ROP 2020 May 11th Breaking News: Long-Term Care Facilities and COVID

Long-Term Care Facilities and COVID

Joe Weatherly, DO and Heidi James, MD

Individuals living in long term care facilities are at higher risk of COVID-19 infections: in fact, one-third of COVID deaths in the US are nursing home residents or workers. Heidi sits down with Dr. Joe Weatherly to discuss how to keep our most vulnerable patients safe. 

Why are these institutions at risk?

• Many residents are medically complex and frail
• Communal living such as shared rooms and bathrooms 
• Dementia can make it difficult to recall/adhere to regulations
• Staffing matters
• Staff may work in several different facilities
• Caregivers move from room to room
• Lack of sick time for staff
• Inadequate access to or education re PPE

How to prevent outbreaks? 

• Have and implement infection control policies
• Handwashing
• Proper PPE
• Handwashing
• Educate staff and residents
• Non-punitive sick time policies
• Adequate airflow
• Early testing and isolation
• Visitation restrictions

How to manage once there is an outbreak?

• Isolate or “cohort” as much as possible
• Strictly enforced visitation policies
• Strictly enforce infection control measures
• Adequate testing and screening
• Restrict staff to one home

Remember the importance of goals of care discussions with your patients! 

References

COVID-19 Preparedness in Nursing Homes in the Midst of the Pandemic
Quigley DD, Dick A, Agarwal M, Jones KM, Mody L, Stone PW. [published online ahead of print, 2020 Apr 28]. J Am Geriatr Soc. 2020;10.1111/jgs.16520. doi:10.1111/jgs.16520

Nursing Homes Are Ground Zero for COVID-19 Pandemic
Barnett, Michael L., and David C. Grabowski. JAMA Health Forum. Vol. 1. No. 3. American Medical Association, 2020.

Coronavirus Disease 2019 in Geriatrics and Long-Term Care: The ABCDs of COVID-19
D'Adamo H, Yoshikawa T, Ouslander JG. [published online ahead of print, 2020 Mar 25]. J Am Geriatr Soc. 2020;10.1111/jgs.16445. doi:10.1111/jgs.16445(2020).