Nursing Home disaster plan Archives ⋆ Cathy Cress

The 2 Deadliest US Sites of COVID-19 Nursing Homes & Prisons

May 2, 2020

PRISON INMATES AND NURSING HOME PATIENTS NOT 6FT APART – 6 FEET UNDER

70% of inmates in federal prisons have COVID-19. In Kansas, the Lansing Correctional Facility had a riot of inmates over COVID-19 lack of care or protection It took the rebellion to get the coronavirus testing PPE and care. The Bureau of Prisons in Kansas confirmed finally that 79 staff have coronavirus and 88 prisons and prisoners dead.

Older residents in nursing homes cannot rebel like prisoners. Many can’t even walk. The Atlantic Magazine just published an article, We are Killing Elders Now. The writer states “In at least six states, these fatalities account for half of all COVID-19 deaths, and according to the World Health Organization, half of all coronavirus fatalities in Europe have been traced to nursing homes too. Some of this mortality is linked to long-term-care facilities that are shoddily run or that violate health standards. But most of them are doing the best they can with what they have. And they don’t have much”.

KAISER FOUNDATION NURSING HOME STAFFING AND USE OF PPE NOT REQUIRED IN MOST STATES

Kaiser reports -Staff Screening. It is more common for states to recommend rather than require daily screening of staff for illness in NFs (24 states recommend, 16 states + DC require)

Use of PPE. More states recommend (23 states) than require (7 states + DC) staff to use PPE

Two States that require testing for coronavirus of ALL residents of nursing homes are Maryland where 556 have died as of the Washington Post article. and Tennessee

THE FEDS HAVE NO CMS FEDERAL GUIDELINES OR REPORTING

We have no federal guidelines for safety testing according to an article by the Kaiser Foundation

It is now estimated that 16,000 deaths have occurred in nursing homes and that is without the federal government revealing any numbers and not making available any testing. But the numbers are probably huge- if we could just do testing.

CMS announced it would have a meeting of a “panel” of experts “ sometime at the end of May”. After probably 20,000 older people died and the feds did nothing this shows their sense of urgency about this pandemic’s national “elder cleansing”.

WHAT CONNECTS PRISONS AND NURSING HOMES – CONCENTRATION CAMPS

So, what is the connection between the viral spread of COVID-19 in nursing homes and prisons- 6 feet ? Prisoners and residents, in nursing homes, and prisons cannot social distance. Jails and prisons have human beings crammed together with no choice. Nursing homes have 2 beds or if you are on Medicaid three to a room. Neither group has a choice to social distance. They are ” concentrated” as in concentration camps or death camps.

Do SOMETHING – HELP NURSING HOMES PREVENT MORE CARNAGE

So, as someone who has spent her career in aging, I am calling out to everyone, especially professional in aging – do something. Since the feds appear to be doing little- call your congressman, write a letter to the editor.

BE KIND LIKE RACHEL MADDOW REPORTS LA JEWISH HOME LA WAS

Rachel Maddow suggests calling your local nursing homes and see what they need. Be kind like the LA Jewish Home was to a smaller nursing home LA Brier Oaks. They wanted to test their residents and had no tests and the larger LA Jewish Home had tests and shared them with the smaller as a good neighbor. What they found was ravaging but it also showed caring and generosity. Care and be generous and show the helpless elders in nursing homes in your town you are opposed to -nursing home being prisons or concentration camps.

Why is Rachel Maddow Telling Aging Professionals About Nursing Homes Death Instead of the Feds????

April 27, 2020

Nursing Homes Turning into Death Camps

I have been learning that nursing homes are turning into death camps from Rachel Maddow not the federal government or aging community. I watch her every night as she is someone who reports the news fairly, focuses on facts and science,not what politicians and the president says. She reports what politicians actually do to avoid what the Trump camp calls fake news. This enrages me as why aren’t I hearing this from the aging community?

I learned that 17 dead bodies piled up in an NJ Nursing Home a week ago . Three days ago it was reported by the Kaiser Family Foundation that Nationwide, among the states reporting data, states indicate that cases have occurred at more than 4,000 facilities, and nearly 51,000 cases and over 10,000 deaths have been reported by in-long-term-care-facilities/

No Fed Requirements To Report Covid-19 Deaths

According to the Kaiser Foundation until recently, there was no federal requirement for nursing homes to report coronavirus outbreaks and COVID-19 deaths. This lead to an information gap for families, residents, and policymakers. After gutting the Obama regulations to improve care in nursing homes in 2017, On April 19, 2020,( many days after Rachel Maddow and the NY Times were reporting the horror(,CMS released guidance that would require nursing homes to report cases of coronavirus directly to the Centers for Disease Control and Prevention (CDC).This move is totally hypocritical after Trump is the one who caused the horror by slashing regs that would have prevented deaths. This new data is not yet available, but there are a number of states that are already reporting data on long-term care facilities.

When I saw the carnage of nursing home deaths, yet SNF’s asking feds for immunity I was even further outraged.

We Need Inquiry Into Federal Response

I blogged about the root of this problem a week ago We need an inquiry but more than that we need a federal response, which there is none and national coverage which is just starting to occur after the most vulnerable on the planet were locked up in buildings where no one could visit, filled with the people with the highest risk, and staff going from facility to facility as they need three jobs to keep them afloat and spreading the virus then becoming ill themselves

TRUMP CUT BACKS IN NURSING HOME STAFFING INFECTION CONTROL

This lack of staffing and cut back in infection control federally mandated by the Trump government. Trump cut back regulation upgrades mandated by the Obama administration

The Obama administration effort, finalized in 2016, requiring all long-term care facilities to develop infection control and prevention plans to detect, report and contain communicable diseases.

It also covered telemedicine, so required publishing infection control rates weekly in Nursing homes that manage from 1.6 million to 3.8 million infections each year, according to the Centers for Medicare and Medicaid Services. A 2017 analysis by Kaiser Health News found that 74 percent of nursing homes have been cited for lapses in infection control — the most frequent type of health violation.

So, aging professionals, I am going to give you Rachel Maddow’s sage advice,

Sound the alarm- Aging Professionals

Read your local paper for nursing home problems in your area. Now they are only being reported cumulatively by the New York Times and major papers. Send letters to the editor. Write to your governor. Alert your Area Agency on Aging.

Call Your Local Nursing Homes

Call the nursing homes locally and ask what you can do. Besides setting off the alarm can you organize PPE by getting a local club or group of women who sew to help, Even kids have contributed like this child in Boston who sews masks.

Scream to the top of your lungs.

A holocaust is happening and the Trump administration is ignoring the carnage – Rage against the coming of the night for the older people we all love and have devoted our lives to helping.

Concierge Clients Who Can Afford Private Geriatric Care Management No Longer Taking Cruises

April 7, 2020

Tens of thousands are dying in the US and worldwide of coronavirus so a cruise ship of any cruise now wreaks of expiring slowly on the ocean with no real hospital and no place to disembark. This is not the product that the upper 10% or anyone would board now. But in better times concierge products like a Viking Cruise as it is understandable to a high-end customer. They buy it –because it has exceptional services and recognizes their entitled station in life. Coronavirus recognizes no status class and kills all equally.

Sell Products Clients Need During the Pandemic

Geriatric care managers, rather than tell inquiry clients they do assessment–should offer products they need in this pandemic – like relocation (moving an older person). Elders who live in dangerous SNF facilities, so vulnerable to COVID-19

In an article from the LA Times Charlene Harrington a Professor from UCFS states”Families with loved ones in nursing homes should consider pulling them out if it’s at all feasible to care for them at home, said Charlene Harrington, professor emeritus at UC San Francisco’s School of Nursing.

“The risk of exposure is so overwhelming,” said Harrington, who has studied nursing homes since the 1980s. “It’s a terrible concern.”

ALCA suggested that you call all the SNF’s in your area and explain that you specialize in moving elders and can be of help to their clients who are moving out of SNF’s due to family concerns.

GCM Products for the Isolated and Lonely Seniors During Stay at Home Orders

Quality of Life (increasing the joy in an older person’s life who is lonely) can be an important service to offer during the coronavirus pandemic. Seniors who live alone are already isolated, lonely, and depressed and the virus only causes this to explode in their lives. Quality of Life programs like Sage Eldercare’s Humminbird Program has gone remote and can be purchased for a minimal amount for client’s by families or agencies, nationally. Nina Herndon GCM, Sage owner and innovator, started this program several years ago because she was tired of watching elders she served watching TV 40 hours a day. She has brought it into the digital world to serve coronavirus patients nationally. Nina also wrote the Chapter on how to set up a Quality of Life program in my book Handbook of Geriatric care Management 4th edition

Products For Seniors Discharged from Hospitals in Pandemic When SNF’s will NOt Take Them

Home from the Hospital is a GCM product the Safely helps the older client through discharge and the first 3 months to make sure they do not return to the hospital, which now is overrun with coronavirus patients and at capacity.

Home From the Hospital pinpoints exactly what the older person needs for discharge with the hospital and why the family is desperately calling for help. They are calling for help at a piercing decibel level because nursing homes will not take them for fear of COVID 19 infection of their residents

To do this, offer these products to families third parties, hospitals, and nursing homes in this crucial time. Develop continuously integrated solutions through a product procedure placed in your company operation manual, along with all of your products so you ensure your staff can deliver, step by a step-that high-end product that the Concierge client especially under the huge stress of the coronavirus with vulnerable parents -just purchased and demands.

If you do not have an operation manual, I have all these products in my GCM Operations Manual plus 11 more, with all the procedures in place so you can instantly offer them. I will offer a 20% discount for the GCM manual during the pandemic for Geriatric Care Management Agencies suffering during the coronavirus outbreak. Contact me here

Medicare For All Includes Long Term Care – Perhaps Pay Attention Now With -Covid 19 Raging ?

March 25, 2020

Long Term Care Not Covered by Medicare

Geriatric Care management and home care, among other critical services tin aging are not covered Long term care services, is not covered by Medicare. In Bernie Sanders & Elizabeth Warren’s Plan, Medicare for all would cover long term care, a point that the Washington Post said that Sanders did not emphasize enough.

Medicare For ALL Would Cover Long Term Care

Time Magazine, recently reported that Covid-19 ‘s effect right now is making Medicare for all seem like the present need nor an unaffordable dream . The “Department of Housing and Urban Development halted foreclosures and evictions during the emergency; the Department of Education slashed federal student loan interest rates to zero and will allow borrowers to completely suspend payments if needed; Congress is negotiating a plan to send direct cash payments to families, and a version of paid sick leave just became law.”

What If We Had Medicare For All During Covid 19 Pandemic?

If we had Medicare for all during the Covid 19 pandemic, we would be better able to disburse funds in emergency situations and to purchase necessary machinery, such as ventilators ( that only the president seems to be able to dispense through the Defence Production Act & does not, during a crisis and get them where they need, like the 30,000 needed and missing in New York) face masks that as so needed that the CVC recommended bandanas and a 10-year-old student in Boston is sewing herself the height of the pandemic right now.

Unlike our current health care system, Medicare for All would include specific funding for dealing with pandemics or other health emergencies that could be distributed quickly without requiring additional legislation of presidential planning, which seems not to have happened at all. The United States cannot be left unprepared for mass health risks like COVID-19. It is time to put in place Medicare for All and better protect the health of the American public.

Ethical Dilemma

This lack of Medicare covering Long term care leaves geriatric care managers in an ethical dilemma of being able to only be able to serve the upper 10% and leaving 90% of seniors and thus under 64 with chronic care needs like MS, unserved.

Elizabeth Warren’s plan for Medicare for all could cost 20 Trillion over 10 years. Existing Medicare over the 10-year period would cost 16 trillion. The bill we are just passing in Congress to fund is 2 Trillion. We will need another bill. Are all the mounting deaths from Covid 19, 55,000 people with Covid 19 and counting, disruption to business, our lives and the hospital really worth not paying attention to Medicare for All- which it looks like we just might be able to afford?

Find out about this ethical dilemma and what care managers must do to serve the upper 10%, and ignore lower 90%, who have no long-term care under Medicare .

Since geriatric care management must be privately paid for, in the absence of coverage under present Medicare, in spite of our moral dilemma

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With Dorian’s Carnage- Do You Need a Midlife Family Meeting for Aging Parent Disaster Plan ?

September 3, 2019

What is MidLife Sibling Hurricane Nightmare

The catastrophic disaster of Hurricane Dorian unleashed on the Bahama’s and heading to Florida should conjure up a midlife sibling nightmare. It brings back the goblins of Katrina -the most gruesome weather cataclysm where 39 elderly residents died, trapped or abandoned in retirement centers and 1400 elder overall died in Katrina’s watery wrath.We just plunged into possible horror again. On Dorian’s heels we may have more hurricanes with hurricane season upon us, and global warming making them , like catagory 5 Dorian, monsters storms. This should terrify adult children enough to take emergency action to protect their parents.

Midlife Sibling Need Emergency Disaster Plan for Aging Relatives

This recent confluence of hurricane deaths and hurricanes looming right now, should be a deafening roar in the ear of midlife siblings that they need to convene a midlife sibling disaster plan family meeting to protect any aging family members-, no matter where your elderly parents live or what level of care. You need that disaster plan because older people are more likely to die in catastrophes than any other population. As I pointed out in my last blog, just because they are often in a facility in a facility or alone and too frail to escape .Katrina and Irma tell us perhaps they are more in peril.

So before another hurricane, tornado, earthquake, flood, or any disaster hits, you need to have a midlife sibling family meeting to come up with a disaster plan for aging family members

What would be the agenda of that midlife sibling disaster family meeting?

If your loved ones are in a FACILITY- do not trust the facility to handle the situation. Look at what just happened in Irma.

1)Get a copy of the facilities disaster and evacuation plan.Compare it to state regulations. If it does not include calling the family before the disaster, consider moving your loved one or make sure that is changed.

2)Appoint a sibling to be in charge of reading the disaster evacuation plan and be the contact person.

3)Call your state facility licensing body and find out the state regulations to see if they match the facilities- CCRC, Assisted Living or Nursing Home

4) Have a telephonic family meeting before the disaster if possible

5) Make sure the state requires backup generators for heat and air conditioning- a flaw in Florida’s regulations in Irma

If the loved one is LIVING AT HOME alone or with an adult child.

1) Create a disaster plan for the older person. This would map out what each sibling and family member needs to do

2) Create a disaster team. This would include every adult siblings all over the country, family nearby, caregivers and neighbors.

4) Include someone on the team who can carry heavy objects like wheelchairs.

5) Name a substitute caregiver if the regular one can’t get there.

6) Make an evacuation plan for your aging family member’s house. Where is the nearest Red Cross shelter

7) What disaster supplies do you do you have on hand? Get list from your local Red Cross

8)Find out how many people do you need to make the move to safety or a shelter?

9) Put all of the above in writing.

10) Share a copy your disaster plan with everyone. E-mail copies to everyone on the family disaster team including all adult siblings, neighbors and friends.

11) Get everyone’s agreement especially midlife siblings and the older person. Be a unified disaster team.

12 ) Call a geriatric care manager to manage the plan or help you create it with your elderly parents, if you live long distance. They can do the heavy lifting, can help moderate a family meeting- can research state laws, be there in a disaster immediately, create and implement a disaster plan for your parent, that you approve and can be part of.

Professionals check out the chapter “ Preparing for Emergencies” in my Handbook of Geriatric Care Management fourth edition,

Professionals Check out my book Care Managers Working With the Aging Family, Jones and Bartlett, with its chapter on Family Meetings and the Aging Family by Rita Ghatak, director of Stanford’s Aging Program.