Is it the right time to consider a Patient Advocate and plan for private In Home Care Givers?



If you have a loved one living in an assisted living facility, or a nursing home right now you are very aware of the restricted visitation due to COVID-19. Beside the threat of the COVID-19 pandemic to one's health and daily life practices we observe the burden of loneliness for the residents, anxiety for family members, and the troubling heavy workloads for the facility staff. What are some of the difficulties that families are experiencing now, and what may have helped with accessibility to loved ones?

Before we knew it everything was totally closed to all visitors, and at first a lot of confusing instructions floated in the community. At first we were told that one family member could visit once per week.  Then a few days later it was no family member can visit. Then we happily learned that if their family member lives on the premises they can stay six feet away and talk with them without of course entering the building. So especially husbands and wives were allowed some sort of face time.

For those who were fortunate enough to have a private caregiver through a home health agency, or a private health professional they hired, they had their shifts still covered. They are essential workers so those families were still allowed to communicate directly with their family members. Some agencies experienced caregivers not wanting to go to the facilities, and not wanting to work in client's homes either. So families and agencies had to find caregivers willing to pick up those shifts.

Those caregivers who declined their shifts were allowed with no fuss to give up those shifts which were then covered by other brave souls. What I noticed was that everyone who had a caregiver attending them for previously consistent weekly home health agency shifts were all still receiving a private caregiver. We are operating under stringent new rules, and literally each day a new rule is added. We don't mind however, because it is for everyone's good.

 Many of the caregivers did not want to continue working, because they needed to protect themselves and their families. They simply notified their agencies that they would not be working. They stopped going to their regular shifts. Now they have introduced bi-weekly COVID-19 testing for caregivers which will cause more to quit. And who will replace them? This has always been a profession that struggles to retain workers.

Facilities are trying to operate with so few workers that the same person is delivering food, then stopping to care for an upset resident, and even stopping in to care for a resident who needs immediate bathroom care. Those same caregivers are then also feeding those who are unable to feed themselves. Fortunately most of these dedicated souls do their jobs with deep caring, joviality and love. 

Unfortunately, at a time when there is more need for caregivers within the facilities they are cutting the staff, and those staff members they retain are experiencing reduced working hours. Added to that are all the new rules that the facility staff must now adhere to including the many temperature checks.  If that was thought of as a burden before for the caregivers there is now the bi-weekly COVID detection test.

The nasal test is uncomfortable and painful a friend told me, and so much so that she had to stay out of work for three days after taking the first one, because of how deep the person administering the test plugged into her nasal cavity.  Is this going to cause an even greater shortage of staff who will just say I will change professions, or those closer to retirement to just quit as many teachers are doing? 

So who will care for the residents of these nursing homes and other facilities? What type of care will residents get due to the potential shortage of staff, and how will you know what is really happening? We all know what happens when they know the state is coming to check. The walls get painted, the floors get extra mopping, carpets get cleaned, and an adequate number of caregivers get called in for an extra shift which shows proper coverage.

As the pandemic rages on changing how we live our daily lives it's interesting to witness the change it has brought to the lives of those who are in facilities, such as nursing homes and assisted living facilities. It is quite difficult. The changes instituted by the facilities which most times are mandated by the state affect not only the resident but in large part their families. Great though that the state mandates changes otherwise the many facilities may not operate under the strict guidelines they have to follow right now.

The families with private caregivers still enjoy contact because their families are always going to see that their family member has a private caregiver by their side as usual. They are at an advantage to get real time reports via text or phone calls. They facilitate the use of technology for face time, or other direct means so family members can see each other and hear each other's voices.  Those visits are never curtailed unless the agency through which the caregiver comes could not find a caregiver to take a particular shift. 

But for those who are not able to either afford to have private caregivers, or are quite old with no family members left or, ones with no one who lives close by, the situation is different. Even if family members wanted to make the visitation journey they are prohibited. Many were looking forward to vacations to visit their family members, which had to be  postponed. Fortunately the visitation problem is beginning to let up in some areas with New York leading the way. See the news release from Spectrum-news:

The Coronavirus pandemic has certainly made us re-think many practices of the past in our lives. We keep hearing about when we get back to normal. But that may never happen. For many families there was someone visiting their loved one every day or every week for years. They follow in many cases a daily routine of visiting their loved ones in nursing homes and assisted living facilities. They perhaps have lunch with them push them in a wheel chair on the grounds, but are not allowed to do so now. No family celebrations of birthdays, or anniversaries have been allowed with outsiders.

Will nursing homes and assisted living facilities continue to enjoy the influx of residents they were seeing? Or will people want to stay in their own homes even more than before? What are the alternatives open to our aging population? How about those who are independently single with no children to check in on you?

Instead, we might consider how to perhaps protect ourselves and our loved ones should we face more of the same soon. There is need for some good planning for the future. The isolation of residents in nursing homes and assisted living facilities has created a need that may increase the relevance of a Patient Advocate. This profession may see more people taking a look at it for the future. Most people want to stay in their own homes, and this will increase the need to plan for a private in-home caregiver.

I have worked with one lady who was 93 years old at the time, and had an apartment in an assisted living facility. Her family lives very far away but speak with her every single day. She has a Patient Advocate who visits often, ensures she has a steady supply of her groceries (which are picked up by her personal shopper), and her medications are all delivered from the pharmacy.

She never has to go out if she doesn't  want to do so, and most times only went downstairs to the beauty shop to get her hair done. We took her down in her wheel chair. Occasionally she would go for dinner in the main dining room. Most times she just had dinner delivered from the dining room, or we went to pick it up downstairs (they charged extra if they had to deliver). She still chose her menu items herself. Even the doctor came to her home which now can be done through telemedicine. She planned well, or someone helped her plan well. 

She is a voracious reader (used to be a teacher) even at that age, and her son makes sure she has a steady stream of books. Everything is coordinated with and through her Patient Advocate. In addition, she has a private in home caregiver 24/7 with the shifts changing every twelve hours. Her caregiver days were carefully planned. COVID-19 didn't give us very much warning to plan.  We may want to plan for the next time.

It is time for us to do some research of what type of additional help we may need, so that there is a bit more organization if we need extra help. If you are interested to learn more about patient advocates here is a website where you can review what is offered. Advocate

 Like everything "trust then verify" those you would hire.

Preparing for accessibility when necessary requires giving thought to when a private caregiver may be needed in home, and when a patient advocate may be the right way to go. For some both will be the best arrangement. 


Stay Safe!

Ruth Y. Webster

-Caregiver Daze






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