nursing homes) are around on their days off? This new resident is probably given many more precautions than they are.
They should not have admitted this woman. They don't know where she's been. My mom is in a small assisted living and I was given no notice of shutdown except a phone call that it was shut down immediately. No cases in the entire county until a week later and then only one. I'm pissed!! If given ten minutes even, I would have taken her out of there. That was probably their fear... $$$ gone. Now they get no activities, no hair washing... just food and bed. Well, how do you take down a dictator - cut off their resources. April's rent will come due soon. I didn't co-sign the rental agreement. She was the only one. Now she has dementia and needs help to write the checks. If I can't get in, I can't help. Let them kick her out. That's what I wanted anyway. AL is very expensive everywhere now. I think this will be the end of many of them. Residents and family are very upset.
They can’t have activities. They are being quarantined. Be thankful there aren’t activities. They are being responsible and practicing social distancing.
I agree. The facilities and other places are doing everything possible. Yes, we have almost 400 infected here in New Orleans and 10 deaths. The governor is enforcing all the regulations.
All of the people are being quarantined. They are practicing social distancing. What else can be done?
My dads here in Southern NM and we got a new gal sometime this last week. Only 12 rooms per house and we were down to 8 as a lady passed earlier this week (NOT fr the virus). If they take necessary precautions I don’t mind b/c I’d hate to lose valuable staff if our numbers drop significantly! We’ve never been full in the year Dad’s been here.
MIL’s (97) Nursing Home is on lockdown. My Aunt (87) just fell and broke her leg, they admitted her to the rehab section of the same NH yesterday. Her temperature was taken, and she was showered/washed as soon as she entered. Her clothing was brought to laundry and she was put in a Johnny until her clothes were returned.
I am grateful they let her in and I feel they did a good job with precautions. She is private pay and they did have an open private room - so in her case she is further quarantined.
Will make visiting so much easier on us when the quarantine is lifted 😉
I just admitted my wife to memory care facility TODAY (3/17/2020). That had been our plan and the management and staff were wonderful! They took every precaution possible and now I know my wife is comfortable and SAFE! Who knows how much longer I’d have to wait until this lockdown is lifted? Who knows how many falls she might have suffered? I am extremely grateful!
Wow, that is tricky, but valid question. I would also ask them how they are screening them, or what precautions. VA NH are not taking new people. Oue NH is on lockdown for 30 days, no one in or out they said
I read some extended /updated guidelines from a federal or state level in the wee hours...but my take on it was they should still accept newbies although the screenings would be done. I don't know what to think any longer. My heart is breaking for those who aren't able to see each other...I don't know what I would do. My instinct would want the impossible...to bring my loved one home. Maybe we need to learn from this as far as designing places of the future...so that each room has a separate entrance from the outside, as well as one from an interior space so those working could tend to the person.
"...each room has a separate entrance from the outside, as well as one from an interior space so those working could tend to the person." Are you talking AL, IL, MC, NH, locked entrance, etc?
When mom's facility first mentioned potential lock down, one person told me those in IL would NOT be able to enter the common areas if they go outside. I believe they have a separate entrance area (not for each room, unless it opens to the back yard area maybe.) The latest update basically said all the common areas will be closed, residents are to stay in their rooms, have meals delivered to rooms, etc. MC will continue to allow free-roaming within the MC area only (no going outside MC for anything, other than necessary Dr appts.) I am sure the IL people can go out, but they will be shut off from the rest of the AL section.
Hard also to have an exterior entrance to AL units if on second floor, as mom's place has. The "interior" MC rooms would only have access to garden area, and the rooms are not large, so another door takes away "living" space. The "exterior" facing rooms would have the same space issues and there's a lot of shrubbery around the building. ANY secondary entrance in MC would have to be locked all the time, only unlocked if they need to come in that way. This would cost more money too.
I don't see any simple solution to this, other than having some kind of isolation area. By the time one realizes isolation is needed, in the current situation anyway, it has likely already spread to most residents and staff.
The hospitals need to be cleared of people who need rehab and assistance in order to make beds available for the upcoming tsunami of patients. They are going to have to allow rehabs and nursing homes to admit people.
It would be great if all admissions were quarantined for 14 days, though.
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The main point about this is that everything we all of us do just at the moment falls into one of only two possible categories: Helpful, and Unhelpful. It contributes to getting everyone through this crisis, or it makes it more difficult.
If what you are thinking of doing cannot be made to fit into the Helpful column, please don't do it, at least for now.
So, for example, ringing up the NH - good luck getting hold of anyone in authority at the moment anyway - and demanding information about another resident - yeah, that's going to happen - and how they're going to correct this situation...
Not helpful. Not even helpful in protecting the OP's own mother, come to that - because the new resident is already there, she is a fait accompli.
Sigh. Roll on universal testing, that's what I say. Anyone heard any updates on how long that's going to take?
Hospitals are having to release elderly patients before they usually would to open up healthcare resources for the flood of COVID patients. That means there has to be Skilled Nursing Facility space for them to go to to recover. And that means that the SNFs are going to have to open up space for them by discharging less frail residents to ALs (or a relative's home, if there's someone to care for them).
Depending upon whether or not we acted fast enough to 'flatten the curve' (in the absence of test results that would have guided the decision), we could be in for a situation where we will just have to do what we have to do. Old rules will no longer apply.
The hospital probably needs the bed. In the Executive order President Trump signed last week CMMS regulations and rules may be relaxed in some areas to permit Medicare/Medicaid to waive time periods etc to get beds in an acute hospital opened up.
Yes it’s scary but as CM said, at this time think to yourself whether it would or would not be helpful to call the facility as we are in a worldwide pandemic.
But how many times can they do that? Realistically, in not very much time the option will be between workers who might be carriers, or nobody.
Moreover, reducing staff numbers will further overload those carrying on, which will make them more vulnerable to infection.
We have to be clear-sighted about this. We are containing and delaying mass infection for as long as possible so as not to be overwhelmed by a sudden surge in case numbers. But it is not going to be possible indefinitely, and we had better think more about caring for people who are ill instead. Forget intensive care and aggressive therapy, I'm talking about relieving symptoms and (God willing) nursing them through it.
You're going to call - what do you want them to say? Assuming that your mother's information is correct, what's your better idea of what everyone should do *now*?
Ours is on total lockdown except for hospice. And has been PRIOR to the orders that came out.
https://youtu.be/G-HGTwY2XGw
This is a good video up to date from CDC about long term care facilities.
I live in New Orleans. It is really strange right now. Some of it does remind me of Katrina. My husband’s office is on Fulton Street in the Warehouse District and they sent everyone home last week. The entire firm is working from home. I am so thankful he wasn’t traveling. My husband travels a lot, here in the US and international travel too.
The cases of the virus are increasing in Jefferson Parish.
Awful about Lambeth House. Really sad about Dr. Lancaster. Sad about all of the deaths.
Did you see that church in Baton Rouge on the news for holding a service with 300 people? That was crazy.
My daughter is in Baton Rouge. She graduates from LSU this year.
AL do not have to stay open, they can shut down with very little notice. AL, like IL, are not mandated by Medicare or regulatory agencies to provide for safe discharge / transfer like a NH aka skilled nursing care facility does. AL can decide to close. It’s AL and so the residents - in theory - can “do” for themselves with a bit of assistance. Facility can close their doors like manana and residents & their families have to just flat figure it out on their own. Also as AL is not skilled, staff do not have to have on hand the safety & sanitation (masks, spill bags, gloves) that a NH must. If AL can’t provide these, staff is gonna walk, they are not going to jeopardize their life, health, their family. Plus they can now go over to one of the hospitals and get a new job with a signing bonus.
The Lambeth House outbreak happened in the IL / AL section (23 cases with 4 confirmed Covid-19 deaths). The NH / SNc part (St Anna’s) only has 1 case which happened after the initial outbreak. What happened at Lambeth imo will put pressure other AL in Louisiana to seriously think about closing. Lambeth is pretty unique as it’s a very well off CCRC (buy-in abt 300k) and has partnered with Oschner for preventive care and research studies for IL, AL, NH, MC. It’s a well run facility with lots, lots of amenities & lots of staff. It puts out menus for its restaurant. It has $$$$ to pay for staff, it’s private pay & al la carte for care for AL, NH & MC services. It has its own foundation & does annual fundraiser/ auction..... it’s not a low profit margin AL or NH. But cause it’s IL/AL where Covid took off from, there not much the administration could have done as residents come & go. Lots of Lambeth residents have cars and drive; it’s a CCRC.
my point is, realize that all this is a balance. If folks panic pressure to IL & AL facilities, they can just shutter.
This new resident is being quarantined so they are not in contact with each other. Personnel are washing up, wearing gloves. What else can be done?
All of the people are being quarantined. They are practicing social distancing. What else can be done?
Her temperature was taken, and she was showered/washed as soon as she entered. Her clothing was brought to laundry and she was put in a Johnny until her clothes were returned.
I am grateful they let her in and I feel they did a good job with precautions. She is private pay and they did have an open private room - so in her case she is further quarantined.
Will make visiting so much easier on us when the quarantine is lifted 😉
I hope your mom’s facility will stay safe. Lambeth House here has had a few deaths related to the virus.
Tulane University was asked to study the virus and how it spreads through testing at their primate center in Covington, LA.
I am extremely grateful!
When mom's facility first mentioned potential lock down, one person told me those in IL would NOT be able to enter the common areas if they go outside. I believe they have a separate entrance area (not for each room, unless it opens to the back yard area maybe.) The latest update basically said all the common areas will be closed, residents are to stay in their rooms, have meals delivered to rooms, etc. MC will continue to allow free-roaming within the MC area only (no going outside MC for anything, other than necessary Dr appts.) I am sure the IL people can go out, but they will be shut off from the rest of the AL section.
Hard also to have an exterior entrance to AL units if on second floor, as mom's place has. The "interior" MC rooms would only have access to garden area, and the rooms are not large, so another door takes away "living" space. The "exterior" facing rooms would have the same space issues and there's a lot of shrubbery around the building. ANY secondary entrance in MC would have to be locked all the time, only unlocked if they need to come in that way. This would cost more money too.
I don't see any simple solution to this, other than having some kind of isolation area. By the time one realizes isolation is needed, in the current situation anyway, it has likely already spread to most residents and staff.
It would be great if all admissions were quarantined for 14 days, though.