The pandemic proves it: We have to reimagine nursing home care from the ground up | Ray E. Landis

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Infection and death rates for COVID-19 have climbed over the past few weeks with much of the focus on the impact on younger people. The fact remains, however, that older Americans are the most likely to die from the virus and those in long-term care facilities are at the most risk.

As the death total in the United States climbs past 150,000, close to 40 percent of the deaths have been residents of nursing homes, assisted living facilities, or personal care homes. Pennsylvania’s percentages are significantly higher – well over 50 percent of the 7,000+ deaths attributed to COVID-19 are of those who resided in a long-term care facility.

I wrote earlier this year about the initial impact of the virus on our long-term care system. Since then steps have been taken to isolate many long-term care facilities in an attempt to contain the outbreak among residents and staff.

But the number of cases and deaths continue to grow. And as elected officials debate the next round of financial assistance to individuals and businesses impacted by the virus, they are being urged to commit more resources to help the long-term care system weather the crisis.

There is no doubt urgent action such as getting more protective gear into long-term care facilities is needed to better protect those receiving long-term care. But simply pushing more money into our current system is not going to address its fundamental problems. We cannot throw money at long-term care then walk away without ensuring needed changes are taking place.

For instance, a necessary step is to increase staffing. But more direct care workers alone will not prevent long-term care recipients from contracting COVID-19.

New and existing staff need better training in the short term, but to improve the long-term care system both now and in the future, staff needs a sense that being a direct care worker is a profession, not a temporary step on the way to somewhere else.

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That will take money. But the funding needs to be allocated strategically and there must be conditions. One of those conditions is to take the steps necessary to build a career ladder for direct care workers, with a pay scale that doesn’t entice an employee to leave a nursing home position to work in retail just to make ends meet.

Beyond the situation of those who are caring for residents of long-term care facilities is the nature of the facilities themselves. Our long-term care system is muddling the differences among people who can no longer care for themselves without assistance.

Some need a safe place to live and help with a few of their daily activities. Others may be bed-ridden and need 24-hour a day health care.

Theoretically nursing homes provide 24 hour a day care while assisted living, personal care homes, and home health care provide lower levels of assistance.

But nursing homes are increasingly being operated as a combination rehabilitation and end-of-life facility, while assisted living, personal care services, and home health care vary widely, with the care receiver’s ability to pay the biggest factor in the quality of life at any particular location.

COVID-19 has exposed the flaws in this system. Corporations who cut corners to profit off the most vulnerable in our society have seen the virus decimate residents and staff. Too many smaller, local facilities don’t have the expertise or financial ability to take the necessary steps to protect residents. And the complicated nature of the long-term care system is unknown to most Americans unless they have a family member who needs care.

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Pages and pages of new regulations and rules won’t fix our long-term care system. Revising the system so people in need of help are living in the situation that makes the most sense for them is where we need to start.

That means getting the greedy corporations out of the business, focusing on improving conditions for those working directly with care recipients, and establishing a high-quality system open to all regardless of their ability to pay where individuals can easily transition into new types of care as their needs change.

The dire state of our long-term care system has been exposed by COVID-19. The people who have died of the virus in these facilities must not be allowed to have died in vain. We must take the steps necessary to immediately protect long-term care recipients and staff, but now is also the time to insist upon the fundamental reforms we know must take place.

Opinion contributor Ray E. Landis writes about the issues that matter to older Pennsylvanians. His work appears biweekly on the Capital-Star’s Commentary Page. Follow him on Twitter @RELandis.