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.