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What’s the Future for Nursing Homes after COVID-19?

By Bart Astor

The successful nursing home in the future will be the one that has a team of professionals who provide strength, healing, belonging, and purpose.

Catherine McCallum, a clinical social worker and aging care management consultant, has many positive things to say about nursing homes, including how they’ve improved enormously over the years. “But,” she says, “I think this pandemic is a breakout moment for alternatives to the current long-term care institutions.”

“Anyone whose parent or partner may need to move into a nursing home or long-term care facility has got to be concerned about the high risk in these homes,” according to Steve Gurney, an eldercare expert and publisher of Positive Aging Sourcebook.

The pandemic has taken a huge toll on the residents of long-term care facilities. The numbers are indeed sad but also not surprising given the fact that nursing home residents are older, often need round-the-clock care, and are also more likely to have chronic conditions like high blood pressure, diabetes, or COPD, all of which we now know are serious risk factors with COVID-19.

But the high number of infections and deaths cannot be ignored as society reconsiders how older adults are cared for. And, in particular, where and how they live out the rest of their lives. 

Infection control is an area that needs to be addressed if older adults are to consider living in nursing homes.

“The record so far with COVID-19 is not particularly comforting,” Gurney laments. “I think we’re all very aware of the problems and I’m confident that will be a focus in the years ahead.”

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Gurney and others also point out how the pandemic uncovered the isolation that so many residents experience and the lack of support staff to monitor and moderate the health of the residents.

“Relationships with the caregivers and family are critical and the nursing homes that did well during this crisis are those that emphasized the importance of social connections,” says McCallum.

This is echoed by Donna Fuller, the Director of Outreach at Ingleside Engaged Living. Although Fuller acknowledges the pandemic-highlighted problems, she also feels there was too much negative presentation of these senior care facilities. “So many of the homes handled the crisis well and they did so by engaging the residents with the staff as much as they could.” This approach, she believes, is a model for the future, especially after COVID-19, that encourages more involvement from family and friends.

“The fact is,” Gurney says, “there is going to be more and more growth in nursing homes as baby boomers age out, people realize how demanding it is to be a caregiver, and how expensive it can be to retrofit homes to accommodate older adults.”

The nursing homes that will do well, he believes, are the ones that not only deal successfully with infection control but also meet the residents’ other needs.

Bill Thomas, a gerontologist and leading international authority on geriatric medicine and eldercare, agrees wholeheartedly.

“Those of modest means may have limited options,” he says. “But for those who can afford it, they’ll have many choices. Where they choose to live out their last third of life will depend heavily on the amenities offered by each option.”

At a bare minimum, he believes a sense of community will be essential. Thomas, like other experts, believes strongly in the value of good neighbors. There will need to be additional services offered, including professional dietitians. “The theory is that when you know somebody really well, you notice when there’s atypical behavior such as eating less or not participating in activities.” That, in turn, raises a red flag that may indicate a more severe problem. Thomas is optimistic about the future, but there have to be huge changes from the past.

“Aging is not a disease,” Thomas says. “It’s a team sport.”

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September 18, 2020

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