Quality in Nursing Center Care

A blog for and about The Joint Commission’s Nursing Care Center Accreditation Program.

Meeting Needs in Nursing Homes During COVID-19

04/28/2020

As we discussed in the last blog post, social distancing goes against everything we’ve been taught about caring for our residents in nursing homes.

Though life as we know it has done a 180 degree change from the beginning of the year, there are some steps we can take to make this time less stressful for residents, not to mention staff.

Maintaining Family Contact
One of the most difficult aspects of the COVID-19 pandemic has been the ban on nursing home visitors. Although it makes sense from a public health perspective, it is heartbreaking for residents.

Nothing can replace face-to-face contact but there are alternatives that can help residents maintain connections with their loved ones. Below are some tried-and-true tips:

  • Encourage outside window visits and provide walkie talkies, if possible.
  • Facilitate daily or more frequent phone calls (with or without staff help). Some facilities are scheduling times for residents to call their families.
  • FaceTime on phones or iPads. Skype is another great alternative.
  • Support letter writing and written communication.

Increasingly, nursing care centers are establishing their own Facebook presence and posting pictures of residents. Just make sure you’re HIPPA compliant first!

Hallway Activities
Moving resident engagement activities outside of rooms and into hallways is key right now. Some winning practices in hallways include:

  • Bingo led by any staff member calling numbers out from the middle of the hallway
  • Rehab staff member-led exercise
  • Sit and Be Fit classes
  • Worship sessions led by a hospice chaplain
  • “Reminiscence Group” led by recreation or social work staff
  • Daily sing along in each hallway with songs voted on by residents
  • Creating “Thought of Wisdom for the Day” on handmade paper airplanes and scheduling daily “Flight of all the Airplanes” at a set time by all residents 
  • Outdoor musician performances
  • Museum and art gallery virtual tours
  • World travel via virtual tours

Staff Wellness
It’s understandable that staff stress is also skyrocketing during this difficult time. Mental health experts advice focusing on the “What Is” (which we can control) rather than the “What if” (which we cannot control). 

  • Additional mental well-being tips include:
  • Limit the amount of time spent watching news about COVID-19.
  • Commit to calling one person you care about each day.
  • Exercise regularly—dance to a favorite song, climb stairs, do yoga, walk, hike, or lift weights.
  • Eat right—include fruits and vegetables.
  • Practice good sleep hygiene to avoid sleep disruption. Find a buddy you can call during the night if you find yourself getting anxious.
  • Stay healthy—follow the recommendations of good hand hygiene, social distancing, wearing a mask while out and staying in place as recommended.

Every day brings a new change to the stay-in-place orders. Remember, they will be lifted eventually. When this happens, there will be a new set of guidance to learn and adopt. Stay flexible, remember that every sneeze isn’t necessarily COVID-19 (it’s allergy season too) and keep bringing your best to your residents!

Cheryl S Frenkel, MS, RN, GNP, field reviewer, surveys the standards in the Comprehensive Accreditation Manual/Accreditation Manual for Hospitals, Critical Access Hospitals, and Long Term Care. Prior to becoming a full-time surveyor for The Joint Commission, Ms. Frenkel was CNO at Terence Cardinal Cooke Health Care Center in Manhattan, New York. Ms. Frenkel was also Vice President of Nursing at Bay Care Center in Bronx, New York and the Administrator at Sutton Park Center for Nursing and Rehabilitation in New Rochelle, NY.