The Register Citizen (Torrington, CT)
Nursing homes maintain restrictions despite vaccine
After residents and staff are vaccinated against the coronavirus, long-term care facilities do not anticipate immediately relaxing restrictions and precautions.
These facilities said they’ll take their cues from federal, state, and local guidelines on visitation rules and other measures. But strategies like masks, social distancing, temperature checks and COVID-19 testing are likely to continue for some time.
“The best guess I have is that everything would just stay the same,” said Timothy Brown, the spokesman for Athena Health Care Systems, which owns 27 facilities in Connecticut. “I don’t think we’ll see a significant change in vision in the nursing homes probably until the spring or maybe early summer, when we start seeing vaccinations across the state.”
But Dr. Patrick Coll, a geriatrics expert with UConn Health, said restrictions could be lifted sooner based on the effectiveness of the vaccine.
“It’s [the vaccine] going to be a game changer, without a doubt,” he said. “The key, I think, will be making sure as many residents as possible are vaccinated and also as many staff as possible get the vaccine.”
He expects infection rates in nursing homes and assisted living facilities could drop by late February or early March due to the vaccine, leading guidelines to be loosened.
“If the vaccine does the job we all anticipate it will
do, we’ll very quickly see those infection rates drop,” Coll said.
If that’s the case, it should be allowable to hug your older parent or grandparent again, he said.
“[Vaccinated residents] will be a very low risk, probably not zero risk, but certainly such a low risk, where the importance of a hug from a family member is better — more important — than the very slim risk of them potentially getting COVID,” Coll said.
Remaining vigilant
Maplewood Senior Living, which offers assisted living and memory and respite care in seven Connecticut facilities, plans to remain “diligent” in its precautionary measures, said Gregory Smith, president and CEO.
This includes cleaning and disinfecting protocols, enhanced screening of residents and visitors, and at least weekly COVID testing of associates, vendors and private duty aids, he said.
Nursing homes will rely on the Centers for Disease Control and Prevention to guide them, said Dr. Richard Feifer, chief medical officer at Genesis HealthCare. But the same testing, visitation rules and personal protective equipment must remain, he said.
“The vaccine will not provide immediate protection and we still need to see prevalence in the surrounding communities decline,” he said in a statement.
Guidance from the CDC and state and local health authorities will determine Benchmark Senior Living’s plans.
“We are pleased that vaccinations are available to further protect Benchmark Senior Living’s communities from COVID-19, but they are just one tool to help stop this pandemic,” said a spokesperson from the company, which owns 17 assisted living facilities in Connecticut. “Infection prevention and control will remain a top priority even after the vaccination process is complete.”
But Smith said he is optimistic that the vaccine will provide an “extra line of defense” for residents and employees.
“We are hopeful that the vaccine will aid us in our commitment to help our residents get back to living their most fulfilling version of life as soon as they possibly can,” he said in a statement.
Vaccines popular
Residents and staff in nearly all of Genesis HealthCare’s nursing homes were expected to have their first dose by mid-January, Feifer said. The company has more than a dozen facilities in Connecticut.
CVS will return three to four weeks after the first dose to administer the second and give the shot to anyone who did not receive it the first time, he said.
“Vaccination is the critical third leg of the stool, along with personal protective equipment and testing, in stemming COVID-19 spread in nursing homes and protecting residents and healthcare workers,” Feifer said. “This is unquestionably the biggest vaccination effort ever undertaken and will help prevent further tragedies, especially in this vulnerable population.”
At Athena, the vaccination process with CVS has been “flawless,” Brown said. All buildings have received their first dose, with second doses starting in the past week. Staff are vaccinated within a common area, with residents being vaccinated in a lounge or at the bedside.
In some buildings, as many as 80 to 90 percent of residents have opted for the vaccine, Brown said.
“We’re seeing a good response,” he said.
Educating staff and others about the benefits of the vaccine will reduce some hesitancy about it, Coll said.
“Most, if not all, staff who work in nursing homes care a great deal about their residents,” he said. “Pointing out that receiving the vaccine as a caregiver not only protects you, but protects those you care for, I think that’s a very strong message.”
Need for visitors
Coll argued family members and support staff at nursing homes and assisted living facilities should be prioritized for the vaccine. This is not yet the case.
“They may still be hesitant to come in if they’re not vaccinated for their own sake or the sake of their other family members,” he said. “To ensure that nursing home residents have access to their families, I think ideally both parties should be vaccinated and be immune.”
Family provide psychological support and sometimes come at meal times to help residents eat, he said.
“Residents have been so isolated for so long,” Coll said. “It’s increasingly recognized that there are negative health side effects to that.”
Family and other visiting volunteers are crucial so the residents feel “connected” to the outside world, Brown said.
“We welcome visitors, loved ones, family back into the nursing homes as soon as it’s humanely possible and safe,” he said.
Staff have held individual activities and—when possible— group programs to keep residents engaged, Brown said.
“The primary goal would be to have residents together doing group activities, interacting with each other,” he said. “Hopefully in the spring, we’ll be able to get back outside with warmer weather and continue with the community vaccinations.”
Some precautions here to stay
Some protocols, such as mask wearing and temperature checks, may be permanent.
“I would imagine certain infection control measures that we have in place will not change,” Brown said. “If anything, they will be things we’ll be able to continue and evaluate and build upon.”
Coll agreed staff should still have access to the appropriate personal protective equipment and be trained on infection control measures.
“Hopefully this particular pandemic, this particular infection will fade,” he said. “But that doesn’t mean that good infection control shouldn’t persist.”
The pandemic has raised awareness for the need to protect and support nursing homes and other congregate settings, Coll said.
“There may be a silver lining here because this particular part of the tier system is getting more attention than it has in the past,” he said. “Hopefully, there will be better care and outcomes because of that attention.”