EDITORIAL: Post-pandemic, revisit care for elderly

Day, The (New London, CT)

Apr. 27--While the COVID-19 pandemic is hitting U.S. nursing homes particularly hard, having those frail elderly cared for in their homes would have presented different risks.

In Italy and Spain, many residents live in multi-generational households, and some preliminary assessments conclude that this cultural reality contributed to the coronavirus pandemic striking both countries with particular force. The theory is that younger family members living under the same roof brought the virus home and infected their more vulnerable older family members.

But while clustering the frail elderly together for care or tending to house them with family both present big challenges in a pandemic, one approach does have an advantage. Residents sharing households with their children, grandchildren and sometimes great-grandchildren, should they fall ill, are more likely to be surrounded and comforted by familiar and loving individuals, at least until the point when hospital care is needed.

In America, on the other hand, some of the most heartbreaking images from the pandemic are those showing our most vulnerable elderly residents trapped and isolated in nursing homes shuttered to guests as the coronavirus sometimes ravages both employees and residents.This has left family members scrambling to communicate with their loved ones via technology or waving to them through nursing home windows.

There will, no doubt, be plenty of lessons learned from this pandemic. Among the most important of these is the imperative to reform a healthcare and insurance system that leaves too many families with no alternative but to send elderly relatives who need advanced care to a nursing home. And too often those nursing homes are understaffed with underpaid employees.

It would be both cost effective and more humane if our healthcare system made it financially viable for more families to keep elderly relatives at home, provided with the outside assistance they need. This is what lawmakers must work towards post-pandemic. After all, few people envision a nursing home as their ideal choice for end-of-life care.

Some of the savings could be used to better compensate those playing a vital role by providing nursing home care.

While live-in home care can cost thousands of dollars a month, it remains a much less expensive option than nursing home care. Despite this, home care generally is not covered by insurance. Medicaid picks up home-care costs for the very poor, and some more affluent residents pay for pricey long-term care insurance to assure this type of coverage. The cost of visiting nurses who travel to patients' homes to provide care is generally covered by insurers only for a limited period.

Many middle-income families in which elderly relatives are covered by Medicare opt for nursing home care for financial reasons because it will not require out-of-pocket payment, at least in the short term. Medicare covers the cost of nursing home care for a time for many patients when they are released from hospitals, but who still require assistance, for example.

While patients and families may pay less for relatives' care in nursing homes, that care is extremely expensive for the healthcare system overall. Despite that, the preponderance of nursing home workers earn relatively low wages. Certified nurse assistants, for example, on average earn about $30,000 a year in Connecticut if they are employed full time, according to information from the employment site indeed.com. Only about a third of CNAs in the United States say their salaries are adequate for the cost of living in the area in which they live, reports indeed.

The pandemic has revealed in a most stark manner these failures. Lawmakers must take the lessons of the pandemic and seek ways to heal this system to better serve employees, patients and their families - and to provide people with options.

When the pandemic is over, residents of countries such as Spain and Italy will have to assess what they could have done better to protect their older family members. But they can continue to point with pride at the way they honor and respect their elderly. Will America's elected leaders make the changes necessary to allow more of us to do the same?

The Day editorial board meets regularly with political, business and community leaders and convenes weekly to formulate editorial viewpoints. It is composed of President and Publisher Tim Dwyer, Editorial Page Editor Paul Choiniere, Managing Editor Tim Cotter, Staff Writer Julia Bergman and retired deputy managing editor Lisa McGinley. However, only the publisher and editorial page editor are responsible for developing the editorial opinions. The board operates independently from the Day newsroom.

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