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Understanding Risk In Your Homecare Population: Remember To Protect Your Patients At Risk Of Dying, Not Just From The COVID 19 Virus, But From The Effects Of The Pandemic

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As we continue to deal with the effects to family, friends, and ourselves, we must also consider the effects of Covid on our patients. You may be thinking this is an everyday thing! However, often this focus is about the virus and not about the effects of the pandemic. We need to have care plans that cover more than the disease because we are losing patients because of the pandemic and not the virus. Let me explain.

A Typical Issue:

A friend of mine had an elderly mother in an assisted living facility for the last several years. She was thriving there until a fall required her to be temporarily placed in a SNF. You guessed it. Covid hit. Suddenly, the individual who was accustomed to multiple visits from family every week was isolated when the SNF no longer allowed visitors. She had an iPhone, but it often had a dead battery. It limited the ability for family to Facetime call or be able to see her face and she theirs. Family reported calling the SNF several times per week to ask them to plug in her phone. Over the course of a couple of months, my friend’s mother became very depressed and felt very isolated. She told her family she would like to go on hospice and that she was basically ready to go.

Then, after hospice had admitted, the SNF came to a point that lockdown was no longer deemed necessary. Family was able to visit at certain times and they had to do so on the patios where there was adequate ventilation. Things changed for the patient. She was discharged from hospice and doing well with therapy. Her goal was to return to the assisted living facility. Everything was moving in that direction. Then, there was a covid outbreak in the SNF and lockdown was back in effect. Later, this patient ultimately tests positive. She is asymptomatic with the exception of some noted shortness of breath. However, she also had CHF, so the shortness of breath could have been a combination of both. These symptoms resolve, but the SNF is still on lockdown while others recuperate. Family continues to do everything possible to connect like phone calls, Facetime, and visits to her window. Ultimately, she lost the will to continue on with no foreseeable end to all of this in sight. My friend gets a phone call her mother is gone. Her mother was listed as a covid death even though her symptoms resolved  and she was no longer positive. Her daughter told me that if the virus didn’t take her, then the pandemic did.

The Virus Didn’t Take Her, But The Pandemic Did:

This is such a huge statement. I know we all see commercials from our health departments speaking to mental health issues associated with the pandemic. Usually these commercials feature young people or middle aged folks who have ongoing mental health issues. I know we see the feel good commercials with the family outside the nursing home and everyone smiling back and forth at one another. However, our care plans and post acute care aren’t structured to drill down and keep these patients from deteriorating because of the effects of the pandemic. We are doing everything in our power not to spread the virus and that is great, but we need to consider more. Educate staff to be cognizant on admission to what is different for patients today and how they are coping with isolation issues. What does your agency do or attempt to do in order to prevent isolation? Do you do more calls to the patients? Do you ever Facetime patients? If you pulled 10 random care plans of patients currently living alone, would those care plans address social isolation issues or do they look the exact same as before the pandemic?  These changes to how you take care of patients can make the difference in outcomes and overall wellness for your patient population.

Kenyon Homecare Consulting:

At Kenyon Homecare Consulting, we focus on high-quality, patient-centered care. We can help you with clinical, operational, or financial issues you may be struggling to overcome. We work with agencies and clinical staff to help with education and patient-focused outcome-based care planning. Call us today at 206-721-5091 or contact us online to see how we can help you make a difference for your patients and business.

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