In March, after an outbreak of COVID-19 in a Seattle nursing home launched the pandemic in the United States, long-term care facilities generally shut their doors to visiting family and friends. This ban followed guidance from the Centers for Medicare and Medicaid Services (CMS) which regulates most nursing homes: Facilities were ordered to restrict visitors except for “compassionate care” for a resident who was dying. It made sense, right? Well not so fast!
In a study published on Pubmed in May 2009, researchers examined the quality of nursing home care for residents with advanced dementia and identified that the care was described as suboptimal. One relatively understudied factor in the provision of care is the role of oversight and monitoring by family members and friends.
Future research will need to address whether families with greater oversight tend to make decisions that promote worse quality care or whether worse quality of care promotes great family oversight. At the end of the day, how does this impact the outcomes today with quarantine and essential visitors only? Who determines who is “essential” and when a resident will enjoy better outcomes with the touch of a close relative or friend? If we look at the “greater good” we may find some comfort in knowing that centers with strict adherence to CDC recommendations tend to have better outcomes related to the spread of infection.
A lot to ponder on, no “right” answers but hopefully, one day, in the near future, we will look back on 2020 and learn from the good/bad and be a stronger industry for it! Stay well, stay safe and stay tuned!