Why haven't they gotten a handle on nursing homes yet??

[Rae]

In my state, over half of the deaths have been in nursing homes or assisted living centers. 23% of the positive cases are over age 65, yet they account for 87% of deaths. Zero deaths under age 24.

What are they doing to address this? It should be all hands on deck in these facilities.

[WhiskeyGrinder]

1. What? And staff them generously with people who are well-trained and have the equipment they

need to keep themselves and people safe? Think of the cost!

[brooklynite]

2. Answer:

Large number of vulnerable people in a limited space who can't be moved or socially distanced because of need for ongoing medical care.

[Voltaire2]

8. so nothing to do, just what it is.

interesting.

[Solomon]

35. Well, they are lobbying for immunity from being sued.

That's doing something

[captain queeg]

3. Money. Those places almost all run on the cheap.

[Wounded Bear]

4. Because "they" don't want to...

[CentralMass]

14. This.

[Wounded Bear]

15. After all, "they" do what "they" want to do...

and by "they" I mean the Trump organization.

[SoonerPride]

5. Incompetence and apathy

The neither care nor are capable of doing anything other than let millions die.

[superpatriotman]

6. Lobbyists

And lack of giving a shit

[qwlauren35]

7. I was thinking this today.

I think my state - Maryland - is grappling with this. And if there was an easy answer, I think we would have tried it. We have done everything imaginable to lock down the state, but our numbers keep growing. It is nursing homes and meat packaging facilities.

It really hurts to see the numbers grow. We have lost over 1000 people, with 25,000 cases. Nothing compared to the North East, but still painful.

I remember seeing one nursing home split up the people into with COVID and without and move half of the cases out of the building. (I don't remember which half or where.)

If that's the solution, it requires money AND SPACE and twice the number of employees. Finding skilled workers to address this is probably non-trivial. Finding the space to move 50% of all nursing home residents in the state is impossible. Even if the money was there.

It is amazing that our jails and prisons are not also experiencing this problem.

[Rae]

9. The average age of the prison population is far less

They are testing positive but not experience a death rate anywhere nearly that high. As of 3 days ago, it was 16,000 deaths nationwide.

Look at how much money we're throwing at this. There has to be a solution, especially give the fact that many hospitals are currently below capacity. It's heartbreaking.

[LisaL]

13. Yes, prison population is on average consists of healthier and younger people than those in

nursing homes. So even if a lot of prisoners get infected, less end up dead.

[Voltaire2]

10. the prison system likely is having a serious issue and it is likely grossly underreported.

[Ms. Toad]

30. They are having the same problem in prisons

But deaths are lower because of the age of the population, and it is less reported because rapists and murderers are less sympathetic than grannies.

[LeftInTX]

34. Our jail has an outbreak

I think 300 inmates have it. Most are asymptomatic.
They are testing everyone at the jail. I do think it is easier to control in jails and prisons than in nursing homes.

[sarisataka]

11. It isn't difficult to understand

In all countries the older members of the population account for the majority of the fatalities. There is no reason to expect any other result in the US.

Also consider how many in that age range have DNR/DNI orders. It doesn't matter how many hands are on deck in those cases.

[Rae]

16. I understand the "why" of it.

I just find it hard to believe that nothing can be done to prevent more from getting the virus.

[sarisataka]

18. Once the virus is inside

It is almost impossible to stop the spread. That is why so many nursing homes and care centers have stopped allowing visitors.

My wife's mother is in an independent living community. So far they have kept it out but are vulnerable as many residents have to go out to shop.

A month ago my mother was in transitional care following heart surgery. When the first case was confirmed in the building, they sent her home within 24 hrs to continue care there. Most residents don't have the option to change to home care, we were lucky.

The nurses told us she has a 100% chance of death if she catches Covid. I don't know how many at the TC have been infected but they have had 15 deaths since she left.

[forthemiddle]

26. DNR/DNI are the reason

I hate to be morbid, but the vast majority of residents sign DNR orders before becoming residents in these nursing homes. Because of them most won’t even be transferred to the hospitals for treatment.

Because of the community living accommodations of nursing homes, the virus will spread quickly in this fragile population. I don’t know any answer outside revoking the DNR orders when it comes to Covid19.

[mantis49]

28. DNR does not preclude hospitalization.

Having said that, though, many who sign DNR also direct no intubation.

[forthemiddle]

29. Your right

But it’s much less likely. I also know providers are very reluctant to hospitalize a patient from a nursing home, even in the best of times. This is not by any means a condemnation of the providers decision, it’s just reality. It is also a huge problem getting the patient readmitted to the nursing home when they are ready to be discharged.

The nursing home is most of the time the place of convalescence of choice. If a patient isn’t going to be ventilated because of standing orders, the nursing home can generally give the best care. Unfortunately that puts other residents at higher risk of getting it.

[LisaL]

12. High risk population in a communal like setting.

Healthy people don't normally end up in nursing homes. So you have a bunch of old people with pre-existing conditions, and we know those are most vulnerable to the virus.
Virus is airborne, so very hard to contain.
Unlikely you could make the older people in nursing homes to wear masks, especially if they have dementia.

[appalachiablue]

17. - How nursing homes (mortuaries) are run here, it's appalling:

Why Humanity Will Probably Screw Up The Next Pandemic As Well; Our Economics & Politics Dictate It, NY Magazine, April 2020.
... in this country, the pandemic has taken root in a medical environment characterized by continuous disinvestment, particularly at the county and state levels. There are 60,000 fewer employees in public-health departments than there were before 2008. So many [Great Recession–era] cutbacks haven’t been undone. Meanwhile, since the election of Ronald Reagan, we’ve been converting hospitals into financial systems running on just-in-time inventory and keeping as few beds as possible.

-> Nursing homes are a similar story. They’ve become a big industry dominated by private-equity firms, which extract the highest profits they can out of the lowest costs. And from the very beginning of the outbreak at the Life Care Center in Kirkland, Washington, it was clear that nursing homes were going to turn into mortuaries. James Straub, who’s the union representative for that nursing home, was telling me in March, “Look, the public-health people are not on top of this.” You know, everybody thinks Washington is the most progressive state in the world. But not on these issues. The homes are very poorly regulated.

And when the public-health officials went to collect the first bodies, they didn’t bother to interview the nursing-home workers. These workers had no protective gear at all. They had minimal to no training in infection control. The officials didn’t bother to interview them. These nursing-assistant jobs pay $10 an hour. The only way people can make ends meet is to moonlight. So a large minority of people who work in nursing homes also work at least part time in another nursing home. So you have this transmission belt that links all the nursing homes together in a given region. James told me in March, watch what happens in nursing homes — thousands of people are going to die. Well, 12,000 have died in them...

More, https://democraticunderground.com/?com=view_post&forum=1127&pid=137593

[MineralMan]

19. In Minnesota, over 80% of the COVID-19 deaths are of people

from nursing homes and other care facilities. The common denominator is age and poor health. Skilled nursing and long-term care facilities concentrate old people who have underlying conditions into situations where they are easily exposed to the virus.

It's not at all surprising that the virus spreads quickly in such facilities and that the death rate is high. A solution? That is going to be hard to come by, I suspect, since there is no other place such ill people can be placed in most cases.

[Wellstone ruled]

25. And the bottom line is MONEY.

In your State you have one Operation that is expensive to access. And they do have a P A as well as Nurses on staff 24//7 as well as a fully malfunction Clinic tied to Mayo Medical. Ah,but the Freight is well north of 5k per month. And that was in 2003,most likely 10k per month now.

[forthemiddle]

27. And DNR orders

Most nursing home residents have DNR orders on file. The aren’t mandated, but it is one of the first questions on admition. That generally means the patient won’t even be transferred to a hospital.

If this is a good thing or not is another question not for this thread.

[Rhiannon12866]

20. Statistics in my (NY) county, as of 5/1, 14 have died of coronavirus, 11 of those in nursing homes

[Rae]

21. Do they need to covert them to hospitals

and bring in HCW in full PPE to deal with this? And better isolate those who test negative?

I don't know the answer, but there has to be one.

[irisblue]

22. The corporations that own these centers are not going to spend a penny more then they have too

Welcome to DU by the way.

It comes down to money and lobbysts and legislatures.

[Rhiannon12866]

23. Obviously something needs to be done

But in the article I read, the nursing home director explained that many of those affected have additional issues, like dementia, so require additional special care.

[LisaL]

24. Well, in NY, they made nursing homes to take in patients even if those patients had covid.

That clearly is not going to help with spread.
"Three states hit hard by the pandemic — New York, New Jersey and California — have ordered nursing homes and other long-term care facilities to accept coronavirus patients discharged from hospitals. The policy, intended to help clear in-demand hospital beds for sicker patients, has prompted sharp criticism from the nursing home industry, staff members and concerned families, as well as some leading public health experts."
https://www.nbcnews.com/news/us-news/coronavirus-spreads-new-york-nursing-home-forced-take-recovering-patients-n1191811

[Sugarcoated]

31. Why in the world would they do that??

Huge mistake...

[Mariana]

38. Where should those people have gone instead?

I agree it's bad to send them into nursing homes, even when the nursing homes say they're properly equipped to handle them safely. But where else can they go?

[JI7]

32. Because of Republicans who don't want to

[roamer65]

33. Repuke health care.

They want them to die.

[jmg257]

36. Yet in some states, nursing homes are mandated to take in C-19 patients, contagious

Or not, no questions asked.

Whether the homes have the means to handle the virus or not.

Murder.


https://www.nbcnews.com/news/us-news/coronavirus-spreads-new-york-nursing-home-forced-take-recovering-patients-n1191811

But in New York, the controversy over the mandate has escalated as the virus has battered hospitals and nursing homes alike: The state not only has more coronavirus cases than anywhere in the country, but also the highest number of known long-term care deaths — at least 3,500 — related to the virus, according to the state health department. A broad swath of nursing homes across the state have already accepted COVID-positive hospital patients in compliance with the mandate, and Gov. Andrew Cuomo has openly criticized facilities for opposing it.

“They don’t have a right to object. That is the rule and that is the regulation, and they have to comply with that,” Cuomo, a Democrat, said in a Thursday news conference. “If they can’t do it, we’ll put them in a facility that can do it.”