Why (And How) You Should Review Care Plans During COVID-19

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

Published on:

The COVID-19 pandemic has thrown people’s lives into turmoil in unexpected ways. It has also shone a very bright light on our aging population. Age is a risk factor for not only contracting the virus but for developing complications and even death. Many senior communities have been disproportionately affected by the virus.

Jump ahead to these sections:

Care plans are developed for the purpose of providing a roadmap to medical and other caregiving staff. During normal times, these care plans were very accessible and provided families with a clear picture of the care their loved ones were receiving. Now, COVID-19 has made that much harder.

If you have someone in congregate senior housing, assisted living, or a nursing home, you have cause for concern. Yet, with some effort, persistence, and patience, you can continue to manage and monitor care.

What is a Care Plan and Where is it Used?

Care plans are developed and used in a wide variety of settings and circumstances. If you have a loved one in assisted living, memory care, or a nursing home, they have a care plan. If your family member is receiving in-home care or home health, they too have a care plan. Every plan will be different and should be individualized and flexible. Care plans include some or all the following:

  • An assessment. A comprehensive care plan can’t be developed without assessing the client or patient. Ideally, this should be done in collaboration with the client themselves. For in-home companies, the assessment may also include specific tasks that have been requested like shopping for groceries or cooking meals.
  • Diagnoses. This includes the person’s medical conditions and any mental health or neurological conditions. All medications will be listed. 
  • Outcomes and goals. These are short and long term. An example would be someone who has a wound and needs immediate and ongoing treatment until it heals. They may also have a heart condition that requires ongoing monitoring with no expectation of recovery. 
  • Interventions. Interventions may need a team approach. Your family member might have a nurse, physical therapist, speech therapist, and an aide. Each person has their own set of interventions based on the assessed need.
  • Advance Directives. Advance directives are required in almost every health care setting. The medical staff needs to know what your wishes are with regard to medical interventions. 
  • Healthcare Proxy. The care plan will have the names of important family members to contact during an emergency and healthcare proxy information. If your loved one isn’t able to make medical decisions, someone needs to fill that role.
  • Personal Preferences. If you have in-home caregivers taking care of a parent or grandparent, the care plan will include personal preferences. Examples include hobbies, food likes and dislikes, places to visit, and times for getting up and going to bed. 
ยป MORE: Grief is never linear. This post-loss checklist is here for you.

 

Why Should You Review Care Plans During the Pandemic? 

The coronavirus pandemic has created an unprecedented and extraordinary set of circumstances for people who are receiving care. Isolation and increased loneliness have been the primary consequence of the pandemic.

Aside from in-home care, congregate senior care communities across the country have been under quarantine with no end in sight. Families aren’t able to visit their loved ones, which has made advocacy very challenging.

Assisted living

  • Most assisted living communities across the country have restricted access to activities and congregate meals. Leaving the community means having to self-quarantine for up to 14 days. Loneliness and isolation are enormous risk factors for depression, and quarantine has increased that risk.
  • Lack of exercise or access to the outdoors can result in a decline in strength and endurance.
  • Some communities are limiting in-home caregivers or home health staff. This can increase health risks.

Nursing homes

Nursing homes have seen a tragic loss of life due to COVID-19. If you have a loved one in a nursing home you are understandably worried about exposure to the virus and the level of care being provided.

  • Nursing homes have a high staff turnover rate, which was an issue even before the pandemic. Staffing levels are generally lower in nursing homes than in other senior care settings. 
  • Poor infection control has been a problem in nursing homes for years.
  • Inadequate testing and very limited personal protective equipment have contributed to an explosion of infections in nursing homes across the country.

In-Home Care and Home Health

With staff coming in and out of someone’s residence weekly and sometimes daily, infection control is critical. Companies across the country have had to supply protective equipment for all their staff and do additional infection control training. 

How to Review and Update Care Plans Right Now

As daunting as the situation may seem, you can take control and advocate for your loved one with perseverance and patience. 

1. Ask to see the care plan

If you can’t review the care plan, you will have no idea about the care your family member is receiving. You will need the authorization to request this information due to HIPPA regulations. If the care plan can’t be faxed to you, ask if you can come by to pick up a copy.

2. Review the care plan 

Care plans can be confusing. If you need help, you may want to reach out to your family member’s physician to ask for clarification. Pay special attention to safety and infection control protocols. If possible, reconcile the care plan with any information you have to make sure everything is correct. 

3. Request COVID-19 safety protocols

Whether your family member is in a nursing home or receiving in-home care, ask for a copy of infection control protocols. These protocols are now the new care plan for virus control. You want to feel confident that every precaution is being taken.

4. Find out who to talk to

It can be very frustrating trying to get through to someone who will listen to your concerns. Don’t give up. Keep going up the chain of command until you find the person who will take your concerns seriously.

If you don’t get the satisfaction you want, call the local Ombudsman, and file a complaint after you have exhausted efforts to get a response. 

5. Write down your suggested changes

As you review the care plan, write down any concerns or changes that you want to recommend. Most people are intimidated by medical professionals. We suggest taking a bold approach that is kind but firm. 

6. Ask specifics about care

The care plan alone doesn’t tell you how your loved one is being treated. Are they getting fed, assistance to use the bathroom, and getting changed? Even though you may not be told the whole truth, the staff knows you are watching and have a vested interest in their care. This can make a significant difference. 

Your family member has specific preferences or might be struggling with loneliness and isolation. Even though healthcare providers are very busy, you may want to mention these preferences and make specific requests to help alleviate boredom. 

Assisted living and home care companies are making an effort to keep people engaged as much as possible. One suggestion is to ask the staff to help your family member access technology so they can connect with you. This not only lifts their spirits, but it also allows you to see first hand how someone looks.

7. Be persistent

Once you have found someone who will listen to your concerns, you need to follow up. Perhaps ask for the updated care plan to make certain your recommended changes were made. If possible, make as many calls as you can until you get answers. 

The same holds true for in-home care. Care plans from in-home care companies can be fairly generic. You may want to ask for the care plan to include more specifics. If you want changes during the course of care, ask for them. Most companies are very willing to make recommended changes.

8. Call the authorities if you need to

If you have made every effort to improve care with no results, you may want to call the Ombudsman program. Ombudsmen are trained to solve problems and advocate for residents.

If you suspect your family member is being neglected or abused, call Adult Protective Services. These calls can be made anonymously.

The problems in nursing homes have come to light due to the diligent and brave voices of  family members. COVID-19 has exposed the weaknesses in senior care and hopefully, changes in the future will keep people safer and happier.   

Reviewing Care Plans During COVID-19

The anxiety of not knowing whether your loved one is being cared for or whether they are being exposed to COVID-19 can be devastating. Control and knowledge can be the best antidotes if you are feeling powerlessness. Take charge with a kind but firm attitude and know that you are doing everything you can to make certain your loved one is safe and well-cared for.


Sources

  1. Kacik, Alex. “Nursing Home Staffing Levels Often Fall Below CMS Expectations.” 1 July 2019. Modern Healthcare. www.modernhealthcare.com/providers/nursing-home-staffing-levels-often-fall-below-cms-expectations
  2. Rau, Jordan. “Coronavirus Stress Test: Many 5-Star Nursing Homes Have Infection Control Lapses. 4, March 2020. Kaiser Health News. khn.org/news/coronavirus-preparedness-infection-control-lapses-at-top-rated-nursing-homes/ 

Icons sourced from FlatIcon.