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Caring for Aging Loved Ones During the Pandemic

The Covid-19 pandemic has turned the way we have traditionally done business on its head. Looking for skilled nursing, assisted living, in-home care or memory care for an aging loved one during these uncertain times is no exception.

Finding the appropriate care setting for a senior needing anything from acute rehabilitation to long-term placement is more important now than it ever has been. As Certified Senior Advisors, we have put together a list of common questions we continue to hear from seniors and their families during the pandemic – and the answers we believe to be the most accurate, up-to-date and safest for you and your loved ones.

Q How prevalent is COVID-19 in Skilled Nursing Facilities (SNF)?

A. California is home to 1,223 Skilled Nursing Facilities (SNFs); as of 8/4/2020, there have been 19,772 positive cases of Covid-19 in residents and 3,381 Covid-19 related resident deaths – a 17% death rate among those testing positive. https://www. cdph.ca.gov/Programs/CID/ DCDC/Pages/COVID-19/SNFsCOVID-19.aspx

Q How prevalent is COVID-19 in Assisted Living (AL) and Memory Care (MC)?

A. While the prevalence of Covid-19 in assisted living and memory care is difficult to calculate in granularity (due to the <11 number used to report incidence in Residential Care Facilites for the Elderly [RCFE], a requirement to protect one’s identity), a cumulative estimate is 6,305 residents and staff tested positive for Covid-19 with 689 resulting in death – a 11% death rate. These numbers are according to the California Department of Social Services as of 8/3/2020. Active cases of Covid-19 reported in California in Assisted Living and Memory Care as of 8/3/2020 is 2,475 residents and staff – in San Diego County, for example, 63 staff members have tested positive while 29 residents are positive for the virus in the AL/ MC setting. https://www.cdss. ca.gov/Portals/9/Additional-Resources/Research-and-Data/ DSSDS/RCFE-8-3.pdf

Q Should I place my loved one in Assisted Living or Memory Care during COVID?

A. That depends. There are many factors that go into this decision and each family’s situation is unique. Your Certified Senior Advisor should take a “one size fits one” approach to you and your loved one’s care needs, budgetary considerations, and geographic preferences. CarePatrol continues to keep strict tabs on which RCFEs have active cases of Covid-19, who is admitting new residents and their protocols for admission, and each RCFE’s care violation history with the state of California Social Services department.

Q What are these places doing to stop the spread of the virus?

A. Many of the RCFEs in California, both large and small, were not taking any new admissions during the height of the pandemic. As more and more RCFEs begin to open their doors again to new residents, they are doing so cautiously. Many are requiring negative Covid-19 tests from the hospital, SNF or the potential resident’s primary care physician (PCP) before they will allow a move-in. Some are requiring new residents to use provided furniture until such time that it is safe to bring in the resident’s own furniture (disinfected by the home or community much of the time). Residents are practicing social distancing and other precautions outlined by the state of California, the CDC and the WHO. Many regularly scheduled activities have taken on a virtual nature or have been put on hold for a future date when it has been deemed safe by the local, state and federal entities.

Q What are my options if I want to take mom/dad home?

A. Taking mom or dad home after a hospital or SNF stay may seem like the safest option at this time. Again, each situation is different and the care needs of each senior unique. Does mom or dad have 24-hour care needs? Can they take care of their own Activities of Daily Living (ADLs) such as showering, grooming, laundry, cooking, cleaning, and running errands? Does mom or dad have dementia and prone to wandering? If so, is the house/ property equipped to keep mom or dad safe (pool enclosures are fenced, ponds or water structures are fenced, doors and windows have wireless monitoring)? How many stairs will they have to navigate at home? In-home care can be one possible option if home conditions are safe and manageable. In-home care is non-medical care that can help seniors with ADLs and is paid for privately (Medicare/Medicaid does not pay for this service). Average cost for in-home care in San Diego is between $28 and $36 per hour with a two to four hour minimum typically.

Q The hospital wants to discharge my aging loved one to a SNF. Is that safe to do right now?

A. Again, that depends. SNFs, like many other healthcare entities, are subject to a rating system put in place by the Centers for Medicare and Medicaid Services (CMS). CMS ratings, Yelp ratings, word of mouth and visiting various SNFs before placing a loved one there are just a few of the things you can do to find the best and safest setting for your loved one. If the SNF stay is covered by Medicare, you have a choice of the SNF you would like your loved one to be discharged to; this does not necessarily mean it will happen, however. The SNF must have an available bed and the appropriate staffing ratios to admit your loved one. If your chosen SNF is unable to accommodate your loved one, the hospital discharge planner will continue to look for a SNF that can admit your loved one. Doing research into the SNFs that have had Covid-19 positive residents and staff – and to what degree – is highly recommended. A Certified Senior Advisor can help with this search.

Q What is the difference between a SNF, a nursing home and assisted living?

A. There are many differences between the three. A Skilled Nursing Facility or SNF is meant to be a short-term rehabilitation stop along the path of someone getting better and going home. An example of an appropriate SNF stay is someone who has suffered a broken bone, went to the hospital for a surgical procedure to repair it and has been discharged to a SNF for rehabilitation. This person will likely receive physical and occupational therapy until such time that the skilled staff feel the person is able to discharge home safely (able to maneuver everyday life in his/her home given the injury and rehabilitation progress). Nursing homes are larger facilities that exist to house and care for elderly residents who can no longer live at home safely and often do not have the resources to pay for assisted living. Most residents in a nursing home are on Medicaid/Medi-Cal and the state of California along with the federal government is paying the monthly bill (a Medicaid enrollment specialist can answer questions and assist with eligibility). Many residents in a nursing home are very sick and in some stage of failing health and/or decline. Assisted Living or AL is for people who no longer wish to remain at home or who can no longer safely stay at home and need some level of care and assistance with Activities of Daily Living (ADLs). Assisted living can look like a residential home licensed by the state to care for up to six residents or a larger community licensed to assist many residents with varying levels of care needs (independent living, assisted living and memory care needs). As of 6/5/2020, according to the California Department of Social Services website, California is home to over 7,400 RCFEs which include assisted living and memory care homes and communities. These 7,400+ RCFEs translate to 35,403 beds or capacity for residents. To find the appropriate setting for your loved one, call a local Certified Senior Advisor.

Q What is a Certified Senior Advisor? And when should I be using one?

A. A Certified Senior Advisor or CSA is someone who has studied the aging process – from the physical, mental and emotional aspects to the various financial, spiritual and social needs of older adults. CSAs have engaged in a rigorous course of study and sat for a national examination accredited by the American National Standards Institute (ANSI) and the National Commission for Certifying Agencies (NCCA). Continuing education is a keystone of The Society of Certified Senior Advisors, founded in 1997 by experts in the fields of physicians, attorneys, financial planners, accountants and gerontologists in order to create high standards, ethics and practices among those working with our aging population. You can find a local Certified Senior Advisor by going to https://www.csa.us/, scrolling down to “For Seniors & Families” and clicking on “Find a Professional”… or just call us.

You Have Questions.
We Have Answers… and Choices.

  • Who pays for assisted living, memory care, inhome care and hospice? How does Medicare/ Medi-Cal fit in?
  • Do I have a choice about which company I want to work with for home health or hospice?
  • How can I know if my loved one needs a nursing home or if assisted living can take care of their needs?
  • My loved one has dementia, has started getting combative, tends to wander, sleeps all day and/ or stays up all night. What are my options?

  • The hospital/skilled nursing facility (SNF) is going to discharge my loved one in two days – what do I do now?
  • The hospital/SNF gave me a list of five places to check out – are those my only options?
  • How do I know if these homes and communities are any good?
  • What happens if I live across the country and my mother needs assisted living? Who will work with and advocate for her in my absence?

Let us put our experience and expertise to work for you today!

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This article can be found in this months newspaper.

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