Moving on from COVID-19 in Long Term Care
COVID-19 spoke to us about an issue long overdue for attention, that issue being long term care and the nursing home industry. The pandemic has changed the way we think of long-term care, and if we lean into the crisis-earned set of lessons learned, we can do more than just tweak the system. We can transform it and here at IPAC Consulting, we are set out to do just that.
First, we need to come to grips with what went wrong. The pandemic came into our lives like a tornado—fast, furious, and deadly. But it did not leave like a tornado. It is still here. We need to take all we have learned in the past year and act now to prevent this tragedy from happening again. We must transform long-term care. Even pre-pandemic, we knew many ways to do that—from past research and demonstrations, experiences from different places that pioneered new approaches to long-term care, and promising ideas from both the private and public sectors. Many factors contributed to long term care homes becoming COVID-19 hotspots, including lack of experience and knowledge about the COVID-19 virus, workers who were asymptomatic carriers, the highly infectious nature of the virus, and the vulnerability of a nursing home population who are mostly elderly and have multiple chronic conditions. Staff members in the home’s were serving a large number of residents and often working across various facilities. Additionally, residents’ use of common areas that promote residents’ socialization inadvertently contributed to the spread of infection.
Some of the problems we saw were unique because of COVID, while others were exacerbated or made more apparent during COVID. For example, the need for PPE stockpiles was unprecedented, but the lack of consistent infection prevention and control measures in nursing homes was a problem long understood. The COVID-19 pandemic highlighted nursing home safety and infection control as critical public health issues. The pandemic’s outsized impact on residents and staff in SNF underscores the immediate need to re-examine the relationship between the physical environment and infection control, health outcomes, quality of life, and overall resident and staff safety.
The first thing we must do is strengthen the HCBS infrastructure. Rather than build more buildings, we can build the workforce that can provide services in structures already built. We also need to improve the work experience of home care workers. This includes, amping up on education and providing safe working conditions for staff. Additionally, abandon semi-private rooms and “wards” and move to private rooms, which reduces the risk of infection spread and improves the quality of life for residents.
COVID-19 exposed what many already understood concerning the need to transform long-term care. That is not to say, however, the pandemic hasn’t taught us a great deal, for it has. Yet perhaps its greatest lesson is its message that we must act now. It is time for all sectors to work together with experts, consumers, and advocates and make that happen.
