Coverage of novel coronavirus is supported by the Mick Hitchcock, Ph.D., Project for Visualizing Science, a science reporting project from the Reynolds School of Journalism.
The COVID-19 pandemic has disproportionately affected those living in long-term care facilities nationwide. In most states, at least a third of deaths are in those hotspots. And in Washoe County, the deaths associated at these centers account for more than half of the 48 total deaths so far.
KUNR’s Anh Gray reports that the pandemic exposes some particular vulnerabilities for older adults.
Twenty-five residents and two staff members at long-term care facilities in Washoe County have died from COVID-19. That’s according to a state database as of May 18. Those facilities include various types of care, like behavioral inpatient, assisted living and skilled nursing.
Dr. Mordechai Lavi is an assistant professor with the University of Nevada, Reno School of Medicine and specializes in geriatric care.
"Those facilities are vulnerable because of just the way that people are living in close quarters,” Lavi said, “and often they share communal dining areas and communal activity areas.”
The Centers for Disease Control and Prevention recommended canceling all group activities and communal dining at long-term care facilities, along with other safety measures.
Nationwide, many of these residential communities continue to be hotspots. NPR reported recently that for most states, at least a third of COVID-19 deaths are in long-term care facilities. In Washoe, that percentage is much higher.
And some Washoe County facilities have been especially affected. One in particular, Lakeside Health and Wellness, a skilled nursing facility for post-hospital care in Reno for people of various ages, accounts for more than forty percent of the Washoe County COVID-19 deaths.
On Sunday, Washoe County saw the biggest one-day spike in confirmed cases — 54 reported in one day. Health officials said that’s partly due to increased testing. And nearly half of the people were from one facility, Arbors Memory Care in Sparks, a state-licensed facility for seniors with Alzheimer’s and other dementias. Three residents have died.
There have been reports of various issues at long-term care facilities nationwide. In Washoe, KUNR has reported that at Willow Springs Center, a behavioral and mental health treatment facility for children and teens, and Lakeside, there has been a shortage of personal protective equipment, or PPE, and limited staffing.
Peter Reed is the director for UNR’s School of Medicine Sanford Center for Aging and a public health gerontologist.
“When it's something that went wrong, not in one institution, but in dozens or hundreds around the country,” Reed said, “it's clearly a much bigger issue than any decision that a single administrator made within a single nursing home in Reno.”
So far, there have been confirmed cases at 15 long-term care facilities in Washoe. Reed said older adults have been disproportionately affected because of higher risk factors.
"In large part because of underlying chronic conditions. Things like diabetes, hypertension, heart disease, the virus creates a bigger impact on people with those kinds of conditions,” Reed said, "and therefore, as the age increases, then there's a higher likelihood of mortality or severe illness.”
Those risk factors combined with communal living have led to deadly consequences.
“When you bring those things together, a group of older people who live in an assisted living or skilled nursing home, are people who have pre-existing chronic conditions and dementia and vulnerabilities in terms of their health in general,” Reed said, “then couple that with their predisposition towards more severe consequences, then these become hotspots.”
The CDC has also recommended that long-term care facilities enforce a no visitors policy, but Reed said it’s still difficult to entirely shield the community from infections.
“You have the staff who are coming and going, right? So they're going out into the community or into their homes and then coming back into the nursing home or assisted living community,” Reed said, “and they're in that way, they're sort of creating this flow of interactions across the community and then bringing in them into a setting that has a large group of people. That doesn't have to do with the fact that they're older adults.”
For those who wish to age at home instead, Reed said the pandemic exposes a larger societal problem, which is the lack of support available to those who want an alternative to long-term care facilities. He would like to see more investments and policies target those who wish to remain at home.
Cheyenne Pasquale is with Nevada’s Aging and Disability Services Division. She said the rapid response network, the Nevada Care Connection Resource Center, is a service available to help older adults and those with disabilities navigate solutions to meet their long-term care needs.
“We have some individuals [who] have long-term care needs to stay at home. They want to delay or prevent moving into a long-term care facility,” Pasquale said,” and we have other individuals where they are getting to a point in their life that long-term care facility is the option that they want to pursue."
Pasquale said there are nearly half a million older adults statewide, and during the pandemic, she’s seeing a higher number of people who are at home reaching out to the state for help with food or medication assistance, or other needs like transportation.
“There are many more people trying to access the Nevada Care Connection system, reaching out for assistance, that typically wouldn’t have reached out for assistance,” Pasquale said, “but because of changes in social distancing, or changes in their health care, or changes even in their employment, they’re now reaching out for assistance.”
The rapid response program, which has been around before the pandemic, has seen a 55% increase in requests for assistance over the last two months, Pasquale said. As a result of increased need, the state agency recently received a federal grant of close to $500,000 during the crisis.
To support seniors at long-term facilities, the American Association for Retired Persons is urging elected officials to protect older adults by ensuring facilities have PPE, increasing testing, and pushing for more adequate staffing. In addition, federal authorities are now mandating that nursing homes report COVID-19 infections to the CDC.
Editor's note: The image of Lakeside Health and Wellness included in this story is a screenshot from Google Maps. View this map. This story was also updated on May 19, 2020, to include audio.