Nursing homes simply were not ready - Are we prepared to make them better?

Last week the Chicago Tribune reported 286 at nursing homes estimating 25% of our deaths in Illinois at the time. In the general population today it is an estimated 200,000 people worldwide. Considering our interventions out of 8 or 9 billion people those numbers are low compared to what it could've been.

 In the city of Joliet where I live, Symphony had 84 cases, and 24 deaths reported to lead the state. The caregivers at Symphony stated that they had the highest rate of testing in the state. They claim every nursing home needs testing to see what is going on. 

 The New York Times reported from the article 6,900 COVID 19 deaths were tied to nursing homes nationwide. About 20% of all the COVID 19 deaths reported. The State of Illinois has about 23% of those who died of COVID 19. The variance of numbers could be related to the testing done in the state compared to the national average. but a ballpark figure is relatively the same throughout the states. Any state with a higher population is going to have greater numbers. 

 Nursing homes provide a service in our country but they exist to be the lowest cost possible. The cost to the people in the nursing home usually dries up their life savings. If they live longer then projected their resources are less. Caregivers they use don't match the qualifications found in hospitals. Training and in-services do not match the same levels as hospitals. What are our expectations? We have the neediest with fewer resources. What did we expect as an outcome? I know our hospitals weren't ready and I know our nursing homes came into the virus war already stressed, overworked, and undertrained. 

 A reality check as we age our ability to fight diseases lessen. For many people who are older and healthy, 80-90’s it is the flu or other viruses that lead to pneumonia and death. A new virus-like COVID 19 which is a very contagious will, hit heavily in elderly care. 

What can we do?

• All of our retirement plans must invest in nursing home care. 
• We have to encourage qualifications with an incentive for education. I always knew to improve job performance as para pros in education, (they are good people) but to improve work there have to be incentives for education and qualifications. Many para pros in healthcare are there as aids. They are needed, but they need to be educated in qualified as professionals in their work. Nursing homes depend a lot on LPN’s. Their training is about a year unless it's been updated. But they need incentives for education for example level one two and three. Each with training to go with it. Their license may require education units to stay licensed. But these incentives have to be matched with pay. Not a lot of people are going to do this for nothing.
• Maybe it is time for nursing homes to employ physician assistants.
• Nursing homes can develop a mobile virtual assessment cart. Here the Dr. can see the patient and have the necessary vital signs the doctors looking for to help evaluate care. Working with the doctor's assistants, RNs, and staff. Puts the elderly patient in quarantine or even regularly in better contact with the physician. 
• We have on a personal level to expect as we get older will have more health issues. We are not all going to be working on a beach in the Caribbean. 
• I think about veterans in VA homes, many older people in nursing homes are lonely and forgotten. In what I hope is a historical event, not a regular one, we need to prepare virtual visits that we give regularly to the ones we love. Life isn't perfect but there's a lot of things we can do.

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James in Unbelief

Questions, Questions Living with COVID 19

I ran into a line of argument concerning hype and loss of freedom is part of this outbreak? The impact of being confined for part of March and April some states like Illinois possibly going on into May will have many unintended negative consequences of loss of work, school, suicide, abuse. A strong argument for our mitigation actions is the millions of lives saved. The president and team projected 2,200,000 which I believe is a conservative estimate. My estimate was 1% of 350,000,000 or 3.5 million. The actual numbers so far are lower, thank God.
Decisions to save lives will be noble but as we move forward may not be appreciated as we recover to normal. Doctors will soon find lawyers pushing back in the weeks and months ahead. Hype and loss of freedom is part of this discussion. We rarely call the media into account as they move for ratings.  The media will sway with no moral base to wherever the wind may blow.
I want to see ballparks filled again and freedom restored. I am concerned we will lose freedom.
Will steps taken this time to restrict public gatherings be used next time to restrict gatherings those in power oppose? I believe the government acted in goodwill this time but we have to raise 1st amendment rights each time this takes place.  Martial law sometimes comes into place. Here we see it because of medical concerns. Will actions from this point further move in the direction COVID 19 reveals with solid data and knowledge or will it be used to broaden elitist control left or right? Hold to your political beliefs but I encourage thought concerning our basic rights. Mitigation seems most reasonable in regard to lives lost to fight this unseen enemy. It can not sustain us but it seemed wise to apply it. It is my hope we ask a lot of questions and maybe next time we can target our mitigation better.
Was this a created virus by humans? Will terrorists change weapons to bio-weapons after seeing how we reacted and worldwide? I ran into a line of argument concerning hype and loss of freedom is part of this outbreak? The impact of being confined for part of March and April some states like Illinois possibly going on into May will have many unintended negative consequences of loss of work, school, suicide, abuse. A strong argument for our mitigation actions is the millions of lives saved. The president and team projected 2,200,000 which I believe is a conservative estimate. My estimate was 1% of 350,000,000 or 3.5 million. The actual numbers so far are lower, thank God. Decisions to save lives will be noble but as we move forward may not be appreciated as we recover to normal. Doctors will soon find lawyers pushing back in the weeks and months ahead. Hype and loss of freedom is part of this discussion. We rarely call the media into account as they move for ratings.  The media will sway with no moral base to wherever the wind may blow.
I want to see ballparks filled again and freedom restored. I am concerned we will lose freedom. Will steps taken this time to restrict public gatherings be used next time to restrict gatherings those in power oppose? I believe the government acted in goodwill this time but we have to raise 1st amendment rights each time this takes place.  Martial law sometimes comes into place. Here we see it because of medical concerns. Will actions from this point further move in the direction COVID 19 reveals with solid data and knowledge or will it be used to broaden elitist control left or right? Hold to your political beliefs but I encourage thought concerning our basic rights. Mitigation seems most reasonable in regard to lives lost to fight this unseen enemy. It can not sustain us but it seemed wise to apply it. It is my hope we ask a lot of questions and maybe next time we can target our mitigation better.
Was this a created virus by humans? Will terrorists change weapons to bio-weapons after seeing how we reacted worldwide response? If we have the ability to create viruses what will be done in the name of science or defense in the future? Science can be used for good or bad. We have learned that right?
Did we do well regarding the most vulnerable, the aged and those whose health has been compromised?  Did we improve therapy for the people in the nursing home that could help some of these people survive? Were they so weak and aged that this fast-spreading and powerful virus overcome them? Are there times when we are helpless against death? This taps into our greatest fear. We may be so afraid we attack each other and follow unreasonable behavior.
My wife and I have been living with COVID 19. She contacted it helping disabled adults as an RN. After she came down with the virus she was tested with drive-in testing that wasn't even in our county. She tested positive. I came down with flu-like symptoms several days later. When her health improved, I called my doctor had a virtual check-up with him and he agreed I needed to be tested. Because I am not in health-care I was tested at a local hospital drive-in which sends a test to the lab. I am still waiting for the results. As soon as I hear, I will share the results. Questions. The delay in this disease is not good. That is a good question, Can we create lab connections that are faster?
In my next blog, I would like to explore improving elderly care? What are our limits? In a local nursing home, there have been 24 deaths out of 120 people in the home. That is 17% of those in the home. Scary, keep walking

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