The COVID-19 crisis in nursing homes is still going on. You can help. | Expert Opinion
An advanced practice nurse who cares for older adults residing in nursing homes on the stressful, traumatic -- and emotionally transformative -- events she has witnessed.
Recent media attention has focused on how COVID-19 has affected the younger population. Yet the crisis is not over in U.S. nursing homes, where cases first emerged. Let’s not forget the nursing home residents and staff who have survived COVID-19 and the risk that still exists.
Older adults have been identified as the most vulnerable to severe illness during this pandemic, and nursing homes have seen the highest death rates. The presentation of the virus is highly variable among older adults and decline can be rapid.
Those who survive are unlikely to return to their previous level of functioning and will have greater care needs. Many residents report having new physical and emotional symptoms such as insomnia, nightmares, anxiety, depression, weight loss, and loss of strength and mobility despite surviving COVID-19. The increase in physical and emotional problems has created new challenges for nursing homes, which need to not only get through the pandemic, but also to meet the needs of a more frail resident population.
Nursing home staff are amazing people who dedicate their lives to caring for older adults. I am grateful for the service they provide to older adults in their care. Despite the negative media attention nursing homes have received, these caregivers are heroes.
I have personally witnessed the dedication of front-line staff caring for vulnerable older adults. Staff have shown up for work knowing the risk of getting coronavirus. Many have not seen their families for months, living in hotels or on-site housing, working double shifts, knowing that their presence has a profound impact on keeping residents safe and alive. These are the staff that care and provide emotional support for the 1.5 million older adults living in nursing homes who also have not seen their families for months, have been eating their meals alone in their rooms, and have lost friends to COVID-19.
We must recognize that the staff caring for these residents need our support, care and compassion. The stress is overwhelming, and its impact might last for months, perhaps years after the pandemic ends. Many of them report feelings of traumatic stress and physical and emotional exhaustion. They report worrying about themselves and their risk of contracting COVID-19. They report worrying about meeting residents’ needs and those of their own families. They are stressed as they face the uncertainty of the course of the pandemic. They are frequently experiencing grief and loss as they cope with the decline and death of residents they have come to love. These are the heroes who have been at the side of a dying resident when families could not be with their loved one, except perhaps from the other side of a window.
I am an advanced-practice nurse providing medical care for older adults residing in nursing homes, so I can relate to the stressful, traumatic, and emotionally transformative events that many nursing home staff experience on a daily basis. Under my watch, five residents diagnosed with COVID-19 died within two days after symptoms developed. The loss of these residents changed my life forever.
The fight is not over. The lives of residents who have survived COVID-19 and the lives of the staff caring for them have been changed forever.
They need us. Please reach out to your local nursing home and ask the administration how you can help support the residents and staff. Visits are generally not possible now, but perhaps there are ways — sending cards, for instance — that you can let them know you are thinking of them. We need to help them talk about their stories of survival.
Susan M. Renz is a geriatric nurse practitioner and director of the Doctor of Nursing Practice Program and of the Primary Care Program at the University of Pennsylvania School of Nursing.