State rules on PPE will prevent people from seeing relatives in long-term care sites

Anyone paying attention to the news lately has seen both heartwarming and heartbreaking stories about residents in Long-Term Care (LTC) facilities, their “homes,” and their families. In our best efforts to protect LTC residents from COVID-19, we have created another health risk. Our safety measures to restrict visitation and communal activities the past three months have negatively impacted residents’ physical, mental and emotional health. In fact, residents have documented physical, mental and emotional decline due to the social distancing and isolation measures in place to keep them safe. Some residents have experienced weight loss as they have no socialization while eating.

I have been an infection preventionist in a hospital setting, currently working in an Adult Day Services program connected with a long-term care community. I am also an independent living resident on a continuing care campus. I am writing in support of both keeping our residents in LTC settings, many of whom are my friends, not only physically healthy and safe but also mentally and emotionally healthy. With everything going on in our country right now, LTC residents feel as though they no longer have rights and have been imprisoned in the name of safety. We have lost sight that this is their home and that they have a voice. They cannot have in-person visits with their families and are isolated from their friends in the place they call home.

I have to admit that I too have felt some frustration. In order to keep fellow residents in assisted living and LTC safe on campus, I have needed to limit my daily comings and goings off campus. Leaving campus is limited to trips for groceries, medications, and a drive in the country or a safely distanced walk to a park.

I, along with everyone on our campus, have been watching the rest of the state reopening on the news and have been looking forward to the state’s easing of restrictions in LTC so we too can socially distance on a visit with our families and friends and have limited communal dining. These small acts do wonders for residents’ well being.

Our campus has had one resident test positive for COVID-19, and that resident has recovered and returned to their neighborhood. If all goes as planned, we hope to meet the state’s requirements to progress to Phase 2 of the reopening plan on July 1. However, that progress is in jeopardy because our campus cannot obtain the amount of Personal Protective Equipment (PPE) to meet the additional precautions the state requires us to have in place. Having a background in infection prevention and employee health, I fully understand the need for PPE as it relates to transmission-based precautions. However, the state is requiring LTC facilities to go beyond precautions utilized in the past and to do so without any extended use or reuse of PPE.

Precautions should be based upon known or suspected likelihood of transmitting pathogens. With additional precautions applied to all residents, regardless of symptoms or their history of potential of exposure, it seems unnecessary and will require unlimited amounts of PPE that would be better saved for conventional situations.

Unless the state helps us find considerably more medical-grade PPE or addresses their PPE requirements for reopening, our campus, and I’d venture to say almost every LTC in the state, will not be able to move to Phase 2. This means our vulnerable residents will continue to have limited interactions with people or, in their words, be locked away “in jail.” This is not what they signed up for, not even in the name of safety. Further, how can we ethically reopen the rest of the state while forgetting about our greatest generation?

Linda Opheim, RN, CIC, is a nurse at Schmoker Adult Day-Friendship Haven in Fort Dodge.


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