At one time, people expected to receive good care in nursing facilities. Life expectancy after a serious medical crisis is longer now because of the surgical, medical, and pharmaceutical progress we have made over the years. Yet that very progress has created a growing population of elderly who struggle to live independently, while living longer. If it weren’t for family caregivers, our already fractured health care system would implode. Today, caregivers are our nation’s power.
The Covid pandemic has revealed the long standing chronic staffing shortage that has plagued many nursing homes, assisted living facilities, and memory care units for a long time. Now, with vaccine mandates in place, facilities will lose some desperately needed staff. This results in empty beds because facilities have even less staff to provide adequate care to our most fragile.
AARP
I came across an insightful article, Nursing Homes are filled with Empty Beds, Raising More Concerns About Care, by Emily Paulin, AARP, October 4, 2021. https://www.aarp.org/caregiving/nursing-homes/info-2021/nursing-home-low-occupancy.html
Because so many staff members and residents died because of the pandemic, facilities closed their doors to prevent spread. Hospitals cancelled elective surgeries, thus drying up the need for those lucrative rehab beds as well. And honestly, if a bed were available, how comfortable would you feel in it with Delta still a threat, and unvaccinated personnel caring for you?
“Nearly 60 percent of nursing homes are limiting new admissions due to staffing shortages, according to a recent survey by the AHCA/NCAL, with almost 80 percent concerned that workforce challenges might force them to close.”
The article goes on to say nursing homes are looking to the federal government to help, beyond what it has already allocated for relief.
What quality of care can the most devoted certified nursing assistant give when he/she has 30 patients to care for? I’ve worked on hospital floors, and there were some shifts when I had to stop and triage which disaster I needed to tend to first. Me and the one LPN and one aide for 40 people on the night shift. Residents are developing the side effects of poor care, such as bedsores and weakening muscles for lack of assisted mobility. Angels of mercy are not blessed with the miracle of bi-location.
Alas, some are not “angels” any longer. They are burned out, underpaid, underappreciated, the brunt of families’ frustrations, and aren’t that healthy themselves. Might get a little testy?
When quality of care sinks, the family tries to advocate for their loved one, often with little success. It helps for families to know what to look for when visiting and what to do about their concerns. Here is a helpful link that addresses these issues (with thanks to AARP providing the link). https://theconsumervoice.org/uploads/files/general/CV_ChemicalRestraints_GoingBackLTCFguide_508web.pdf
The Home Care Alternative
I admit I favor home care over institutional care when possible, but home care is not always feasible for a variety of reasons. Even before Covid, family caregivers have had to wait for personal care/ home health coverage, many living as prisoners in their own home until someone can spell them for a while. Places like day care centers that added quality to the elders’ and their caregivers’ lives, have become largely inaccessible in this new normal. And such gathering places still pose health threats with the Delta variant. The family caregiver faces greater challenges and threats to their own well-being because one hesitates to turn to respite care, for example, no matter how much they may need it.
Reform
Yeah, right. With a Congress I don’t believe could come to agreement over flushing the toilet, I’m not holding my breath. Caregivers need help now. The most I can hope for is that my home care referral ends up in the right department of the Certified Home Care Agency (CHHA) — not a given — and I have a community healthcare nurse (CHN) to assess my needs (which won’t be met because there are few aides), put together a plan of care for my loved one (POC), which as a nurse myself, I did already), and make appropriate referrals for additional services if needed, such as physical, occupational, or speech therapy.
So it’s down to the old adage, “If you want something done right, do it yourself.” I think of this as a call to arms, a call to the big hearted Americans we are. We band together to help neighbors when there is a flood or tornado. We do what we can for each other.
I suggest, if you are inclined to want to “help” people, and wonder what you may do, ask a caregiver if you can visit with their loved one so they can get out to shop, or have coffee with a friend. Perhaps stay with the care receiver so the caregiver can go to church or go to a doctor’s appointment. Run a few errands for them or lend an understanding ear with a wad of Kleenex.
Churches are uniquely equipped to make a ministry out of this, but any caring person or group would find unexpected joy and satisfaction in helping.
And by the way, chances are great you will become a care receiver or caregiver yourself someday, if not already. This is a challenge that does not care who you are or what you are doing, and probably only a hermit is immune.
Oh my goodness, I enjoyed this article so much. So much truth to it and you add just the right words to it. God Bless.
Thanks, Ade. We need change now!
Your perspective as a long-term caregiver provides so much credence to this problem, Sue. Even though medical research has discovered amazing ways to prolong human life, the scientists have not been able to equalize the balance by enhancing how people live those lives. It always comes down to “quality versus quantity”, it seems.
At this point other experts need to weigh in. Social scientists, ethics leaders, mental health professionals come to mind, but tying them all together? Nurses. Nurses view patients as a complete entity and can devise care plans that lay out goals and methods to achieve these goals. Also: social workers, schooled in utilization of resources to fulfill these goals, plus assist in the psychological counseling needed for the elderly.
The problem? These are two career paths that have been uniquely stressed due to staffing imbalances, heavy workloads and financial compensation in the past, and our Covid pandemic has only exacerbated these. We need coordinators in the trenches who can work with both businesses and government to champion efforts to right these wrongs.
Absolutely, Cathy! You nailed it. Perhaps this is the time to champion these universal needs, when the gaps in our system are so glaring.
Another great article, with many valid points. However, I respectfully disagree with your one sentiment about’ how would you feel if unvaccinated personnel were taking care of you?’ Before the vaccine was available, caregivers took excellent care of seriously ill patients for months, and we all know now that those of us who are vaccinated are not immune to getting it or spreading it.
Good point, Karen. Thank you for clarifying that.