Friday, May 15, 2020
Another interesting conversation with a long-term care administrator this week was about "what kind of tests" are important in the Covid-19 context, especially for older adults in a congregate setting. A first question is whether every member of the staff and the residents should be tested regardless of the presence or absence of any symptoms. A Washington Post editorial on May 14, 2020 called for "extreme measures" Of course, the utility of such threshold testing mandates depends upon the availability of the means to test and how quickly the results of the tests will be processed. It is unlikely that the nation's number of residential care facilities will have the White House's "instant" testing equipment, right?
But when Covid-19 is present in any congregate care setting, the administrator explained a second test may be even more important. The test is for oxygen levels, taken with a monitoring device, sometimes referred to as an oximeter and often attached to a finger of the person in question. She explained to me that with Covid-19, the impairment of the lungs can occur with dramatic quickness and not necessarily with any complaints from the patient about shortness of breath. The director explained that donations of oxygen concentrators to her community meant they are able to respond to lowered oxygen levels within seconds -- rather than within life threatening minutes or hours -- to provide enhanced oxygen for the resident. Further, many at-risk people resident not in nursing homes, but in the many other variations of congregate senior care.
Have you tried to convince a person with a cognitive impairment or an anxiety disorder to wear a mask or agree to keep that oximeter attached to their hand? Will "extreme measures" include funding to support needed increases in care-staff ratios?