Elder-care facilities keeping their fingers crossed and COVID cases surge

LACONIA — While there have been 2,558 coronavirus cases statewide among those living in long-term care facilities, until October rest homes in the city had managed to remain COVID-free.

The Belknap County Nursing Home learned a month ago that one resident had tested positive for COVID-19. The facility immediately went to the highest level of restrictions, which resulted in the immediate cancellation of inside visits and all resident activities, including the opportunity for residents to take their meals in the dining room.

That resident has since recovered, according to Shelley Richardson, the nursing home’s administrator. And now the restrictions have been eased somewhat, though they are more strict than before the October infection occurred.

Administrators believe that scrupulous adherence to COVID safety precautions such as the wearing of face masks and other personal protective equipment, and enhanced sanitation procedures, frequent health screening for residents and staff, and minimizing any close personal contacts with residents have been key to keep the number of positive cases to date so low.

“You can’t take any shortcuts … you have to be more attentive to infection control,” Richardson said of the need to strictly adhere to all precautions.

Richardson was quick to stress, however, that this is not meant to suggest that facilities where more infections have occurred have not been adhering to the precautions just as carefully.

The risk of contracting the coronavirus appears no higher for people over 65. But for those who do become infected with the virus, their less robust immune systems make it harder to bounce back from serious infection.

As the number of new COVID cases across the state again rise, it is only a matter of time before even COVID-free facilities have their first case.

“It’s not a matter of if, but a matter of when,” said Michael Flaherty, the president and CEO of the Taylor Community, which so far has had no infections among its 400-plus residents.

But Flaherty noted that, now that the country is six months into this pandemic, those who care for the elderly have much better guidance on ways to minimize the chances of residents becoming infected. They also have better procedures for how to care for any residents who might contract the virus.

St. Francis Rehabilitation and Nursing Center, which also to date has had no COVID cases, has been relying on guidance from the federal Centers for Disease Control, the Center for Medicare & Medicaid Services, and the World Health Organization, according to information posted on the center’s website.

At present, St. Francis is conducting weekly testing of 10 percent of its 51 residents and 10 percent of its staff.

In addition St. Francis, like the other centers, is screening staff members frequently for various health signs, such as temperature and respiratory signs, which might indicate potential COVID symptoms.

While the Belknap County Home and St. Francis operate as conventional nursing homes, at Taylor Community the majority — 75 percent — of the residents live independently, either in cottages or apartments.

After going through a total lockdown of the campus which lasted for three months over the spring, independent residents are now able to come and go as they please, as well as have visitors. However, those visitors must stop at a checkpoint at the entrance to the campus to answer health-screening questions as well as have their temperature taken. Those visitors are required to go directly to the resident’s cottage or apartment and they are not permitted to interact with any other residents.

Visits to those living in the community’s assisted living and nursing facilities are more restrictive, Flaherty said. Visitors can have window visits where they can talk with a resident on a speaker-assisted cellphone. Those who visit face-to-face inside either of the licensed facilities must wear full PPE and the visitors and residents are not allowed to touch each other.

Window visits are also available at the County Home and St. Francis. In-person visits need to be arranged in advance and the availability of them is limited to certain days and times.

Flaherty said that with the varying degrees of restriction which residents have been living under for six months-plus, COVID fatigue is beginning to set in.

“We’re living much differently,” he said. “These restrictions are not instinctual. They wear on residents and their families.”

For the Belknap County Home’s Richardson, one aspect of COVID fatigue that concerns her is in the challenges that living amid the uncertainties of the pandemic is having on staff members.

The home is currently operating at 79 percent of its capacity of 94 beds because COVID-related uncertainties — having to stay home to care for an elderly family member or because a child is suddenly switched to remote learning — can raise havoc with staffing levels at the home.

“I lost four people in one day,” Richardson said. “If you lose five people (all of a sudden) you could lose a whole shift.”

Flaherty said that because of the greater knowledge health experts have gained about the coronavirus since March, if Taylor has to shift to more restrictive measures in the coming weeks or months, those steps would not be as prolonged as earlier ones.

He said a COVID-positive case among Taylor Community’s independent population would result in a lockdown of the facility, but that lockdown would be far shorter than the three-month isolation period in the spring.

“We’re taking a balance approach,” Flaherty said. “We don’t need to be afraid of the virus, but we need to respect it.”