Given the risk of COVID, what should one do with a loved one in a nursing facility?

One of the questions I am often asked: given the risk from COVID for an an elderly loved one in a nursing facility, should you move them from the facility? This is obviously not an easy question to answer, but there are a number of things to think about before making any changes in your loved one’s care.

If the individual is totally disabled and requires skilled nursing care, it’s clear that they should not be moved. On the other hand, if the person is independent and cares for themself, bringing that individual home is an option. However, in doing so, you have to make sure that the risk of COVID exposure at home would be less than their risk in a nursing facility. This is important to assess moving forward especially when young people go back to school and work, and potentially bring a viral infection back home. In those situations, it may be that the safest place for your loved one is in a skilled nursing care facility.

Other considerations: 

Look carefully at the type of care that your loved one requires. In most cases, even basic nursing care is not something that people can provide in their own home. In addition, facilities like hospital beds and handicap bathrooms are not available in most homes. Therefore, moving even a minimally disabled person to your own home is not an option unless you’re planning on using part of the first floor of your home to care for them. This may require renovations.

It is important to ensure that an individual in the nursing home is appropriately protected from COVID as best as possible. Review the COVID management plan for the facility.  All of the workers in the facility should be wearing masks and gloves, and it would be important to know whether the facility was specifically housing COVID patients, even if they are in a different wing.

It is especially important to review COVID precautions based on the health status of your loved one. If they are truly at high risk from infection, not just because of age, but due to cardiac or respiratory problems, or neuromuscular problems that make it hard for them to breathe, then the best place for them to be is in a nursing facility. 

If your loved one is in the independent area of a facility, it would be important to understand what the interaction is between the independent facility and areas that have more debilitated patients.

What to do with elderly individuals is an agonizing decision, but moving them simply because of COVID risk is often just not feasible. The majority of individuals (80%) of those 80 and above survive COVID infections. Any decision should be made in light of this outcome. 

Published by jbakerjrblog

Immunologist, former Army MD, former head of allergy and clinical immunology at University of Michigan, vaccine developer and opinionated guy.

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