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COVID-19: Cascading Problems at Nursing Homes

Published Thursday Apr 2, 2020

Author David brooks, Concord Monitor staff

GSNC LogoThis story is being shared by partners in The Granite State News Collaborative. For more information visit collaborativenh.org.

The mail is taking a day or two longer to get to residents at Woodcrest Village in New London these days, but it’s not the fault of the Postal Service.

“We keep all mail and packages quarantined outside for 48 hours because we don’t have the cleaning products to wipe them down. We’re running out of cloth wipes, and I think we’re down to two cans of Lysol,” says Bethany Brenner, executive director of the 44-unit facility, which was started by her mother in 1989.

That’s the least of their worries, however. The facility is running out of protective gear like gowns and masks that the staff needs when dealing with residents who have symptoms of COVID-19 – including the 11 residents who live in the memory care unit and can’t always understand what is happening.

“We were having a meeting discussing this. The health services director said the gowns have to be a moisture barrier, so you can’t just use paper. … But we just received a bunch of paper tablecloths that have a plastic barrier; I said, ‘maybe if we start duct-taping them, we can use them as gowns,’” Brenner said on Wednesday. “We’ve resorted to eBay, wherever we can get anything. We went online to order welder face shields.”

At the heart of their problem is the lack of tests to know who actually has COVID-19 and who has only an unrelated cough and fever. Without that knowledge, they have to assume that every person with symptoms is “a positive” – infected with coronavirus – and act accordingly. That means wearing clean masks, gloves, and gowns for the many daily interactions necessary with residents, especially Alzheimer’s patients. 

“We had a supply of equipment and at the time, it seemed like it was adequate. But the moment you have a positive, every time somebody walks into that room you’re gowning up. That goes through your supply very quickly,” she said. “I don’t even know if we have nine gowns left.”

Until recently, New London Hospital would test people with symptoms, which ruled out false cases. This was part of state guidance to give priority to employees and residents in long-term and assistant-living facilities where an outbreak of COVID-19, which is particularly deadly for the elderly, can wreak havoc.

“Last week we had four instances where four staff members came down with symptoms. They went to New London Hospital and were tested,” and were not infected, said Brenner.

Then, last Friday, the hospital sent an email saying that it no longer had enough tests to help out Woodcrest, and would only test patients staying at the hospital or first responders.

Other facilities have imposed similar restrictions due to limited supplies. That’s even the case with Dartmouth-Hitchcock Medical Center, which recently became the first place in New Hampshire other than the Public Health Laboratory with the expertise to do on-site testing. They don’t have enough of all the various items needed to run the thousands of tests being called for.

On Monday two Woodcrest residents came down with symptoms in the memory care unit. “We called their physicians and said they can’t test them, so what do we do?” Brenner asked.

Brenner, who said she doesn’t like to take no for an answer, began rattling cages. She reached out to U.S. representatives and senators and talked to the offices of several of them. Soon after, hospital personnel arrived and did the tests, with negative results.

“Let me be clear, I have no complaint with New London Hospital. They’ve been great, they’ve been helpful, they have been completely supportive. Who I am mad at is people at the national level who are making these things inaccessible to us,” she said.

Staffing at the nursing home, which has about 60 employees, is another issue, since they can be indirectly tainted by family members.

“The business manager, her son has a sore throat and I said you can’t come in for 14 days. if her son could be tested, we could bring her in,” Brenner said.

“The reality is most long-term care facilities are teetering on having enough staff on a good day,” she said. “Having to pull somebody off for half a month is devastating, especially when it happens on an overnight shift. Good luck finding somebody to work that.”

Brenner has worked at the facility, which was started by her mother, who was a nurse, since she was 12 years old. She said the only bright spot is how staff and residents are responding. She pointed to an email from one resident who responded to a family member’s query by saying she was “great.”

“There’s an entire tornado spinning around this building. For our residents to smile and say they’re doing great means the staff is doing an amazing job,” Brenner said.

(David Brooks can be reached at 369-3313 or dbrooks@cmonitor.com or on Twitter @GraniteGeek.)

These stories are being shared by partners in The Granite State News Collaborative. For more information visit collaborativenh.org

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