Questions to ask when considering a care facility
We still seem to be at a confusing place in our world with regard to COVID-19. In our own town, there are those who are fully vaccinated and those who do not have any intention of getting jabbed.
At this point, this is still a personal decision that we each have to make. Questions arise if you or a loved one are considering a move to an assisted living, memory care or even a skilled nursing facility. What are the COVID protocols you might want to consider then?
We have two assisted living facilities in Ashland, Maple Ridge and Skylark. We have two memory care facilities, Village at Valley View and Skylark. We also have one skilled nursing facility, Linda Vista, as well as several adult foster care homes. What are the important questions we might ask about the policies for both the residents and the staff in order to gauge the level of safety and quality of life we are looking for? This protocol changes all the time, as you well know.
In March 2021, the COVID Tracking Project found that residents of long-term care facilities comprised only 1% of the U.S. population, yet they accounted for 34% of all COVID deaths.
The following are recommendations by the Centers for Disease Control and observations from members of the National Aging Life Care Association. Below are the primary domains to consider, items to note, and questions to ask. Some refer mostly to those in skilled nursing facilities like Linda Vista.
1. Personal protective equipment: From masks to gloves, suits and shields, what are their policies and how is the facility situated?
What is their access to PPE? Is lots of hand sanitizer being used?
2. Staffing: Facilities are sensitive about this topic. Staff shortages, staff turnover and general staffing policies could be considered proprietary information.
What is being done to monitor staff health daily? Is there nonpunitive, paid sick leave? The more a facility invests in training on safe use of PPE and infection control, the better the outlook. Having a COVID coordinator to stay up to date on CDC recommendations helps a lot.
3. Vaccination policy: Although it is not legal for an individual (e.g., family member) to be told the vaccination status of a given employee, it is entirely legal for a resident or family to require that all the people providing care are vaccinated. For some employees, pressure to get vaccinated feels too invasive and is contributing to the nationwide staff shortages in long-term care. What percentage of the staff and residents are vaccinated? Are existing or new unvaccinated residents allowed in the facility? How are the unvaccinated being protected?
4. Testing for COVID: Ask what the policies and procedures are should a staff member or resident test positive, and whether they are using contact tracing. These are especially important questions for skilled nursing facilities. Do they do daily screening for residents? Is testing mandatory? For staff? For residents? What if an individual refuses being tested? What if a staff member or resident tests positive?
5. Visitation and re-entry: Of course, family members want to have open visitation. But that does create more exposure and proves risky for the population as a whole. How is family visitation facilitated? Are policies different during a local surge than during a safer spell? Do new residents coming in need to be tested? Vaccinated? Is there a quarantine period?
6. Addressing socialization: Isolation is devastating, and is especially true for persons with dementia. How does the facility provide for safe social activities? How will they accommodate special needs for mental stimulation, exercise, touch and social contact?
7. Communication policies: Families like to be kept informed of how their loved ones are doing. What are ongoing communication policies about a resident’s status, especially if visits are limited again?
There are many more questions to ask and no clear-cut perfect answers as this is an ever-changing environment. We may never all agree on best approaches to this virus, but you can certainly ask all the right questions.
Ellen Waldman is a certified aging life care professional. Submit questions about aging and Ashland-area aging resources and column suggestions to her through her website, www.SeniorOptionsAshland.com.