The age of COVID-19 is filled with uncertainties — When will a vaccine be ready? How will businesses recover? When will it be safe to see friends and family?
For those with an elderly loved one or patient in a nursing home, one question may be consuming their thoughts: Should they stay in their facility or transition to home care?
While there is no one-size-fits-all approach to care, it’s helpful to look at the big picture, understand all the options available to a patient and their family, and weigh the pros and cons to determine the best course of action.
The State of Nursing Homes in COVID-19
It’s been said that nursing homes are the overlooked epicenter of the COVID-19 pandemic.
According to a New York Times database, more than one-third of all U.S. coronavirus deaths are attributed to nursing home residents or workers. At least 46,400 residents and workers have died from COVID-19 at nursing homes and other long-term care facilities for older adults in the U.S., and so far the virus has infected more than 238,000 people at some 10,100 facilities.
The Centers for Disease Control and Prevention (CDC) states that given their congregate nature and resident population (older adults, often with underlying chronic medical conditions), nursing home populations are at high risk of developing complications from a coronavirus infection, and those complications can increase the risk of death.
This data is scary for families who have a loved one living in a nursing home. And with devastating stories of COVID-19 infecting nursing homes appearing daily on the news, it’s understandable why many are now reconsidering if a nursing home is where their elderly loved one or patient should continue receiving care.
The Benefits of Home Care
For those wishing to exit nursing homes or help a loved one do so, home care presents a promising alternative. Some of the obvious benefits of “aging in place” may include the ability to enjoy the familiar comforts of home, having family and friends inside the home or nearby, and maintaining a greater sense of independence and freedom.
It’s also more affordable.
“The fact remains: You can serve on average three people in their homes for the price of one person in a long-term care facility,” said Shona Eakin, CEO of Voices for Independence, an organization based in Erie, Pennsylvania, that strives to empower people with disabilities and promote independent living.
As noted in a recent NBC News report, “For people recovering from COVID-19, home care can be both essential and elaborate, involving a health care professional who provides additional oxygen, monitors vital signs, administers medication and helps with daily tasks such as eating, bathing, and getting in and out of bed.”
The COVID-19 pandemic has brought to light just how crucial the home care industry is, as it has provided lifesaving services to those most vulnerable in the safety of their own homes. Additionally, experts have said that an immediate expansion of home care services would lessen the strain on the overburdened U.S. health care system.
But before you rush someone out of a nursing facility and into the home, consider why a nursing home felt like the most appropriate option in the first place.
Making the Decision
While federal regulations allow a resident to leave a nursing facility at any time, it’s not a decision to take lightly. Here are some items to consider in deciding if you should move an elderly person to home care:
- Find your ‘why.’ What’s the main problem driving you to consider home care? If a nursing home is a good fit otherwise, how can you solve that problem? For example, if you have a real reason to believe that the nursing facility is unsafe or administering inadequate care, home care may be the right choice. If the issue is that your patient or loved one is lonely, or anxious about the overall state of the world, perhaps more frequent phone calls, regular Facetime sessions, or window visits could be the answer.
- Ask what they want. Remember, the decision is not entirely yours. Even if you don’t believe a nursing home is the right place to be during this time, your loved one or patient may feel otherwise, and the stress of a move can weigh heavily on someone who isn’t open to it. Ask what it is they want and why, and show compassion regardless of the answer.
- Understand their needs. Before making any moves, be sure to consult a medical professional to get a full understanding of the person’s care needs and ensure those needs can be met in the home. For example, would you or a caregiver be able to provide meals, medication management, general hygiene and bathroom assistance, emotional support, and other specialized forms of care? Would you be able to reasonably take on the emotional, physical, and financial demands home care might involve?
- Prepare for the transition. If they want to move to the home and their needs allow for it, inspect the space first to ensure it’s safe. Trips and falls are common among older adults and can be life-threatening, so be sure to:
- Remove loose throw rugs, extension cords, or other tripping hazards
- Organize or remove clutter
- Check that all railings are secure and install grab bars anywhere they might be necessary, such as near toilets and showers
- Fix or remove any unstable chairs or tables
- Check that all lighting is sufficient
If the person needs a wheelchair or rolling walker, ensure that all spaces (i.e., hallways, bathrooms, entranceways) are wide enough, safe, and accessible. Additionally, check up on their dietary needs and restrictions, and confirm that any prescriptions can be filled once they run out.
- Be comfortable with the unknowns. While you can control how much you prepare for the potential move, there are certain factors that are out of your hands. Right now, you may not have answers to questions such as: Would professionals in a long-term facility do a better job than you could at home? If they change their mind, will they still have a spot in the nursing home? When will this pandemic end? The unfortunate truth is that even a health care professional cannot predict the future. But if you can accept the unknowns, you can find peace in your decision and proactively approach this new situation.
If you still have questions, you’re certainly not alone. Coming to a decision about home care for yourself or a loved one can take time and many serious conversations. What matters most is that you make the best decision for the patient, and you make it with love – if you do that, you can’t go wrong.