Elder care in pandemic fueling urgency around improvements

Boston Statehouse

FILE – In this April 16, 2020, file photo, Richard Eberhardt walks along a corridor at a nursing home in Kaysesberg, France. Countries across Europe are struggling amid the coronavirus pandemic with the dilemma of leaving the elderly and others near death in enforced solitude or whether to allow some personal contact with relatives. At nursing homes, everything is done to keep out visitors who might be infected, and family members are almost always banned from coming to see their loved ones. (AP Photo/Jean-Francois Badias, File)

BOSTON (SHNS) – Following the devastation that COVID-19 brought upon nursing homes, assisted living facilities, and other care settings, the chairs of the Joint Committee on Elder Affairs have discussed making this “the year for action on the continuum of care” for older people and people with disabilities.

After a hearing that featured emotional and personal testimony from people who feel their loved ones did not get the care they deserved in a nursing home or similar setting, Sen. Patricia Jehlen, who co-chairs the committee with Rep. Tom Stanley, said Wednesday that the stories “make us feel a lot of urgency this year to really act on the full spectrum of care.”

“My co-chair and I have talked about how this is going to be the year for action on the continuum of care, and so I look forward to moving many bills and many budget items that will help us provide good care and a living wage for the people who care for us,” the Somerville Democrat said.

The committee advanced no legislation Wednesday but heard testimony on 18 bills related to nursing facilities and rest homes, including a bill (S 414/H 727) that Jehlen filed with Rep. Ruth Balser. The multi-faceted bill, which is backed by AARP Massachusetts, would up the minimum number of hours of care per resident per day from 3.5 to 4.1, require nursing facilities to have outbreak response plans, develop a pathway to single-occupancy rooms, and increase staff training through career ladder programs.

“We put a lot of trust into our nursing homes to provide care for our family members, and there needs to be some type of improvement, there needs to be some education and training around how to treat patients like my brother,” Benetta Kuffour told the committee.

Kuffour’s brother, AB, had been a quadriplegic since 2012 and often got urinary tract infections. Due to COVID-19 restrictions and staffing issues, she said, her brother stopped receiving home care through the Veterans Health Administration and was moved to a nursing home in Worcester in November.

In April, AB died of sepsis at the age of 73 after telling his sister that he was very sick, was seeing things and felt “really, really loopy.” Kuffour said her brother, when he lived alone, would call an ambulance for himself if a UTI was getting out of hand but “didn’t have the option to make that decision” while he was in the nursing home.

“The limited staff at the nursing home was not able to address the conditions that he was experiencing or the symptoms that he was experiencing. The nursing home was understaffed, they delayed in transferring him to the hospital because the nurse practitioner was not available. There were times when he was ignored, and even I was ignored,” she said. Kuffour added, “There was not enough staff to take care of him. I believe the staff are overwhelmed and underpaid … I believe had he received the treatment he needed, he would still be alive today.”

Candi Hitchcock told the committee about her significant other, John, who lived at a rehab and nursing center in Gardner for more than two years. In January, after not hearing from John for a week, she said she got a call from the facility “telling me, ‘he’s failing fast, we’re considering sending him to the hospital.'”

“I had no idea what this nurse was talking about. She asked me, ‘Is this the first time that you have gotten a phone call since he’s been sick?’ Sick with what, I said,” Hitchcock told lawmakers.

John had COVID-19, though Hitchcock said no one was able to tell her when he first became sick and later learned he had been treated in the nursing home for 10 days.

“Within the hour, I received the phone call that no one ever wants to receive,” she said. “It was the emergency room physician’s assistant. It was the dreaded words, ‘I’m sorry to inform you…’.”

Through May, at least 6,204 residents of elder facilities in Massachusetts had died of COVID-19, according to the Department of Public Health’s monthly aggregate report. At one point, the state counted more than 9,000 COVID-19 deaths among long-term care facility residents but later changed how it counted those deaths — a change that reduced the number of deaths the state considered official nursing home COVID-19 deaths by about 40 percent to about 5,502.

“We cannot and will not allow these COVID-19 deaths to be ignored as mere statistics,” AARP Massachusetts President Sandra Harris said. “These deaths represent mothers, fathers, grandparents, siblings, and spouses with families that love them.”

While no one spoke in direct opposition to the Jehlen/Balser bill during Wednesday’s hearing, Massachusetts Senior Care Association President Tara Gregorio urged the committee to keep in mind the burden that the bills before them could place upon the senior care industry.

“While we agree in concept with many, most in fact, of the ideas contained in the proposals before the committee … we do, however, have a strong objection to and concern that, combined, these bills as drafted would impose over $1 billion in unfunded mandates on a sector that is teetering on the verge of financial collapse,” she said, citing an annual gap of $175 million between state funding, and the cost of providing quality nursing home care.

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