Impact of COVID-19 on Long Term Care Facilities

By: Patricia Hudak, RN and Chelsea Cassidy, LCSW

Dr. George J. Mehfoud, MD is a Primary Care Physician with Commonwealth Primary Care in Richmond, VA.  Dr. Mehfoud is an Internal Medicine Specialist with over 32 years of experience in the medical field.  He graduated from Eastern Virginia Medical School in 1989.  He believes knowledge is power and takes his time to educate the hospice team on best practices on quality of care on numerous topics.  Recently, he in-serviced hospice clinicians on the impact of COVID-19 in long term care facilities.

The geriatric population and residents of long-term care facilities were the hardest impacted and most vulnerable to COVID since the beginning of the pandemic.  In the beginning, lack of PPE, COVID testing, staff ratio, staff education, proper protocols, financial support, inadequate spacing (shared rooms/bathrooms or dining areas), worker fatigue and fear were all key factors in these facilities being at risk of infection and transmission.  Certified Nursing Assistant (CNAs) have been true pandemic heroes for their dedication on the front lines and financial sacrifice.  Many CNAs work multiple jobs to provide for their families and were forced to choose one job at a specific community for safety and transmission reasons.

Our state went through a period of lockdown to lower the curve of positive COVID-19 cases and needed time to develop and have access to adequate testing, PPE and educate as well as train on protocols for safety and providing care.

Once testing was readily available, facilities were then able to test residents and staff on a regular basis to have a more proactive approach to contain the spread.  Many of these facilities remain closed to the public.   Measures to prevent infection such as restricting visitors, wearing masks, symptom screening and adequate testing of both residents and healthcare personal continues to have a lasting effect on our elderly.   The result of these protective measures has led to social isolation which has caused residents to experience depression and anxiety, increase in dementia by 50% (according to the CDC), promotes Failure To Thrive (FTT) and hastens premature death.

Hospice historically has been centered around maximizing an individual’s quality of life.  Although this pandemic has created challenges for all healthcare providers, we as a hospice team have looked holistically at providing care in person and through a virtual lens for patients, families, and the communities we serve.  With the establishment of Medicare waivers for telehealth services our team can continue to provide the maximize support available.  Dr. Mehfoud outlined specific ways we can care for our patients during the pandemic:

  • Increasing social and spiritual interactions via in person and telehealth
  • Creating opportunities for residents to connect with their family through Zoom, Ring Central or FaceTime
  • Taking residents for a walk or wheelchair ride (when feasible)
  • Offering assistance with ADL care
  • Playing games, reading, and the power of holding someone’s hand

In the caring words of Abode Healthcare CEO, Mike McMaude, he has reminded our company that at our primary purpose is taking care of patients and taking care of each other.  When we do this – we can certainly come out of this pandemic hand in hand.

Safe Activities to Enjoy While Social Distancing

Due to COVID-19, more and more Americans are practicing social distancing. While working at home, schooling from home, and sheltering in place, it’s understandable to wish for a simpler time when you could leave the house or interact with others outside of your household without worry. With new recommendations from the White House to continue social distancing through at least April 30, it’s more important than ever add a variety of entertainment to your life to keep yourself from feeling stir crazy. Here is a list of activities to help pass the time at a socially responsible distance:

  1. Utilize social media and video apps to stay connected to friends and family. Skype, FaceTime, Google Hangouts and Zoom are all video options you can use to connect with your long-distance friends.
  2. Walk, jog, hike or bike outdoors (while practicing social distancing from others).
  3. Read your neighborhood forums to see what types of social-distancing activities they have in place. For example, many neighborhoods are participating in bear hunts, where community members place teddy bears in windows so that kids can look for and count bears during their walks.
  4. Take a virtual tour of the Yellowstone National Park: https://www.nps.gov/yell/learn/photosmultimedia/virtualtours.htm. Many parks, aquariums, and zoos are offering free online tours or virtual experiences at this time.
  5. Write letters to your friends, family, nursing homes, and first responders.
  6. Do some spring cleaning.
  7. Play cards, board games or do a puzzle with your immediate family.
  8. Cook dinner – make a pizza from scratch or try a recipe that you’ve never made before because it was time-consuming.
  9. Join an online book club or meet with your friends virtually to discuss a book.
  10. Take a nap.
  11. Watch a movie or your favorite TV series on Netflix.
  12. Dig out your old coloring books. Coloring isn’t just for kids!
  13. Call the elderly people in your life and check on them. This would be a great time to interview your grandparents to learn more about their lives.
  14. Make a photobook online by uploading your favorite pictures from this past year.
  15. Buy gift cards from your favorite local businesses to use after social-distancing ends.

Let’s make the best out of this current situation by staying positive and being responsible. Spread the love, not COVID-19!

A Letter from Our CEO on COVID-19

Our Continued Diligence to Patient Care

  • Abode Healthcare has hired an infectious disease physician as an expert resource to help guide our decisions related to prevention and management of COVID-19.
  • All employees of Abode Healthcare have been re-educated on infection control, proper use of personal protective equipment (PPE), as well as effective handwashing techniques.
  • Abode Healthcare has implemented new policies and procedures related to PPE and all medical equipment to decrease the potential for disease transmission.
  • As a company, we have revised and implemented new ways for communication to take place within the leadership of our company to ensure that any and all important information is distributed, received and acted upon in a timely manner.
  • Abode Healthcare has developed a national two-level screening process for our patients.
    • Level one is a screening tool that is used for ALL of our patients.
    • Level two is an enhanced screening tool that is implemented in areas where there are confirmed cases of COVID-19.
  • Nationwide, Abode has implemented a screening process that takes place daily for our employees to decrease the risk for any transmission of the disease.
  • We have developed and implemented use of the Abode’s Emergency Preparedness and Response Plan, created specifically for our agency based on current recommendations from the CDC and the WHO.
    • This is a dynamic tool that will we will continue to revise and adapt as the situation evolves.
  • Abode Healthcare has secured necessary supplies for infection control practices as we continue to monitor and purchase more to effectively replenish our stocks.
  • Each of our locations has performed a live “mock” training event across every Abode agency with all employees to review our plans, discuss our specific roles, and ensure that every employee feels confident during this time to continue to provide the best care to our patients.
    • Confidence and dedication to patient care is key!
  • For patients being treated in Nursing Facilities with restricted access to outside visitors, we have implemented the following procedures:
    • Abode Healthcare has developed a remote visit for visits other than nursing, that can be done via phone with the patient, the caregiver, and with a representative at the facility that can provide information to us in order to collaborate on their plan of care.
    • Remote visits are available for social worker, chaplain, and music therapy visits.
    • The patients, families, caregivers, and physicians will be updated of any changes to the frequency or type of services we are allowed to provide.

Our dedication to our patients and family members during this time of need is our focus. We are here. Please let us know how we can help assist in any way with any patient in need during this time.

The coronavirus panic: How you can remain calm

The coronavirus, or COVID-19, is here in the United States and more people are getting sick, but the message remains the same: do not panic.  We’re reminded of the safety briefing on a plane “if the oxygen masks drop down and we lose altitude, put your mask on and stay calm.” Not panicking is easier said than done for many of us.  In fact, it is completely normal to panic when there is fear of catching a potentially deadly virus or fear of your plane going down.

Here are some tips and reminders on how to remain calm and help decrease your panic or anxiety:

  1. Start with grounding. Find the present moment by looking around at your surroundings. Exercise your five senses; what do you see, smell, hear, touch, feel?
  2. Listen to the experts. You’re not likely to get the virus, but if you do, you’re very likely to have mild or moderate symptoms. Live life as you normally would. Healthcare experts provide these practical tips for prevention against COVID-19 or other viruses:
    – Wash your hand frequently and thoroughly
    – Maintain a 3-6 foot distance in social situations with anyone who is coughing or sneezing
    – Avoid touching your eyes, nose, and mouth
    – Stay home if you are experiencing a cough, fever, or difficulty breathing, and seek medical care.More advice is available online on the World Health International website: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
  1. Talk with others. When something is bothering you, talk about it. Tell your friends or spouse or partner “this virus makes me nervous.” Tell them why.  Just talking about it helps.
  2. Be optimistic. Tell yourself, “everything is going to be OK.  Most people are going to be just fine. I’ll be fine, too.”
  1. Use coping statements. “This is a bad virus, but we are going to be OK. This is temporary. I’ve been through bad things before and I can get through this. When the fear comes up, I’m going to acknowledge it and let it roll off my shoulder. I can handle it. I can deal with it. This too shall pass.”
  2. Practice good self-care. Eat healthy. Drink water. Exercise. Engage in your hobbies. Socialize. Nurture your spirit.

 

Shared with permission by First Choice Health EAP.

 

 

The Why, When, and How of Handwashing:

According to the Center for Disease Control, handwashing is your best defense against the spread of germs.

The CDC recommends washing your hands before, during, and after prepping food; before eating; before and after caring for a loved one; before and after treating a cut or wound; after using the toilet; after blowing your nose, coughing, or sneezing; after touching an animal or animal waste; after touching garbage; or after changing a diaper or cleaning up after a child.

Also consider washing your hands after touching surfaces in a public space; before and after work; and after using public transportation.

What is the best hand washing technique?

Wash your hands with soap and water for at least 20 seconds – the same amount of time it takes to sing the Happy Birthday song twice.

  1. Wet your hands.
  2. Apply soap and lather well.
  3. Scrub your hands, including the backs of your hands and in between your fingers. If you’re wearing a ring, make sure to scrub underneath it!
  4. Rinse your hands well.
  5. Dry your hands.

If you do not have access to soap and water, consider a hand sanitizer that contains at least 60% alcohol. Cover your hands with the hand sanitizer and rub your hands together until your hands are dry.

Try to avoid touching your eyes, nose, and mouth, but especially with unwashed hands.

For more information on the science behind washing your hands, visit:

https://www.cdc.gov/handwashing/show-me-the-science-handwashing.html

 

Celebrating the Holidays when a Loved One is in Hospice

This time of year can be challenging for those who have a terminally ill loved one. If this friend or family member is in hospice, the holiday season may feel “off” or a little less joyous this year.

While there are certainly challenges you will have to face, there are still ways you and your family can celebrate the season with your loved one in hospice. We’re here to provide you with some encouragement to navigate this time of year.

Coordinate with hospice staff.

Those working in hospice are not just there for the patients during this time, they are also there for the families. Hospice staff serve as a crucial resource for trying times like these and are more than willing to assist. They can help coordinate visiting schedules to work around holiday events, offer suggestions for support groups, and make arrangements for any holiday traditions you’d like to celebrate with your loved one. Among many other tasks, hospice staff are there to aid you this holiday season.

Adjust your holiday traditions.

While it may seem difficult to change any holiday traditions you have to better suit your loved one in hospice, just know that it will be wroth it. Including your loved ones in these traditions is what the season is all about, so making certain they are a part of some of the traditions you enjoy the most will bring everyone closer together and create a special meaning this year.

Above all, enjoy time with your loved ones.

We know this may sound hard – maybe even impossible. It’s important to use this time to bring everyone together and create memories while you can. Surrounding yourself with friends and family can serve as a reminder that you are not alone in this process.

We’ll leave you with this question – What’s your reason for this season? Is it to cherish another holiday with your loved one?

Keeping Dignity | Caregiver Tips

Your loved one can no longer do the many tasks they once could. They now depend on you for many of these things. The easiest solution may be to simply take over and make decision, but it’s important to be respectful of your loved ones. As a caregiver, you want to protect your loved one’s dignity and sense of self-worth.

Put yourself in their shoes. Imagine if your independence had slipped away. You can no longer drive, walk, or get out of bed. These once simple tasks now require help from someone else. How would this make you feel? You may feel frustrated. This loss of freedom would most likely cause you to want to keep control over as much as you possibly could.

Here are some helpful suggestions:

  • Put yourself in your loved one’s place. How would you want to be treated if you were being cared for?
  • Educate yourself on your loved one’s condition. This can prepare you for what’s ahead.
  • Help them do what they can on their own for as long as possible. This will give them a sense of control.
  • Talk openly and honestly with your loved one. Try to involve them in decisions and be a good listener.
  • Be flexible. Try an accommodate reasonable requests if you can.
  • Give positive feedback if your loved one does a task on their own.

AT Home Care earns recognition from HomeCare Elite

Blue Stethoscope in Heart formation in blue color theme

HomeCare Elite has recognized AT Home Care Williamsburg as a top-performing home health agency for 2018. HomeCare Elite is a compilation of U.S. Medicaid- certified home health agencies annually reviewed by ABILITY and DecisionHealth. The review is conducted using public information evaluating overall performance in quality outcomes, best practices, consistent improvement, and financial health.

Recognition is given to the top 25% ranks home health agencies and further to highlight the top 100 and 500 agencies. HomeCare Elite is unique in a way that it is the only performance recognition of its kind in the home health industry.

Thanks to the AT Home Care Williamsburg team for their continual hard work and dedication to improving the lives of others. Also, thanks to all the families that entrust AT Home Care to provide the care needed for their loved ones. Our team is humbled to be recognized with this prestigious award and hope to continually exceed expectations as the new year arrives.

Green and Grey HomeCare Elite 2018 badge with stars
AT Home Care blue logo

To find out how AT Home Care services can benefit you or your loved one, please contact us.

Sepsis Concern? We’ve Got You Covered.

Sepsis is a severe response to infection that can quickly become life-threatening. More than 1 million cases occur each year. The Washington Post calls Sepsis a medical emergency. Sepsis can be caused by any type of infection, anywhere in the body and is one of the top diagnoses for patients being readmitted to the hospital. This infection is more  likely to occur in the elderly and those with chronic or severe illness or weakened immune systems.

AT Home Care has a Sepsis Program designed to promote quality of care and improve outcomes for those at risk for developing sepsis and those recovering from sepsis. We have the resources and expertise to provide our patients with state-of-the art care for dangerous conditions such as sepsis.

In consultation with your physician and according to Medicare, you have the freedom to choose any qualified agency to provide your care. Be sure your agency is qualified by checking its credentials, specialties, and reputation. AT Home Care is proud to enjoy an outstanding reputation serving our community. We are a Medicare Certified, CHAP Accredited agency that provides the highest quality of traditional and specialized services. It would be our privilege to care for you.

Call us anytime. We’re available 24/7. (804) 359-3400

AT Hospice: Improving Family & Patient Lives in Virginia

No one ever intends for tragic things like cancer to enter their lives. Often times, it comes on suddenly and acts quickly, leaving people and their loved ones with tough decisions to make about their futures. Kelly is one of these people. In early 2015, her husband was diagnosed with cancer. He endured months of treatment, but a few days before Christmas that year, he took a turn for the worse. They knew he didn’t have very much longer to live, so he and Kelly decided for him to go home where he could spend Christmas and live out his days in a familiar environment surrounded by family and friends. That’s when Kelly recognized they needed hospice care.

At first, the family chose the hospice recommended by their hospital, but it turned out to be a terrible fit and ended up doing more harm than good. Eventually, Kelly was told about AT Hospice, and decided to give them a chance. AT Hospice’s amazing team of professionals stepped in, and the family noticed an immediate improvement! The nurses, aides, social workers and chaplains all demonstrated true competence and concern, and Kelly could finally relax, knowing that her husband and family would be taken care of. Throughout the rest of Kelly’s husband’s life, the AT Hospice team could be reached whenever they were needed, jumped at the chance to help out in any way, and helped the family prepare for what was to come. “They were angels,” Kelly said.

Kelly’s experience with AT Hospice was so positive that when her mom’s condition with Alzheimer’s began to worsen, and it became evident that she would need hospice care, Kelly made sure to call AT Hospice again. The response from the company was “We wouldn’t have it any other way.” As before, AT Hospice staff demonstrated their true desire and ability to help. Their relationship with Kelly and her family strengthened, and they were there to help Kelly through the shock of another loss. Kelly noted that the nurse was at the bedside talking to her mother after she passed, showing the type of exceptional care and regard that the AT Hospice team made part of their daily routine.

“I couldn’t begin to thank them enough,” Kelly said. To this day, she still keeps in contact with many of the people who helped care for her mother and husband. One AT Hospice staff member even adopted Kelly’s mom’s dog, giving her a loving home and keeping Kelly updated with stories about the dog’s adventures. People from the company continue to show support as Kelly begins to transition into a new part of her life. When she comes across people in need of hospice services, Kelly recommends AT Hospice. “There are a lot of hospice companies out there,” Kelly stated, “but this one is definitely the best.”