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Keeping calm during COVID-19

Resident safety is our top priority
By Dr. Rhonda Collins
Revera was the first company in the Canadian senior living sector to appoint a Chief Medical Officer. In her blog series, Dr. Rhonda Collins offers helpful advice for seniors to lead healthy and fulfilling lives.

I was disheartened to read some unfortunate advice in the media recently that suggested that families should remove their loved ones from their home in long term care. These statements worried me because I knew they would undoubtedly cause unnecessary anxiety for our residents and their families, which is the last thing we need during a pandemic.

The priority of long term care homes is the health and safety of the residents for whom we provide care. One of the ways in which we do so is by taking all appropriate measures to reduce the risk of transmission of respiratory viruses like COVID-19 in our homes. This includes restricting visitors into our homes, screening all employees on every shift for symptoms of COVID-19, reducing movement of staff between homes and the appropriate use of personal protective equipment.
“For someone to suggest that residents are better off being removed from long term care homes to wait out the pandemic at their family’s home is wrong and presents serious risks for residents and their families.”
Regrettably, there have been outbreaks and deaths in long term care homes since this pandemic began. The reality is long term care homes are not immune to viruses and risks that exist out in the community, whether it’s COVID-19, influenza or other transmittable viruses. The people who live in long term care are particularly vulnerable to these viruses due to their age and underlying health conditions. This is why it’s so important for people to stay home and prevent the further spread of these infections.

For someone to suggest that residents are better off being removed from long term care homes to wait out the pandemic at their family’s home is wrong and presents serious risks for residents and their families. Most residents in long term care are there because the level of care they require exceeds what could be provided in their prior homes. Many have very complex medical needs and are dependent on care staff for basic activities of daily living like toileting, bathing and dressing. Some require assistance with feeding and have modified textured diets that, if not prepared correctly, can lead to choking. Bowel and bladder incontinence requires regular brief changes and skin care to prevent skin breakdown and pressure injuries. Those with impaired mobility regularly require position changes to prevent pressure injuries as well. Many residents require two people to assist with transfers in and out of bed or into the bathroom. Often, they require a mechanical lift. Trying to complete these types of transfers without training or proper equipment increases the risk of falls and injury, not only for the residents, but for the person providing the care.

Approximately 80 per cent of our residents have cognitive impairment or dementia. They now recognize long term care as their home. If we take them to a different environment – even one they lived in previously – they may find it unfamiliar and confusing. This can lead to agitation and behaviours that can include yelling, swearing, leaving the house, hitting and kicking. Staff in long term care are trained to recognize when these behaviours may occur. They know that these behaviours are not intentional and come as a result of an unmet need (like being hungry, being thirsty, having to use the toilet, having pain, etc.) These behaviours can be frightening if you are unfamiliar with how to respond to them.

When medical care or behaviours associated with dementia become too difficult to manage at home, people are often sent to the emergency department. This is not the appropriate place for older persons with underlying health conditions, especially those with dementia. Persons with dementia are much more likely to develop delirium in hospital which can result in physical and chemical restraints. They also have a higher risk of developing hospital-acquired infections and pressure injuries, and research has shown that they generally do poorly, with worsening cognition and function even after they are discharged.

I know that families are scared and only want what’s best for their loved ones. Believe me when I say, so do we. We have well-trained, compassionate staff who are dedicated to providing care to your loved ones. We follow established protocols during outbreaks, including COVID-19, and will do everything we can to continue to provide safe and effective care. So please, I’m asking everyone to continue to be a partner with your loved ones’ long term care home and trust them to deliver the care and support residents need.
Dr. Rhonda Collins, Chief Medical Officer of Revera
By Dr. Rhonda Collins
Dr. Rhonda Collins brings passion and expertise in memory care, dementia, falls prevention and clinical quality improvement to the role of Revera’s Chief Medical Officer. Dr. Collins is a family physician with a certificate of added competence in Care of the Elderly from the College of Family Physicians of Canada.