Oregon’s long-term care ombudsman says protecting nursing home residents from COVID-19 comes with its own set of consequences.
“We do hear from, particularly, the spouses — the husbands and wives — who are used to visiting daily and providing supplemental care, even if it’s just feeding their loved one, and not being able to do that now, then observing through the window, in some instances, where they feel the care for their loved one is not being provided the way they would expect,” said Fred Steele, the state’s official advocate for people who live in long-term residential facilities.
Steele has heard of people with dementia forgetting what their loved ones look like after in-person visits were banned, he told "Think Out Loud" on Friday.
As of mid-April, more than half of Oregon's confirmed coronavirus deaths have been in long-term residential facilities. They include an outbreak at Healthcare at Foster Creek in Southeast Portland, where 21 people have died, and at Edward Allworth Veterans' Home in Lebanon, where some of the state's earliest cases emerged.
Before the coronavirus, Steele relied on a network of staff and volunteer ombudsmen to visit nursing homes, memory care programs and other long-term residences to respond to concerns raised by residents and their family members.
COVID-19 has put an end to volunteer ombudsman inspections — Gov. Kate Brown prohibited most in-person visits to long-term care facilities as of mid-March. Steele said he’s making a point to visit, himself, to see how they are responding to the pandemic.
He recently spent an hour at Healthcare at Foster Creek, at the request of several residents.
A DHS investigation in mid-April found that Healthcare at Foster Creek staff were not taking adequate steps to treat every resident as potentially infected, were not wearing adequate personal protective equipment, and were not enforcing social distancing.
Steele said he saw evidence of the concerns raised in the state Department of Human Services investigation — as well as signs that employees are doing their best to serve residents’ needs.
“The staff I observed were working hard, were working diligently,” he said.
The biggest lesson he takes from the infection rate at that site is that speedy response to an outbreak makes all the difference: “We realize now, even just three or four days of any kind of delay, how fast that virus can spread.”
Steele also noted that many of the challenges that long-term care residences face are also obstacles for hospitals, including shortages of personal protective equipment. Some nursing homes do not have enough staff to respond to a coronavirus outbreak, and in some facilities it’s not easy to separate COVID-19-positive residents from people who are not infected.
“I believe, overall, the state is doing the best we can — and the best we can as a society — in trying to ensure that individuals are healthy and safe,” Steele said.
That’s small comfort for many residents of long-term care.
Steele’s office is getting complaints from residents who are frustrated they cannot leave their homes to get fresh air or visit local businesses, due to the governor’s stay-home order. The office is also getting complaints from people frustrated by their fellow residents who won’t wear masks or comply with 6-foot social distancing guidelines.
Families, meanwhile, complain they can’t see the people they love.
“We hear stories that they are communicating through windows now,” Steele said. “Most facilities are doing great for virtual visitation.”
When the ombudsman’s office receives complaints, it investigates, but does not have the power to enforce. That’s up to the Oregon Health Authority or the Department of Human Services.
And in the case of complaints about isolated seniors and worried families, there’s not much to be done, Steele said. “Some of those cases are very sad, just because of the current dynamic that does need to exist.”