With the coronavirus pandemic hitting nursing homes and assisted living facilities especially hard, families are wondering whether they should take their parents or other loved ones out of their facility and bring them to their home. It is a tough decision with no easy answers.
The number of coronavirus cases in nursing homes and assisted living facilities in Central Virginia and across the country continues to grow. A Washington state nursing home was one of the first clusters of coronavirus reported in the United States. Tragically, as The New York Times has reported, a nursing home in Central Virginia had fatalities representing “more than a quarter of the facility’s population and one of the highest known death tolls in the United States.”
To contain the virus’s spread, most long-term care facilities are limiting or excluding outside visitors, making it hard to check on loved ones. Social activities within the facility may also be cancelled, leading to social isolation for residents. In addition, long-term care facilities face staffing shortages even in the best of times. With the virus affecting staff as well as residents, facilities are having trouble providing needed care. Assisted living facilities, which are not heavily regulated, may have greater trouble containing the virus than nursing homes, because their staff is not necessarily medically trained.
With this in mind, many families are considering bringing their loved ones home. A Harvard epidemiologist is warning that nursing homes are not the best place to house the vulnerable elderly at this time. And a local judge in Dallas has recommended that families remove their loved ones from infected facilities. Still, before taking this extreme step you need to consider the following questions:
- Can your family provide all of the care your loved one needs? Most Virginia nursing home residents have been screened to prove a need for daily assistance with the majority of their activities of daily living, such as eating, dressing, medication, and going to the bathroom. (See the Virginia screening tool to give you an idea of specific things to consider providing for your loved one.)
- Can you adequately provide that care at home? Care facilities have suppliers delivering medical supplies (wipes, diapers, etc.) and durable medical equipment (hospital beds, etc.), and special foodstuffs and diets; will you have these available to you?
- What about the physical demands of caring for the resident? As Virginia and other states begin to relax restrictions and quarantined breadwinners are called back to work, are there plans to replace your family’s assistance of if you are required to resume working out of the home? Is your home set up to safely accommodate the resident? Are there a lot of stairs? Does the bathroom have rails? If your loved one has dementia, there may be other considerations to consider.
- How well can you prevent infection? Will you be better able to prevent infection than a nursing home? If your entire household is homebound, you may be in a good position to prevent bringing home the virus. However, if one or more members of your household is called back to work outside of the home, you will have to take extra precautions to avoid transmission from the worker. Can you take the necessary precautions to keep your home and all the household members safe?
- If the transition is not successful, will the facility permit your loved one to return? If you take your loved one out of the nursing home or assisted living facility, the facility may not have a safe isolation/quarantine room available. You should confirm the readmission policy with the facility in writing before making the transition.
Bringing your loved one home is a hard decision. It depends on the individual circumstances of the family, and consideration of individual interests of each member of the household. For more on the considerations involved, see KFF Health News and the risks in bringing home loved ones.
*This article is provided for persons interested in elder law issues in Virginia and across the United States. This article has been written by a practitioner in the field of elder law, but unless otherwise noted, the writer is not affiliated with ThompsonMcMullan, P.C. Nothing in the newsletter or the articles is, or is intended to be, legal advice or a substitute for legal advice. If you need legal advice of any kind, please consult an attorney with experience in that area of the law, whether in our firm, or otherwise.