In a policy brief published today in its namesake journal (DOI: 10.1111/jgs.16477), the American Geriatrics Society (AGS) offered a road map to guide federal, state, and local governments addressing COVID-19 concerns for a critical--and critically impacted--group: Older adults in nursing homes and long-term care. The brief outlined recommendations based on the latest research and guidance, encompassing actions on resource needs, patient transfers, priorities for public health, and opportunities to better empower health workers on the frontlines of COVID-19 care.
"As we've already learned, outbreaks in nursing homes are a foreseeable consequence of this pandemic, even with experts working as valiantly as they are," notes AGS president-elect Annie Medina-Walpole, MD, AGSF. "We hope this brief can help policymakers, advocates, and clinicians look at but also beyond the circumstances we can control--and those we can't--to prioritize the innovation, collaboration, and compassion that can put key patients and public health first. That's a cardinal direction for planning in crisis and in calm, for nursing home residents but also for us all as we age."
More than 15,000 nursing homes care for the oldest and most chronically ill Americans, who are also among the most susceptible to COVID-19 and its complications. In reviewing existing research and recommendations, the AGS suggested orienting expertise towards several focal points where tangible action can make a difference:
The AGS called for President Trump to exercises his full authority under the Defense Production Act so the U.S. can move quickly to increase production and distribution of important supplies. These include personal protective equipment and COVID-19 tests, but also supplies for symptom management and end-of-life care.
The AGS reinforced the importance of carefully considering transfers between nursing homes, hospitals, and other care settings. AGS experts noted, for example, that individuals who test positive for COVID-19 should not be discharged to a nursing home unless the facility can safely and effectively isolate the patient and implement adequate infection control for staff and residents. The AGS also urged the Centers for Disease Control and Prevention to develop guidance regarding transfers to emergency departments, where direction is still needed.
According to AGS experts, more also must be done to integrate key players in public health. These include geriatrics and palliative care experts with the requisite skills in advanced illness care, but also nursing home administrators and those with experience in local coordination and data analysis, which must include information from nursing homes--a key to confronting COVID-19 in communities across the U.S.
The AGS also reinforced the importance of supporting health professionals, our nation's frontline defense for treating and preventing the spread of COVID-19. The AGS encouraged Congress to advance paid family, medical, and sick leave for the whole health workforce, for example, while also enhancing COVID-19 screening and training to protect staff availability.
Finally, as part of ongoing efforts to protect America's economy, the AGS reminded legislators to consider the value of supportive tax relief and payment opportunities targeting long-term care. The Centers for Medicare and Medicaid Services (CMS), for example, should ensure payment to nursing homes caring for residents with COVID-19 can meet the costs of enhanced precautions, just as Congress should also structure tax relief to support nursing home employers and the nurses, therapists, and direct care workers who care for older adults.
The AGS policy brief is available with free access from the Journal of the American Geriatrics Society (JAGS), which also issued its own call for COVID-19 scholarship to undergo expedited review and publication. AGS updates, including work on clinical practice, public policy, and public and professional education, will be posted to the Society's COVID-19 information hub at https://www.americangeriatrics.org/covid19.
Source: American Geriatrics Society