We have a few days to prepare - what to do?
April 7, 2020 9:31 AM   Subscribe

Cut for COVID-19 content.

My parents live together at a medium-sized assisted-living facility in a nearby city. The facility has recently reported to us that one resident and three staff members have tested positive for COVID-19. Yesterday, at a health check-in, my parents said they had each in the past few days had fleeting symptoms (one had a cough and the other had a sore throat.) Both feel fine now, but there are major concerns for their survival if they are positive due to age and health history. The health program that covers them had them both tested. We get the results in 2-5 days. If they test positive, they will be moved that same day to a nursing care facility in a different city that has been set up for COVID-19 quarantine, and will stay for 14 days minimum.

I am grateful that they have been tested, and trying to see the waiting period as a blessing. In the few days before they get their results, what, if anything should they/we do to prepare?

Logistically:
-I am hesitant to suggest they pack now, but would it be better to have them living out of suitcases for a few days than have to pack under pressure? (I could not get an answer as to how long they would be given to get ready.) I did suggest they make packing lists now.

-I am going to ask them to get all important contact/insurance/etc. information ready and send to me (I have some, not all.)

In terms of health:
-In theory they should receive all required medical treatment at the nursing facility, but I'm going to check in with them about getting refills of any prescriptions they might need in the next few weeks.

-The staff at the assisted living facility states they are following all required practices: not allowing visitors, serving residents food in their rooms, not running group activities, yet I learned that a. their staff have only been required to wear masks since Saturday (this could have been an access issue - but if so why can they suddenly get them now) and b. we received the comforting reassurance that the positive-testing members had not had direct contact with my parents. However, while they say they have been "monitoring" the staff that did have had direct contact with those three staff, and testing sending home anyone who has had symptoms, they have apparently not tested or sent home staff who were in direct contact with them but had no symptoms. They and would not explain why not, except to again reiterate that they have been following appropriate guidelines. This seems wildly irresponsible to me, except perhaps they simply cannot obtain enough tests, and/or those ill staff had direct contact with so many people that to lose them all means the place couldn't function? I find either possibility horrifying for different reasons.

Regardless, since finding this out I have insisted my parents stay in their rooms except when absolutely necessary, stay six feet away from others, have the staff knock and wait until they have masks on before they let anyone come in, (they each have one mask leftover from earlier health crises,) wipe down doorknobs and handles religiously, wipe down covers on the food trays, etc.

-My dad is in remission from leukemia but is otherwise in reasonable health for his age (early 70s.) My mom, mid 60s, has asthma and general respiratory issues. She also has numerous other conditions that may/may not be impacted is she were to contract COVID-19. Is there anything else they can do to reinforce their health and protect themselves over the next few days (and hopefully for the next however months until we can all stop living in daily fear?)

Emotionally:
We are all going to fall apart if they test positive. One or both of them would probably not survive. I am not panicking yet (again, trying to stay grateful for these next few days) but we need to be prepared for the worst.

My mom is the most practical and responds to serious issues with emotional openness. My dad is a very kind and loving person, but he in denial about mortality and refuses to engage with any discussion of end-of-life planning. I do not want to set them up to bicker and argue for the next few days, which is a real possibility of I push things.

Tomorrow we will have a video seder with them, my brother, and our partners. For Reasons, my parents many thousands of unorganized photographs are in storage at my brother's place, or I would suggest they get some out and enjoy/share some with us. What else can we do to make the most of this short time, and without stressing/panicking overly much, get us ready to accept whatever is coming?
posted by prewar lemonade to Health & Fitness (9 answers total)
 
I'm sorry you're going through this. I would make sure that you have any information about end of life care that you can gather, realizing that your dad may not want to provide any, and everything else you've said is good. I don't know if they have to move everything if they have to move or how laundry, etc., works, but it seems like having everything at least organized would help.

Although I see the other conditions, please do remember that even among the elderly not everyone dies. It is a serious situation, but not critical yet. Having been through a few similar experiences, I am not sure there is anything you can do to prepare, other than be sure to keep in touch and say anything you want to have said. Share love and be present to each other where possible.
posted by warriorqueen at 9:43 AM on April 7, 2020 [7 favorites]


To clarify, meals and laundry will be taken care of at the nursing facility. They will not need to move all their stuff if they have to go there, thank heavens. But they would need to bring essentials for a minimum two week stay. It's unlikely anyone would be able to go back to the assisted living facility and get them anything they forgot.
posted by prewar lemonade at 9:54 AM on April 7, 2020


What do they do for entertainment? If they just watch TV, they wouldn't need anything else, but if they get lots of mail and magazines/newspapers like my dad did, or read print books, bringing some stuff to read would be good. I assume their mail would be forwarded over to them--my dad's nursing center was next door to his apartment building at the retirement home, but I still had to go get his mail a lot of times and bring it over to him every time he was in the nursing center. Stuff fell through the cracks all the time, and he devoured print publications.

He got bored super easily and then got cranky because of that. So if there are entertainment things they like, they should assume not everything will make it over to them (cards, puzzles, games). Also, don't forget those device chargers! Every damn time I had to go down and get my dad's chargers. They'll have landlines there, no doubt, but those don't let you download books or call your kids...
posted by kitten kaboodle at 11:43 AM on April 7, 2020 [3 favorites]


It sounds like they are being cared for at a good facility, and that they have been open with you. If your parents test positive but are not symptomatic, why do they need to move? It sounds like isolating would be pretty easy at their assisted living facility, and the known Covid positive people are being isolated.

Probably it is the Assisted Living home that wants to remove Covid positive residents to decrease the risk of infecting others. Try talking to the Assisted Living director about what happens if one is positive but not the other, as it might not be safe for the uninfected one to go along.

Moving to a nursing home would allow the facility's doctor to care for them, The doctor is not usually on site, but rounds a few times a week and is available by phone. This is from my experience with a family member in a PA facility, before Covid 19, and different states may have different rules for nursing homes. Even in well-rated homes staff shortages are often a problem, and my aunt was frustrated by how long she had to wait for care many days. Weekend staff was notably sparse, with all the ancillary staff (therapists, dietitian) and most of the nursing administration working M - F. Hands-on bedside nurses were also reduced in number. Her home was a 3 star rated facility by Medicare. Every nursing home that accepts Medicare is rated and will be easily Googled.

In PA, and probably elsewhere, residents are not allowed to keep their own medications. Instead they show the facility doctor their medication bottles and he or she will order the same medications, which will be dispensed by the nursing home nurses.

If they become symptomatic, it's the nursing home doctor who would decide whether they need to be hospitalized.

As for why the Assisted Living would suddenly acquire masks (and I hope gloves), they are not typically needed in a facility with independent residents who can care for themselves. People who need help with toileting or other intimate care needing gloves are not usually accepted at that level of care facility. Sometimes healthy elders are insulted by caregivers who routinely wear gloves, and facilities sometimes discourage random glove use by staff. The new knowledge of the importance of and shortage of PPE in nursing facilities has opened the floodgates of states trying to reduce the spread.

Your parents' masks will not keep them safe unless they are N95 masks properly used. Simple face masks mostly protect the people they interact with on the chance your parents are actually covid positive.

On a merely practical note, if they do move please do your best to see that their valuables are secured, as people could gain entry to their unit in their absence. When my aunt was hospitalized, the facility placed her purse in their safe at my request. She insisted on keeping her credit cards with her and at her side. Best of luck to you and your parents.
posted by citygirl at 11:45 AM on April 7, 2020 [1 favorite]


You might want to make sure that both parents are comfortable using video chat and individually have access to a separate video chat device (in case they must be separated). In addition, it's probably a good idea to have a back up charger and cable for said devices.
posted by oceano at 11:54 AM on April 7, 2020 [4 favorites]


they have apparently not tested or sent home staff who were in direct contact with them but had no symptoms

Unfortunately, there is still a shortage of tests, so it is very difficult (if not impossible) for someone with no symptoms to get tested.
posted by shiny blue object at 3:14 PM on April 7, 2020


Personally I would far rather have to live out of a suitcase for a few days than have to leave suddenly and not have everything I need. Have them start packing, and make a list of things to bring that aren't already in the suitcase (chargers, etc.)

I would also check into how their prescription medications will make it over to the other facility and that there is some accountability in that process.
posted by yohko at 5:51 PM on April 7, 2020 [1 favorite]


Apologies, for what I’m about to say is grim. Sentimental possessions maybe shouldn’t be packed. This weekend we lost someone in a nursing home whose personal jewelry (watch, chains, wedding ring) was cremated still on his body, over the pleas of his children, because the home refused to take possession of Covid patients’ things. FYI.

My sympathies.
posted by mahorn at 7:15 PM on April 7, 2020 [2 favorites]


Hi all, just wanted to update with some very good news: my parents' tests came back negative. As you can imagine, I am beyond relieved!

For those who answered, thank you so much for your care and thoughtfulness. Your responses were extremely helpful in sorting my thoughts during the past couple of days, and will be valuable references for the future.
posted by prewar lemonade at 11:02 AM on April 9, 2020 [2 favorites]


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