Pandemic particularly hard on seniors
Some seniors avoid watching the news but not Christine Warner. The 82, soon to be 83-year-old resident of American House Lakeside in Clinton Township, enjoys three servings a day starting with her local news at 6 a.m.
So she knows about COVID-19. She also knows that many of the people dying from the novel coronavirus are vulnerable seniors, Americans from her generation, living in nursing homes and non-hospital residential health care facilities. It’s for these reasons that she is both thankful and angry.
“Thankfully, that is not happening here,” she said, referring to the assisted living facility where she resides. “Our staff has been great about monitoring everyone and they’re not letting anyone come here who has the virus.”
Warner understands the need for hospitals to find a place for patients. What she doesn’t understand is why anyone would send a COVID-19 patient to a facility
where there are people who don’t have it but most likely to get it.
“It’s just wrong,” she said. “Why can’t they separate people?” she said. “They put up that big facility in Detroit, the TCF Center. I’m sure it cost a lot of money to do that and it’s empty. Why can’t they use that?”
The TCF Center (formerly Cobo Center) was converted to a 1,000bed field hospital by TCF crews, the U.S. Army Corps of Engineers and the Michigan National Guard when cases were on the rise in the Detroit area. It was staffed primarily with military-based medical personnel, who were brought in to supplement other health care professionals as more patients were admitted.
But more were not admitted. It treated an estimated 39 patients from the time it opened April 10 to the day it closed May 7. Warner is not alone in questioning why the facility did not take more patients.
“I have reached out to news agencies, (legislators), both local and federal, the governor, Ombudsman, Center for Disease Control, CMS, and the Michigan health department on how nursing home staff and residents are not being protected by the COVID-19 virus,” said Ray Jasion of Macomb Township in an email, noting while nursing homes continue to handle overflow patients or those on the mend, places such as TCF Center (bed capacity of 1,000) and the Suburban Collection Showplace in Novi, set up as a temporary hospital (250 beds) sit empty.
“I have a patient that is in one of these nursing homes and all I can do is monitor the daily amount of COVID-19 cases and hope he does not get the virus,” Jasion said. “In the meantime, I will continue to contact as many citizens, family, and friends to let them this is still happening here in the state of Michigan.”
Why would the state not choose to use the TCF Center as an alternative to using nursing homes?
William Ridella, director/health officer of the Macomb County Health Department cannot answer that but would say it is likely because it was never set up to handle the level of patients being treated in nursing homes.
“These are people who need help with everything and 24-hour care,” Ridella said.
No visitors
To make matters worse, families cannot see their loved ones because of the visitation restrictions and in many cases unable to get patient information.
Janise Robinson of Taylor said her father-in-law got a call from the nursing home where his wife was living saying that she had tested positive for COVID-19.
That’s all the message on his answering phone said. After the shocking call he couldn’t reach anyone to get further details about her treatments, symptoms, only that his loving wife, who already suffered from dementia and multiple sclerosis had the deadly virus.
“My poor father-in-law,” Robinson said.
He called numerous times over a two-day period with no luck. There was also no way to leave a message as the voicemail box was full. Robinson also tried and when she finally got through there seemed to be a great deal of confusion about whether or not she was in isolation, or if she even had it.
“It was just maddening,” she said.
The call came on April 17.
Since then, Robinson’s father-in-law has learned his wife is out of isolation, and has recovered from the virus, although that information is sketchy. As with many families caught up in this situation Robinson said she would like to see nursing homes get more support for the job they are doing.
Nursing homes in Europe were caring for COVID-19 patients too but she said they were also supported by volunteer medical professionals who saw the urgency to help.
Why can’t we do that here, she asked.
She also believes nursing homes need to communicate better with the families, as it’s already a terrible situation not being able to visit someone.
The numbers
As of May 11, 2020, Michigan’s nursing homes had 2,874 positive cases of COVID-19 among its employees and residents.
In Macomb County there were 1,083 positive COVID-19 cases (up from 203 on April 8) at 74 facilities including nursing homes, skilled care and assisted living facilities, according to figures provided by the Michigan Department of Health and Human Services.
The Macomb Daily sought this information from Macomb County officials in mid April in an effort to help people make informed decisions about the care of their loved ones. Corporation Counsel John Schapka first denied the newspaper’s informal request for information then, when a Freedom of Information Act request seeking documents detailing the presence of COVID-19 patients in county nursing homes was made, he informed the newspaper his office was seeking an extension into June.
The newspaper’s attorneys asserted the information sought was not HIPAA-protected information as the request sought the number of infections by facility and not the names of specific individuals. The newspaper was in the process of taking more defined action against the county when the state released a database detailing nursing homes that have been designated regional hubs during the pandemic. It also provides reported information on the number of positive cases.
This week, Ridella outlined the response by the county to assist facilities dealing with treatment of patients while caring for their senior populations.
“Tragically, we have had 277 (up from 203 on April 8) deaths amongst our senior populations living in these facilities,” Ridella said.
At the start of the outbreak and spike of cases there was a shortage of both personal protection equipment (PPE) and test kits. “As testing kits and testing capacity has increased we have been supplying these facilities with infection control guidance and have encouraged routine testing of employees, health care workers and residents,” Ridella said, while also working with the county to ensure that they have the PPE and test kits to do it.
The state list includes the cases reported to the Michigan Department of Health and Human Services on May 13, 2020. The totals do not include patients or staff who have recovered or died, and is therefore not a cumulative count but a glimpse of the count. The presence of COVID-19 at a facility is also not an indicator of a facility that isn’t following proper procedures. Many facilities such as these listed, have been designated as regional hubs supporting local hospitals by accepting confirmed COVID-19 positive residents.
• Advantage Living Center, Armada: 0
• Advantage Living Center, Roseville: 23
• Advantage Living Center, Warren: 8
• Autumn Woods Residential Health: 32
• Church of Christ Care Center: 12
• Clinton Aire Healthcare Center: 5
• Father Murray Nursing Center: 75
• Fraser Villa: 0
• Heartland Healthcare - Sterling Heights: 10
• Lakepointe Senior Care & Rehab: 37
• Lakeside Manor Nursing & Rehabilitation: 19
• Martha T Berry Medical
Care: 10
• Medilodge of Richmond: 0
• Medilodge of Shoreline: 12
• Medilodge of Sterling Heights: 15
• Orchard Grove Health Campus: 0
• Pomeroy Sterling Skilled Rehab: 23
• Regency at Shelby Township: 12
• Regency at St Clair
Shores: 11
• Regency Manor: 6
• Shelby Crossing Health Campus: 5
• Shelby Nursing Center: 19
• Shorepoint Nursing
Center: 44
• St. Anthony Nursing Healthcare: 38
• The Villa At City Center: 41
• The Village of East
Harbor: 7
• Warren Woods Health and Rehab Center: 0
• WellBridge of Romeo:
0
• Windemere Park Health and Rehab Center: 0
Official response
Other counties have faced similar concerns regarding nursing homes.
This past week Republican lawmakers voiced concern about the safety of nursing home residents in facilities that also have people recovering from the coronavirus, questioning policies adopted by Democratic Gov. Gretchen Whitmer.
At issue is a month-old executive order that lays out rules for the admission or readmission of people who have tested positive for COVID-19, the disease caused by the virus. At least 687 Michigan nursing home residents have died from COVID-19 complications, 15% of the state’s 4,674 reported deaths. A top state health official, citing data issues, said the number is probably higher.
Robert Gordon, director of the Department of Health and Human Services, said the priority is placing COVID-19 residents in special regional “hub” nursing homes that can provide higher levels of care and contain exposure. More than 290 patients - either recovering from hospitalization or who were never hospitalized - are at 21 such facilities, with nearly 400 beds open.
Regular facilities that can safely isolate and care for virus-infected residents are doing so, too.
Sen. Lana Theis, a Brighton Republican, expressed concerns about residents at the hubs and other homes who do not have COVID-19 and questioned if they are being adequately protected. She noted Whitmer’s order requires nursing homes below 80% bed capacity to create a unit dedicated to the care of the infected and to provide personal protective equipment (PPE) to employees, “if available.”
“This doesn’t seem like the safest scenario for the seniors that are already in the home,” she said. “What we should be doing is looking at a safer alternative than putting COVID-positive patients in the same building with the most vulnerable among our population.”
In response, Gordon said if it is not possible to transfer people to the regional homes, the priority still is to segregate them in COVID-19 units.
“This is a world without perfect solutions,” he said, saying the order aims to ensure care for the infected while protecting those without the virus. Homes without protective equipment or isolation units are not required to accept COVID-positive residents released from the hospital, he said.
Still, until we get it right how many seniors will we lose?
Linda Dorman, 77, and also a resident of American House Lakeside said she doesn’t follow the headlines and issues like her neighbor Warner. But she did receive news of three friends who died and because of the coronavirus restrictions on burials and social distancing never got to say good-bye.
For more information visit michigan.gov/coronavirus/.