COVID-19 on Long Term Care: Challenges and Lessons Learned

Over 676 million people have been confirmed to have COVID-19, and more than 6.8 million have died globally as recorded until March 2023 by the Center for Systems Science and Engineering at Johns Hopkins University.

This makes the COVID-19 pandemic one of the deadliest times in human history.

The outbreak, triggered by the SARS-CoV-2 virus, led to a widespread flurry with a significant rise in mortality rates, especially affecting the elderly and those under care or with pre-existing health conditions.

This health crisis underscored global susceptibility to public health emergencies, showcasing diverse impacts across regions and nations. It emphasized the crucial need for more health and human services.

As well as effective and coordinated social services response to such crises, preparedness, and collaboration on a global scale.

During challenging times like the pandemic, Medallion Financial Resources - a Retirement Planning & Financial Solutions company can help in assisting individuals and families in managing the financial challenges and uncertainties that arise.

With a focus on maintaining the highest standard of integrity and professionalism, we are well-equipped to provide tailored support and guidance - particularly for those with family members who have been impacted and individuals under care in long-term care facilities.

In this blog, Medallion Financial Resources will provide insights about:

• COVID-19 on long-term care
• The impact of COVID-19 on the elderly population
• Discuss the elderly's common financial struggles
• The impact of COVID-19 on healthcare facilities
• List of the challenges faced by healthcare settings or facilities
• Review seven key lessons learned from the COVID-19 pandemic

Overview: COVID-19 on Long-Term Care

The Long Term Care (LTC) sector was ill-prepared to address the challenges posed by the health crisis. It exposed the cracks in the long-term care system - cracks that widen with every lost life.

Only slightly over 50% of the OECD countries had guidelines on infection control in LTC. This lack of preparation has been particularly concerning given that half of those aged 80 and above were long-term care recipients in OECD nations, and a significant number of deaths have occurred within this age category.

As of January 2024, the pandemic is still ongoing, and its effects on long-term care facilities are still being felt. These facilities house some of the most vulnerable populations, and the impact of the pandemic on the elderly has been profound.

The Impact of COVID-19 on the Elderly Population

In the United States, the repercussions of the pandemic were anticipated to rise extensively in the healthcare system, involving services and support in long-term care.

Older adults have been disproportionately affected, with a higher likelihood of severe illness, hospitalization, and death from the virus, especially among those with underlying medical conditions - such as diabetes and heart disease.

93% of COVID-19 deaths in the U.S were among adults aged 50 and older. The pandemic-related isolation has also caused unintended physical, mental, emotional, social, and financial challenges for older adults, with one in five experiencing issues such as depression, anxiety, insomnia, and substance abuse, according to the National Council on Aging.

Elderly Financial Challenges During the Pandemic

In the tough times brought on by the pandemic, older people felt a big hit in their wallets. It's not just about health – money matters got real for them.

During the pandemic, older adults faced several financial challenges:

• Income Decline: Due to job loss or reduced work hours, many older adults experienced a decline in income.
• Financial Hardship: Older adults struggled to pay for their own needs, such as food, housing, and healthcare.
• Material Hardship: Difficulty affording medications or medical care was also a common issue for older adults during the pandemic.

The COVID-19 outbreaks at nursing homes have exposed critical issues with long-term care financing and payment structures in the United States, revealing underfunding and significant variation in payment across states and populations.

The pandemic has emphasized the importance of health insurance and long-term care insurance for older adults, as many found themselves without adequate coverage, leading to financial strain and increased anxiety.

Additionally, the pandemic has shown that isolated and vulnerable older adults require long-term care services because their families were unable to visit or assist them due to lockdowns and social distancing. This has made it clear that older adults need to have a comprehensive plan for long-term care, which includes insurance coverage and strong family member support systems.

The economic impact of the pandemic also affected older adults' retirement savings. Many saw their savings decrease due to market volatility and job losses, forcing many to delay retirement or reevaluate their financial plans.

The Challenges and Impact of COVID-19 on Healthcare Facilities

The COVID-19 pandemic has significantly impacted healthcare facilities, such as nursing homes, assisted living facilities, and adult day services. These settings have been particularly vulnerable to the spread of the virus due to the proximity of residents and the high risk of severe illness and death among older adults.

COVID-19 made life hard for those living and working in facilities - the staff, family members, and high-risk residents. They had to balance stopping the spread of positive infections while also helping residents with their social and emotional needs. Most places had to limit visits and activities to stop the virus, making residents feel more alone.

The pandemic showed problems such as not enough on-duty staff, low pay, and bad working conditions in long-term care homes. These issues, along with the pandemic, caused more infections and deaths in long-term care homes.

COVID Tracking Project (CTP) in 2021 reported that 1 in 12 or around 8% of people in assisted living facilities, and other long-term care facilities had died from COVID-19. For nursing homes, it was almost 1 in 10. Throughout the whole pandemic, one-third of all US COVID-19 deaths happened in these facilities, specifically in nursing home care, and assisted living facilities.

What healthcare facilities are available for older adults during COVID-19?

Healthcare facilities such as long-term care facilities (LTCFs) and intermediate care facilities (ICFs) provide care and assistance - especially during the COVID-19 outbreak.

These facilities are essential for the health and well-being of individuals who require specialized services, assistance, or personal care, such as those with medical needs, chronic illnesses, disabilities, or older adults.

However, there are distinctions between the two in terms of the level of medical care they offer and the types of residents they serve.

Long-Term Care Facilities (LTCFs)

• An assisted living facility is one of the LTCFs that provide specialized daily living care for individuals with chronic illnesses, disabilities, or conditions that require ongoing assistance.
• They offer medical care, custodial care, and skilled nursing services, as well as help with daily activities. LTCFs are home to individuals who can no longer live independently due to physical or cognitive limitations, such as seniors with chronic conditions or individuals with disabilities.
• It is estimated that 1 to 3 million severe infections, including COVID-19 cases, occur in LTCFs annually, making infection prevention, including safeguarding against COVID-19, a priority for organizations like the Centers for Disease Control and Prevention (CDC).

Intermediate Care Facilities (ICFs)

• These are smaller facilities that typically house 8-15 residents, primarily for developmentally disabled individuals but sometimes for elderly patients as well.
• They provide a level of care between medical care and assistance with daily living, catering to individuals recovering from surgery or illness, with temporary disabilities, or chronic conditions not requiring constant medical supervision.
• Unlike a skilled nursing facility, ICFs do not primarily focus on medical services. It’s not eligible for reimbursement under Medicare supplement insurance while Medicaid services offer it as an optional coverage.

Four Challenges Faced By These Types of Facilities:

Infection Control and Prevention:

Facilities have struggled with infection control and prevention, leading to high infection and death rates among vulnerable staff and under care residents. The high prevalence of asymptomatic carriers of the virus has also made it challenging to detect and isolate infected individuals.

Close living quarters, communal spaces, and shortages of protective gear have contributed to the rapid spread of the virus in these facilities.

Financial Strain:

The pandemic has worsened financial challenges for LTC facilities, with increased costs for personal protective equipment (PPE), testing, and staff support. Not having enough protective gear made it hard for staff to stay safe and protect residents.

Allocating resources was also tough because facilities had to juggle the need for protective gear with providing essential services and caring for residents. Due to these factors, many facilities, especially in rural areas, have faced closures causing vulnerable seniors to search for new available care facilities.

Staffing Shortages:

LTC facilities have experienced staffing shortages and burnout, as the increased workload and rapid infection have taken a toll on staff. Persistent challenges such as lack of PPE and mental health issues have affected the workforce.

Mainly, the fear of getting infected led to staff shortages, as employees had to stay home after being exposed to the virus. The hardships of the pandemic require a trauma-informed approach to help older adults, family members, and staff cope with the stresses and losses.

Impact on Quality Person-Centered Care:

The pandemic has affected the implementation of person-centered care in nursing homes, with staff shortages and other challenges hindering the ability to provide individualized care and assistance to under-cared residents.

The COVID-19 pandemic has greatly shifted the operations of long-term care facilities worldwide, with the number of elderly individuals projected to rise in the future.

But, before the pandemic, different ways of taking care of retired people and less money from the government were already making fewer people want to live in long-term care homes. This shows we need new ideas and changes to help the staff in these places after the pandemic.

7 Key Lessons Learned: Pandemic's Impact on the Older Population

Jobs got shaky, retirement savings took a hit, and homes weren't as secure as they used to be - the pandemic taught important lessons about the challenges and strengths of older adults, especially those in long-term care and facing financial difficulties.

COVID-19 has shown how important it is to plan and manage better to protect your money and needs during tough times.

Moreover, the pandemic has led to high infection and mortality rates, but it has also served as an opportunity for facilities to acquire valuable insights into infection control and the importance of adequate staffing levels.

The profound impact of the pandemic has brought forth several crucial lessons, particularly relevant to older adults.

1. Vulnerability of Older Adults

The pandemic has starkly exposed the vulnerability of older adults to the potential dangers of COVID-19. Research done by the American Geriatrics Society found that older adults with multiple chronic conditions, lower income, and lower education levels were more likely to experience COVID-19-related hospitalizations and deaths.

2. Importance of Long-Term Care Preparedness

The pandemic has affected long-term care places, showing the need for good planning and being ready for outbreaks. COVID-19 made it clear that handling crises well is greatly important for long-term care.

Countries that implemented measures such as social distancing, lockdowns, case detection, isolating sick individuals, contact tracing, and quarantining exposed people were more successful in controlling the virus.

Long-term care spots should have a plan for crises that include things like controlling infections, training staff, and keeping families informed.

3. Social Isolation’s Toll on Mental Health

Social isolation and loneliness have significantly affected the mental health of older adults. People with dementia or other neurological functions find it hard to understand why they have to be alone and do things differently.

Targeted interventions, such as telephone-based support and virtual social activities, can help alleviate these challenges. It is crucial to address the mental health needs of residents and staff during the pandemic to ensure their well-being.

4. Digital Inclusion for Older Adults

The pandemic made it clear that older adults need to be part of the digital world, especially those treated for COVID-19. As the world relies more on digital platforms, it's crucial to include older adults.

Many older adults felt lonely during the pandemic, especially if they weren't comfortable with technology. However, using digital platforms and telehealth services effectively provides healthcare to older adults.

Two important technologies that emerged during the pandemic are telehealth and remote monitoring and data analysis.

• Telehealth Implementation

Healthcare providers were able to assist residents remotely, providing services such as medical consultations, mental health support, and medication management. Telehealth services also played a crucial part in reducing the higher risk of COVID-19 transmission among residents and healthcare providers.

• Remote Monitoring and Data Analysis

Healthcare providers can track vital signs such as blood pressure, heart rate, and oxygen levels, alerting them to any significant changes in a resident's health from a distance and analyzing data to detect potential health issues early. This technology and service has been instrumental in identifying and responding to possible COVID-19 outbreaks in LTC facilities.

The concept of "digital inclusion" shows how crucial it is to guarantee that caregivers and older individuals have the training and technology they need to stay connected and make use of services.

5. Community Support Systems

Community support is essential for assisting older adults in overcoming the challenges of the pandemic. Local organizations that provide services such as nursing home meal delivery and transportation play a significant role in this support.

Active participation from family members, friends, and neighbors is highly valuable for older adults in addressing pandemic-related difficulties and maintaining good health. Regular communication with facility staff, virtual visits, and involvement in decision-making processes are crucial elements for the well-being of residents.

6. Elder Abuse Awareness

Amid the pandemic, there is a heightened focus on increasing awareness about elder abuse, particularly in light of the new opportunities for financial exploitation of older adults, especially related to COVID-19 relief programs.

The risk of elder abuse is found to be higher among older adults who experienced social isolation during the pandemic, stressing the importance of protecting older adults from financial exploitation during these challenging times.

7. Resilience and Adaptability of Older Adults

The resilience and adaptability demonstrated by older adults during the pandemic have been truly remarkable. Older adults' ability to overcome challenges serves as an inspiring testament to the strength inherent in this demographic.

Engaging in problem-solving and positive coping strategies has been identified as key factors in enhancing resilience among older adults.

Medallion Financial Resources: Secure Your Long-Term Care Insurance With Us

In the context of the COVID-19 pandemic, Medallion Financial Resources stands out as a trusted service partner. Our expertise lies in delivering personalized planning and financial service solutions, carefully considering the changing circumstances and potential cost of disruptions to your income and savings.

Medallion Financial Resources emerges as a valuable ally for those going through financial challenges during the COVID-19 pandemic. We offer top-notch information, services, and products dedicated to achieving financial wellness and peace of mind, even in unexpected and challenging circumstances.

Are you ready to transform your financial future?

At Medallion Financial Resources, we don't just walk alongside our clients – we pave the way to a brighter tomorrow. We are here to support you and answer any questions you may have.

Please feel free to reach out to us at 941-486-0305.

Conclusion:

The COVID-19 pandemic has presented unprecedented challenges for nursing home residents, healthcare providers, and the broader long-term care community.

Physical therapy has been essential in maintaining the physical and mental health of residents, while healthcare providers have demonstrated remarkable resilience and adaptability in the face of staffing shortages and increased demand for specialized care.

Throughout the pandemic, the federal government has played a crucial role in addressing the challenges faced by long-term care facilities, nursing homes, and assisted living facilities.

The Centers for Medicare & Medicaid Services (CMS) issued guidance on infection control and prevention, emphasizing the importance of testing, contact tracing, and isolation of infected residents. These measures were critical in protecting the health and safety of residents and staff.

As we reflect on the lessons learned, it is clear that ongoing collaboration and preparedness are essential to safeguarding the well-being of nursing home residents and ensuring the resilience of health care providers. Long-term care policies that prioritize safety must be implemented and enforced to prevent future outbreaks and protect vulnerable populations.

Looking ahead, it is imperative for the government and the entire long-term care ecosystem to prioritize the implementation of the key lessons learned and to continue striving for the highest standards of care and support for the elderly and those who care for them.