Ellen Taylor used to envision moving into a nursing home or assisted-living facility in Naples, Florida, when she got a bit older, in part because she’s divorced and her daughters don’t live nearby.
“But the pandemic changed that,” the 75-year-old said last week.
Some older Floridians, like Taylor, are reconsidering where they should spend their later years after watching residents of long-term care facilities go through a wrenching year of isolation and coronavirus outbreaks.
As of March 12, 10,727 residents of nursing homes and assisted-living centers had died from the coronavirus, making up about a third of the state’s 33,120 deaths, according to the Florida Department of Health data.
The pandemic has forced a conversation about the state’s aging population and the best way to care for seniors.
The pandemic created new problems, said Jeff Johnson, state director for AARP Florida, but also exacerbated existing ones — inadequate staff training and management in care facilities and a shortage of community services for those who remain at home.
Over the next five years, Johnson hopes the state Legislature will fund more home- and community-based care, and add new types of long-term care to the mix.
“We need the Legislature to step up and show the creativity and courage of developing a new vision,” he said. “And they didn’t do that this year, at least not so far.”
Johnson’s team opposes a bill that would allow personal care attendants to work for up to four months before completing their eight hours of training. AARP Florida also opposes Senate Bill 72, which passed that chamber on Thursday and would grant immunity from COVID-19 lawsuits to businesses and health care providers, including nursing homes.
“What you really need is to start funding solutions, because they’re out there,” he said. “When you come out of a tragedy, it’s an opportunity to rethink things. I think this is a golden opportunity.”
AARP Florida launched a campaign in January calling for “a new vision for long-term care.”
The plan proposes the state fund more home- and community-based services and encourage less-crowded group living arrangements. It also says that taxpayers should not fund poor-quality long-term care.
“We would argue that those lobbying for immunity from lawsuits for negligent facilities are defacto saying it’s okay for the state and federal governments to pay for poor (quality) care,” Johnson said.
The Legislature remains committed to “every opportunity to maximize people’s ability to stay at home and get treatment at home as long as possible,” said Sen. Jeff Brandes, R-St. Petersburg, who sponsored the immunity bill. “In the future it’s really an appropriations issue.”
Steve Bahmer is president and CEO of LeadingAge Florida, which has 250 long-term care communities. Many of its facilities operate with higher levels of staffing than required, Bahmer said.
During the pandemic, they created COVID-19 wings, screened staff and doled out personal protective equipment, Bahmer said. They were spacing out residents among private or semi-private rooms before the pandemic and will continue to do so.
“We are supportive of efforts to make sure that there are incentives and accountability for investing in care,” Bahmer said. “There is no justification for providing substandard or subpar care in the long-term care environment.”
Moving toward private and semi-private rooms will place financial pressure on the facilities, who will fund the shift with increases in fees unless the state steps in with funding, wrote Nick Van Der Linden, spokesman for the group, in an email.
Alternative senior-living communities, such as Village On The Isle in Venice, Florida, implemented some of the AARP guidance, said CEO Doug Feller, such as flexible meal and medicine schedules.
Of the facility’s 450 residents, it has reported only nine coronavirus cases, he said. Feller credits the facility’s private rooms broken into ‘households’ of 16 residents for the low case numbers.
“From an infection-control standard you can’t beat it,” he said.
The pandemic revealed flaws in infection control at long-term care facilities, said Lindsay Peterson, research assistant professor of aging studies at the University of South Florida.
“I think the regulators are going to start looking harder at infection control all the way around, and nursing homes are going to be under more pressure,” she said. Staffing shortages also persist, she said, and more staff members may choose to leave after such a harrowing year.
Home health services were becoming more popular before the pandemic and might be considered more in the future, she said.
“A lot of time will be spent looking at what worked and didn’t work,” Peterson said. “There will be some good information to come out of this.”
For Ellen Taylor, Collier County provides services that would allow her to keep living in her apartment affordably and safely, she said. Each day, she receives a hot lunch delivered to her complex. She can walk to her doctor’s office down the street or get a ride on the bus when she’s no longer able to drive.
“For me, I feel it is best to age in place,” Taylor said.
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