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Live Life On Your Own Terms

Which is safer during the pandemic:
assisted living facilities or living with family?

coin flip optAmerica’s very first COVID-19 outbreak took place at a long-term care facility. At Life Care Center of Kirkland, in Washington State, two-thirds of the residents and dozens of staff members were infected, and at least 35 people lost their lives due to the coronavirus.

The Centers for Medicare and Medicaid Services later fined the nursing home $611,000 for deficient detection and protective procedures.

But for the more than 1.7 million Americans living in nursing homes and assisted living facilities – even those facilities that maintain scrupulous detection and protection measures – there are risks.

One of those risks results simply from housing members of the demographic group most vulnerable to the coronavirus – seniors, many of whom already have underlying conditions such as diabetes or cardiovascular issues – under the same roof. They share the same air, food and water. Planned group activities – communal meals, exercise groups, classes, etc. – are good for social interaction but defeat the purpose of social distancing. And even when there’s not a pandemic, Centers for Disease Control data show that nursing homes, skilled nursing facilities, and assisted living communities are fertile breeding grounds for one to three million serious infections a year. These infections include not only garden-variety influenza, but also pneumonia, respiratory syncytial virus, norovirus, and methicillin-resistant staphylococcus aureus (MRSA), and others.

So does it make sense to temporarily move a parent or other senior relative out of a long-term care facility and into your home?

It’s a tossup, really, because each alternative has its own pros and cons, which vary from family to family – because your home can pose its own risks, too, of a different nature. That’s why the answers to these questions are so important.

About your family member:

  • Specifically, what kind(s) of care does (s)he need? Ask the long-term care facility for a written list. Many of those services – particularly help with eating, dressing, toileting, and medication management – can be provided at home. But some, like Alzheimer’s care, can’t.

About your home:

  • Do you have a separate bedroom and bathroom for your family member?
  • How accessible is your home? Are there too many stairs? Do you have ramps that people with walkers or in wheelchairs can negotiate? Is there at least one bathroom with grab bars? Have you “seniorproofed” your home by removing things that can cause tripping and falls?
  • Will you be able to control infection risk with frequent hand washing and cleaning household surfaces? In anyone in your family going out to work or other places where they can bring home infection from? Will you have enough washable facemasks? Will any home aides you engage wear masks, gloves, and other personal protective equipment and change their clothes between home visits, as our do?
  • Is your whole family up for this? Will everyone be informed in advance and be prepared to take on new responsibilities?

About the facility:

  • What’s your current quarantine policy?
  • What, specifically, are you doing to reduce infection risk?
  • Are you screening staff members for signs of infection? Training them to reduce their exposure from pother health care facilities and the community? Do they have enough personal protective equipment, and do they know how to use it properly?
  • Are you allowing visitors?
  • Are you practicing social distancing? How?
  • When older adults become infected, is transferring them to a hospital or ICU easier from my home or your facility?
  • If my family member becomes infected after moving out and then recovers, will he be allowed to move back in?
  • If my family member doesn’t become infected, will she be allowed to move back once the pandemic is over?

If you have any questions about coping with the Coronavirus outbreak, or your retirement years in general, please feel free to call or email us. Just as we always have, we’ll be happy to give you honest, objective answers.