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COVID-19: A wake-up call for Iowa nursing home care
John and Terri Hale
May. 2, 2020 8:00 am
The coronavirus has brought important attention to nursing homes and the challenges they face in keeping residents safe and well. Thousands of journalists and citizens from across the country have flooded traditional and social media with reporting and commentary.
Some have been brutal - calling nursing homes 'death pits” and castigating nursing home owners for putting the desire for profits over the concern for resident care. Some have been just as critical of government for being lax in oversight of nursing homes and for allowing poor performers to remain that way. Some have been kinder, recognizing the difficult role that nursing homes are expected to play, the lack of government funding to improve quality of care, and the once-in-a-lifetime nature of this pandemic.
Common themes of the comments:
1. Gratitude for the everyday heroes working on the front lines in nursing homes who literally put their health and lives at risk to care for others
2. The crisis in nursing homes should be a wake-up call - to the industry, to government agencies, to elected officials and to the public.
The crisis presents an opportunity to bring about much-needed improvements in job quality and resident care; to take an inventory of the excellent ideas that have been offered, give them serious attention, and never, ever, go back to accepting the 'old normal.”
A sampling of those ideas:
l Address the fundamental problems that contribute to lower quality care and infection control - too few staff to serve residents, inadequate training provided to front line workers, and low wages and poor benefits that lead to high levels of direct care staff turnover and increased use of temporary employees that travel from facility to facility.
l Prioritize infection control procedures all the time by ensuring adequate testing supplies and ongoing use of personal protection equipment, tightening up who can visit facilities and when, providing routine staff health checks, ensuring that all staff have access to sick leave benefits, and isolating or not admitting those with infectious disease.
l Use tax dollars to pay for results, rather than for volume of services. The consistently good performers should be rewarded and consistently poor ones should be penalized. If the poor ones don't improve, they should be given technical assistance and expected to adopt best practices in the industry. If they don't, tax dollars should no longer pay for unsatisfactory results.
l Re-energize state Long-Term Care Ombudsman's offices by requiring staff members to be out in facilities much more frequently to talk with residents and facility staff in order to identify and address issues of concern before they get to be big problems.
l Give people more options to traditional nursing home care; including using tax dollars to pay family members or friends to care for that special person at home, which after all, is where most people want to live out their later years.
l Respect the rights of people to have more control over the decision on how and when their life ends. If a person sees spending year after year after year in a nursing facility as an unwanted end to their life shouldn't they have the freedom, in consultation with their physicians, to make other choices?
Let's face it: the pandemic didn't cause the challenges in the nursing home industry; it simply put a spotlight on them.
The big question is this - will anything change after this crisis passes?
We're under no illusions here. We know that the easiest thing to do is to go back to business as usual.
Instead, we urge everyone - the nursing home industry, government agencies, elected officials and those seeking elected office to seize the moment and provide leadership that ensures nursing homes will never again be unprepared to control the spread of disease, and that tax dollars will be used to ensure continual improvement in the quality of care being provided.
Shame on those who choose to do nothing. And praise to those who step up to lead.
John and Terri Hale own The Hale Group, an Ankeny-based consulting, advocacy and communication firm focused on older Iowans, Iowans with disabilities, and the caregivers who support them. email@example.com
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