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She’s Alone, 105 and in a Nursing Home Threatened by the Virus She’s Alone, 105 and in a Nursing Home Threatened by the Virus
(6 days later)
For five years, twin sisters in Brooklyn have visited their 105-year-old mother every night in her nursing home, bringing dinner and feeding her, overseeing her medications. That stopped two weeks ago, when nursing homes barred visitors to keep out the coronavirus. Now the sisters have no idea what condition their mother is in or whether anyone is taking care of her.For five years, twin sisters in Brooklyn have visited their 105-year-old mother every night in her nursing home, bringing dinner and feeding her, overseeing her medications. That stopped two weeks ago, when nursing homes barred visitors to keep out the coronavirus. Now the sisters have no idea what condition their mother is in or whether anyone is taking care of her.
“We don’t know how she’s going to survive this,” said Gerry Baker, one of the sisters. “When we couldn’t see her, it felt as if my mom had transitioned and we were waiting to have the funeral.”“We don’t know how she’s going to survive this,” said Gerry Baker, one of the sisters. “When we couldn’t see her, it felt as if my mom had transitioned and we were waiting to have the funeral.”
New York’s nursing homes have long been chronically understaffed, leaving family members to fill critical gaps, from feeding their relatives to checking for bedsores or infection. Now those family members are barred from entry, and existing workers are getting sick, quarantined or quitting because the work has become too dangerous.New York’s nursing homes have long been chronically understaffed, leaving family members to fill critical gaps, from feeding their relatives to checking for bedsores or infection. Now those family members are barred from entry, and existing workers are getting sick, quarantined or quitting because the work has become too dangerous.
At the same time, some nursing homes say they cannot get the protective equipment they need because it is going to hospitals. At ArchCare, which runs five nursing homes,, workers wear rain ponchos and beauticians’ gowns. By Sunday the five homes had around 150 cases of Covid-19, and a number of deaths, said Scott LaRue, the president.At the same time, some nursing homes say they cannot get the protective equipment they need because it is going to hospitals. At ArchCare, which runs five nursing homes,, workers wear rain ponchos and beauticians’ gowns. By Sunday the five homes had around 150 cases of Covid-19, and a number of deaths, said Scott LaRue, the president.
“I can't test, I don’t have PPE,” he said, using the acronym for personal protective equipment. “What am I supposed to do?”“I can't test, I don’t have PPE,” he said, using the acronym for personal protective equipment. “What am I supposed to do?”
The coronavirus is pushing what was once a problem toward a crisis.The coronavirus is pushing what was once a problem toward a crisis.
“Coronavirus in a nursing home,” Gov. Andrew M. Cuomo said on Sunday, “can be like fire through dry grass.”“Coronavirus in a nursing home,” Gov. Andrew M. Cuomo said on Sunday, “can be like fire through dry grass.”
In New York City, nursing homes account for one in four coronavirus deaths.In New York City, nursing homes account for one in four coronavirus deaths.
Nearly 1.5 million Americans live in nursing homes.Nearly 1.5 million Americans live in nursing homes.
Depleted staffs means more residents per worker — and also more room for error or neglect, less time to fully scrub between residents and greater opportunities to carry the virus from one room or wing to another.Depleted staffs means more residents per worker — and also more room for error or neglect, less time to fully scrub between residents and greater opportunities to carry the virus from one room or wing to another.
In understaffed homes, “people are not getting medication when it’s needed, are waiting a long time for diaper changes or other hands-on care,” said Susan Dooha, executive director of the Center for Independence of the Disabled, NY. “This was a problem before, but the current pandemic throws it into high relief.”In understaffed homes, “people are not getting medication when it’s needed, are waiting a long time for diaper changes or other hands-on care,” said Susan Dooha, executive director of the Center for Independence of the Disabled, NY. “This was a problem before, but the current pandemic throws it into high relief.”
Michael Balboni, executive director of the Greater New York Health Care Facilities Association, an industry trade group, acknowledged that absenteeism has increased, but said that it had not affected care.Michael Balboni, executive director of the Greater New York Health Care Facilities Association, an industry trade group, acknowledged that absenteeism has increased, but said that it had not affected care.
“A lot of facilities are developing an incentive program to get people in,” or are bringing in workers from outside agencies, he said. “There are call-outs happening but we’re still providing care. But we are concerned about this.”“A lot of facilities are developing an incentive program to get people in,” or are bringing in workers from outside agencies, he said. “There are call-outs happening but we’re still providing care. But we are concerned about this.”
Many family members declined to come forward about their complaints for fear of retaliation against their relative.Many family members declined to come forward about their complaints for fear of retaliation against their relative.
For Marjorie Fox, who visited her mother, Florence, 98, almost daily at Sapphire Nursing and Rehab in Goshen, N.Y., all of her aggravations with the home have heightened now that she cannot see her mother.For Marjorie Fox, who visited her mother, Florence, 98, almost daily at Sapphire Nursing and Rehab in Goshen, N.Y., all of her aggravations with the home have heightened now that she cannot see her mother.
Sapphire has just a one-star rating, the lowest, from Medicare. “It worries me, that something has happened and they didn’t tell me,” she said, “like they changed her medications and didn’t tell me.”Sapphire has just a one-star rating, the lowest, from Medicare. “It worries me, that something has happened and they didn’t tell me,” she said, “like they changed her medications and didn’t tell me.”
The older Ms. Fox has Alzheimer’s disease and is largely unresponsive. Even before the epidemic, she had chronic bedsores from not being moved often enough. “There are some very fine people there, but not enough of them,” her daughter said.The older Ms. Fox has Alzheimer’s disease and is largely unresponsive. Even before the epidemic, she had chronic bedsores from not being moved often enough. “There are some very fine people there, but not enough of them,” her daughter said.
Especially in facilities where residents do not have telephones, families say they have no way to know whether their relatives are still healthy, whether the virus has affected their neighbors or aides, or what steps the homes are taking to protect them.Especially in facilities where residents do not have telephones, families say they have no way to know whether their relatives are still healthy, whether the virus has affected their neighbors or aides, or what steps the homes are taking to protect them.
“They’re completely understaffed, and the staff is running from resident to resident, and they don’t have time to wash their hands,” said Toby S. Edelman, senior policy attorney at the Center for Medicare Advocacy, a national group. “For some residents, family members are the unpaid caregivers.”“They’re completely understaffed, and the staff is running from resident to resident, and they don’t have time to wash their hands,” said Toby S. Edelman, senior policy attorney at the Center for Medicare Advocacy, a national group. “For some residents, family members are the unpaid caregivers.”
With hospitals scrambling to make room for Covid-19 cases, nursing homes may face even higher risks. Last week the state health department instructed nursing homes to take back any hospitalized residents who are medically stable — even those with Covid-19.With hospitals scrambling to make room for Covid-19 cases, nursing homes may face even higher risks. Last week the state health department instructed nursing homes to take back any hospitalized residents who are medically stable — even those with Covid-19.
Staffing at nursing homes has been in a crisis for some time now, especially as for-profit chains have bought up nonprofit facilities. In New York, which has no minimum staffing requirements, the federal Centers for Medicare and Medicaid Services rated nearly three-quarters of the homes in the city “below average” or “much below average” for staffing, according to a 2019 analysis by City Limits.Staffing at nursing homes has been in a crisis for some time now, especially as for-profit chains have bought up nonprofit facilities. In New York, which has no minimum staffing requirements, the federal Centers for Medicare and Medicaid Services rated nearly three-quarters of the homes in the city “below average” or “much below average” for staffing, according to a 2019 analysis by City Limits.
Low staffing means more citations for infections, which kill as many as 380,000 residents a year, according to the Centers for Disease Control and Prevention.Low staffing means more citations for infections, which kill as many as 380,000 residents a year, according to the Centers for Disease Control and Prevention.
None of this is a surprise to Gerry and Audrey Baker, whose mother, Grace Marie Baker, 105, is in the Crown Heights Center for Nursing and Rehabilitation in Brooklyn, part of the for-profit Allure Group, which made headlines in 2016 for its role in the closing of a nonprofit nursing home on Manhattan’s Lower East Side.None of this is a surprise to Gerry and Audrey Baker, whose mother, Grace Marie Baker, 105, is in the Crown Heights Center for Nursing and Rehabilitation in Brooklyn, part of the for-profit Allure Group, which made headlines in 2016 for its role in the closing of a nonprofit nursing home on Manhattan’s Lower East Side.
Updated June 16, 2020 Updated June 22, 2020
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
The Bakers have not seen their mother for two weeks. “We don’t know how our mother is surviving day-to-day,” said Gerry Baker. “We don’t know what medications she’s getting, if any.”The Bakers have not seen their mother for two weeks. “We don’t know how our mother is surviving day-to-day,” said Gerry Baker. “We don’t know what medications she’s getting, if any.”
Medicare rated the home “below average” for staffing and registered nurse staffing.Medicare rated the home “below average” for staffing and registered nurse staffing.
Overall the home received four stars out of five.Overall the home received four stars out of five.
“When we left her March 13 she wasn’t sick,” Audrey Baker said, “but there’s so many people coming in and out, we have no clue what our mother’s health status is.” On a video call with their mother arranged by a staff member, they said she looked dehydrated and disconnected. “She was calling out, Where are my daughters?” Audrey Baker said.“When we left her March 13 she wasn’t sick,” Audrey Baker said, “but there’s so many people coming in and out, we have no clue what our mother’s health status is.” On a video call with their mother arranged by a staff member, they said she looked dehydrated and disconnected. “She was calling out, Where are my daughters?” Audrey Baker said.
The sisters said that until the lockdown they took their mother to doctors’ appointments, washed her clothes and planned her wardrobe for the week. Often they found too few aides to cover the floor, Gerry Baker said.The sisters said that until the lockdown they took their mother to doctors’ appointments, washed her clothes and planned her wardrobe for the week. Often they found too few aides to cover the floor, Gerry Baker said.
“I walked in one night and there was a man on the floor, who fell off wheelchair. No one saw or heard him. I called for help.”“I walked in one night and there was a man on the floor, who fell off wheelchair. No one saw or heard him. I called for help.”
In a statement, the home responded: “The health, safety and well-being of our residents is always our top priority, especially so during the Covid-19 pandemic.” Though employees have called out from work, others have filled in or worked extra shifts, keeping the ratio of staff to residents constant, the statement said. “We’re following all guidelines issued by the D.O.H. and C.D.C. and remain in constant communication with families.”In a statement, the home responded: “The health, safety and well-being of our residents is always our top priority, especially so during the Covid-19 pandemic.” Though employees have called out from work, others have filled in or worked extra shifts, keeping the ratio of staff to residents constant, the statement said. “We’re following all guidelines issued by the D.O.H. and C.D.C. and remain in constant communication with families.”
At Beechtree Center for Rehabilitation & Nursing in Ithaca, N.Y., which residents have described as a “ghost town” when the staff clears out on weekends, Mitzi Jones said she fed her husband and changed his diaper almost every time she visited. “He broke his hip last September, and I’m trying to keep some weight on him so he has a fighting chance.”At Beechtree Center for Rehabilitation & Nursing in Ithaca, N.Y., which residents have described as a “ghost town” when the staff clears out on weekends, Mitzi Jones said she fed her husband and changed his diaper almost every time she visited. “He broke his hip last September, and I’m trying to keep some weight on him so he has a fighting chance.”
Like the others, she faced the prospect of her loved one dying alone, without the care or comfort she could provide.Like the others, she faced the prospect of her loved one dying alone, without the care or comfort she could provide.
For now, she arranged for someone from the family to stand outside his window and wave to him every day. For all her concerns, she said, “at this point he is alive and in reasonably good spirits when we see him.”For now, she arranged for someone from the family to stand outside his window and wave to him every day. For all her concerns, she said, “at this point he is alive and in reasonably good spirits when we see him.”
Most days she cannot reach the facility by telephone, she said, taking care not to blame the staff.Most days she cannot reach the facility by telephone, she said, taking care not to blame the staff.
“These people don’t get paid a lot of money,” she said. “It’s like child care. We entrust our elders to people on the lowest end of the pay scale. And they do a big job.”“These people don’t get paid a lot of money,” she said. “It’s like child care. We entrust our elders to people on the lowest end of the pay scale. And they do a big job.”