Posted on by Brendan Birth

Nursing Homes and the Coronavirus

As my readers know by now, the death toll from the Coronavirus in the United States has been astronomical—heading towards 600,000. Also astronomical is the fact that 182,000 of those deaths, as of April 15th, have happened in nursing homes, whether it be residents or staff.[1] What this means is that over 30% of total deaths reported from COVID-19 in the United States have been related to nursing homes, in spite of the fact that nursing home residents and staff combine for about one half of one percent of the total population in the United States.[2]

But how did we get here, and where do we go from here?

Yes, a high percentage of the population who died from this virus were over the age of 65, and yes, nursing homes have high concentrations of older persons. However, simply attributing what happened during COVID-19 in nursing homes to their having lots of older persons is a copout to me. It is a copout because people involved with nursing homes are dying at a much higher rate than seniors as a whole.[3]

Instead, what we’re dealing with is that too many nursing homes and too many policy decisions related to nursing homes during COVID were/are broken on so many levels. Here are some of the ways in which many nursing homes, as well as many policy decisions around nursing homes, are broken:

  • Understaffed nursing homes
  • Poor quality of care at many nursing homes
  • Nursing home neglect, which stems from the aforementioned two issues
  • Deprioritizing of nursing homes by many government officials
  • Outdated laws
  • Inadequate government oversight (and oversight in general) with nursing homes[4]

The fact that so many deaths happened, and that so many of the deaths could have been avoided with better care from nursing homes and better government oversight of them, is a point of grief, I think. These deaths needn’t have happened. If it is a point of grief for you as it is for me, you might be interested in attending an event on May 20th that will be focusing on honoring nursing home lives.[5]

However, beyond grief there will be a need for significant reforms of our nursing homes—from the way we do (or don’t prioritize) them to the oversight they are given, there is significant need for wholesale changes. They are needed before the next pandemic, because yes, I believe there will be another one at some point. And they are needed so that we can extend and improve the lives of people in our nursing homes.

It’s time to value the lives of people in our nursing homes.

[1] https://www.aarp.org/ppi/issues/caregiving/info-2020/nursing-home-covid-dashboard.html

[2] The total population in the country is just over 330 million people: https://www.census.gov/popclock/. When adding the 1.25 million or so who live in nursing homes (https://www.kff.org/other/state-indicator/number-of-nursing-facility-residents/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D) and the over 600,000 people who work in a nursing home (https://phinational.org/wp-content/uploads/legacy/phi-nursing-assistants-key-facts.pdf), what we’re left with is a group of less than 2 million people that only takes up approximately half a percent of the total United States population.

[3] As of May 4, out of a total senior population of 52.4 million in the United States (https://acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2019ProfileOlderAmericans508.pdf), about 447,000 people over 65 have died (https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm#SexAndAge); this amounts to .8% of the total senior population. On the other hand, there are 180,000 deaths out of 1.85 million (or so) people involved in nursing homes, which means that nearly 10% the total population related to nursing homes have died from COVID. Truly shocking.

[4] Many of these points come from an AARP report on the number of deaths in long-term care due to COVID. Note that the number back in early December, when this piece was written, was “only” just over 100,000: https://www.aarp.org/caregiving/health/info-2020/covid-19-nursing-homes-who-is-to-blame.html 

[5] Disclaimer: I volunteer for the organization that is facilitating the event. Still, since we’re talking about nursing home lives, I think it is worthwhile to note this event. By the way, the event is the inspiration for this post.

15 Replies to “Nursing Homes and the Coronavirus”

  2. This is a huge issue in Canada too. During the worst of the pandemic in Ontario and Quebec the military were called in to asssist because of lack of staff. It was awful and so sad. Really need strict regulations.

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    1. Thanks for sharing your perspective. It’s all the more valuable because where you live, obviously, has a different health care system from what we have here in the states. And yet, in spite of that, it seems like COVID is still a major problem in nursing homes in Canada.

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      1. Hi Brendan. Covid isn’t an issue in nursing homes too much anymore because the elderly were targeted with the vaccine first. In the beginning back in March tho. It was nasty. One of the main issues was staffing and many of the home care staff worked in different facilities so would go back and forth and that’s where much of the spread came from. But if we learned anything it’s that this damn virus doesn’t discriminate.

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  3. As a senior, I’ve made calls to our state’s dept. on aging. Also, it is because I am a client of their community care program to receive homemaker services. What I’ve experienced is humoring and condescending staffers. It is as if they assume that all seniors are senile, complainers, and not worth listening to. I can only imagine that seniors in nursing homes are treated likewise.

    There’s also the rules of Medicare for the number of lifetime days for hospitalizations. When that number has been exhausted, patients are sent to rehab centers or nursing homes. Two years ago, I had a friend who died from COPD because the hospital discharged him to a nursing home. He died 2 days later.

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    1. Thanks for sharing your experiences, Xena. It’s so sad to read about all these experiences, yet simultaneously also so important. I also find it interesting how you note the role ageism has played in your experiences (even if you didn’t necessarily use the word “ageism.”

      I wasn’t aware of that Medicare rule for the number of lifetime days for hospitalizations. I’m going to need to look into that (if nothing else, for the day I’m on Medicare, which is many years away, but still).

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  4. Maximizing profits by risking the health or lives of product consumers will likely always be a significant part of the nature of the big business beast. Therefore, families may still have reason to worry over their loved-ones being left vulnerable by measures taken by some long-term care-home businesses to maximize profits.

    Like with some U.S. states, there was nursing home neglect in Canada before Covid-19, although the actual extent was made horrifically clear when the pandemic really hit. (Resultantly, I must admire some non-Western cultures for their general practice of not placing their aged family members in seniors care homes.) A most morbid example was the CHSLD Résidence Herron long-term care home in Quebec about 11 months ago, where 47 residents perished. The neglect had become so extreme that the Canadian Armed Forces got involved.

    Western business mentality and, by extension, collective society, allowed the well-being of our oldest family members to be decided by corporate profit-margin measures. And our governments mostly dared not intervene, perhaps because they feared being labelled as anti-business in our avidly capitalist culture.

    A common yet questionable refrain prevails among capitalist nation governments and corporate circles: Best business practices, including what’s best for the consumers, are best decided by business decision makers. Clearly evidenced by the many needless care-home deaths, big business does not always practice what’s best for its consumers, including the most vulnerable.

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    1. Thanks for sharing.

      A common thing I’m noticing, reading both comments here and studies into the debacle with so many nursing homes, is that the for-profit “model” with nursing homes is not healthy or good for too many nursing home patients. As it turns out, big business doesn’t always know best. Plus, big business is a lot of times most focused on profits, not on helping people thrive.

      P.S. I assume Canada’s nursing homes are for-profit in many cases as well?

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      1. Thank you for your interesting article and replying to my posted comments. Yes, most Canadian long-term care homes are for-profit businesses, though I don’t know what percentage.

        In regards to the many Covid-19 deaths within them, the most morbid example was the CHSLD Résidence Herron long-term care home in Quebec about 14 months ago, where 47 residents perished. The staff absences and neglect had become so extreme that the Canadian Armed Forces got involved. Not surprisingly, I’ve always admired some non-Western cultures for their general belief in and practice of not placing their aged family members in seniors care homes. As a result, family caregivers don’t have to worry over those loved-ones being left vulnerable by cost-cutting measures taken by some care-home business owners to maximize profits. …

        When it comes to essentially unhindered capitalism, I tend to see corporate heads (figuratively) shrugging their shoulders and defensively saying that their job is to protect shareholders’ bottom-line interests. Meanwhile, the shareholder also shrugs their shoulders while defensively stating that they just collect the dividends and that the corporate heads are the ones to make the moral and/or ethical decisions. And they all repeat the ambiguous and stupid-sounding catchphrase, “It’s the economy, stupid!”.

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      2. Good gosh. This sounds like some of the horror stories here in the U.S.

        I actually think there is potentially a role for good, well-regulated nursing homes. Some people need the sort of extensive care that a good nursing home can provide–care that I’ve seen a few family members and friends get over the years. But the problem is that too many nursing homes are not of a good quality and do not care for their patients. Probably because the primary motive is profits, not patients.

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      3. Big business’s uncompromising big profits: the more they make, all the more they want to make. And that mentality is too often admired in Western society, including by corporate mainstream news-media. I feel there are some institutions that should not be for-profit, let alone profits large enough to encourage some care-home owners to neglect their human residents via budget cuts.

        Whenever I notice there are even fewer tellers serving the usual long line of customers at my bank, I muse as to whether it is indicative that the financial institution’s most recent (already bloated) quarterly profit was even more lavish than normal. I’m just being cynical? Not really; after all, the more we make, all the more we want to make in the next quarterly earnings report. I can imagine, for example, Bell Canada’s corporate culture being at least as bad, considering the jobs and services they cut: “Despite receiving federal wage subsidies worth $123M and raised shareholders dividends this year, not to mention a whopping $22.9B of revenues in 2020, Bell Media has continued to lay off employees in the midst of an ongoing global pandemic, especially at sports network station TSN.”
        https://dailyhive.com/vancouver/bell-media-layoffs-lets-talk-day-petition

        It all angers and depresses me. It’s as though the corporate heads lull themselves with an inhumane, ‘It’s just business, nothing personal’.

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