As heard in the news, long term care centres have been hit particularly hard by the COVID-19 pandemic. In an effort to protect residents and staff, these facilities have implemented strict protocols and routines, restricted visitation and eliminated most activity and social programs. As a consequence, many residents are feeling isolated and lonely and families are feeling disconnected. With no end in sight to the pandemic, many families are asking us “should we bring our loved ones home?”
This question is very complex and does not have a simple answer that can apply to all situations. It is important to consider the following and carefully weigh the risks when making this decision.
We often suggest that you start by communicating with the current staff or care team to get a good understanding of your loved-one’s medical picture, their functional abilities and the complexity of the care they are receiving. It is important to understand what medical issues are being monitored and how many people are assisting with activities like transferring, walking, bathing, toileting, eating, and dressing. What challenges are the staff monitoring, for example: frequent falls, choking, agitation, recurrent urinary tract infections etc. Once there is a solid understanding of the extent of care required, we then consider the following.
Can the house be set up or adapted to provide a safe and accessible environment?
- Are the entrances/exits accessible?
- Is there space for rails, ramps and lifts if required?
- Can space be modified to provide a bedroom and bathroom on the main floor?
- Can bathrooms be adapted with grab bars and equipment?
- Has the need for appropriate equipment been considered (hospital beds, bedside commodes, wheelchairs, safety monitors)?
Can appropriate care be set up at home?
- Coordination of private, public and family provided care.
- What level of services are required: nursing, caregiver, companion or a combination?
- Who will provide the home medical services (blood sugar and blood pressure monitoring, medication management, wound care, urinary tract infection monitoring, specialized foot care)?
- If the person is cognitively impaired, does the family have a good understanding of the progression and how to manage certain situations if they arise?
- Emergency and back-up care planning.
- Consideration of costs.
What will the impact be on the primary caregiver and the whole family?
- Consider the health and well-being of everyone.
- Ensuring the family caregivers maintain good sleep, exercise and social time with other family and friends?
- Consider the emotional and physical fatigue associated with caring for someone with complex care?
- Consider the impact of having multiple caregivers in your personal space?
- How does the caregiver and the care receiver feel about providing personal, intimate care?
- Does capacity to care change with a return to work?
- Reducing the risk of bringing home the infection
We are truly living in extraordinary times. It is important not make rushed, panic decisions out of guilt and fear. Moving a loved-one home can be successful and very rewarding when undertaken properly. Reach out to experts to help you make informed, well researched decisions that are the best fit for you and your family. If you decide to bring a loved-one home, it is important it is done with proper planning and support.
Marni Tory, BHSc Occupational Therapy, MSc Dementia. Seniors Advisor and Dementia Specialist at Proactive Seniors.