Social Distancing Challenges

• Patients in senior care facilities often need help to perform activities, which can go from a minimal need for assistance to full-time assistance. This makes implementing social distancing protocols more difficult than with the general public. In addition, given how underpaid workers at these facilities often are, many of them have more than one job, which makes them more exposed to people who might be carrying the infection.
• Furthermore, seniors who live at these facilities but who are more independent will wish to come and go as they please as lockdown measures are lifted in the region where they reside. From visiting friends and family to going to church, which would involve socializing and interactions with others. However, this could increase the risk for exposure. At the same time, facilities might be conflicted between presenting themselves as back to normal or keeping stronger security measures to avoid contagion.

New Protocols for Visit Interactions

• Another challenge is the need to implement new long-term protocols for interactions with visitors. While the support of family members and family caregivers is considered more essential than ever during the pandemic, these visits and contact need to take place taking every possible precaution. Facilities need to employ virtual devices that allow residents to interact with their loved ones, which can be costly as well as require more engagement by workers to help residents handle the technology.
• In addition, the constant visits received by residents prior to the start of the lockdown could have played a significant role in increasing the number of infections. Even after the lockdown passes, facilities will need to monitor visitors for any signs or symptoms of disease, which could be met with resistance. A related subject would be considering the performance of tests, not only for all residents of the facility, which is mandatory in most states but also for workers and visitors, which could have a considerable cost.

Mental Health Issues

• Another challenge when facing COVID-19 is the fact that the lack of visitors, the disruption of their activities, and the death of fellow residents are some circumstances that can cause the onset of anxiety or depression among senior residents. In addition, the knowledge that they are the main group at risk of severe disease caused by COVID-19 infection could also be a driver of anxiety. This is a challenge facilities need to get around, which can be done through family engagement as well as with the help of other organizations, which can be related to the faith of the patients.
• There is a high prevalence of residents with dementia in assisted care facilities as well as nursing homes, estimated at 42% and 48% respectively. This can make things considerably difficult as these residents will have trouble understanding the changes that are taking place around them as well as learning new behaviors and protocols that might be implemented for their own safety.

Infection Management Training and Staff Hiring

• Senior care facilities have had to make considerable investments to recruit and train staff due to COVID-19. While personnel should be trained in the management of infectious diseases, this is not always applied. Not only does this make facilities vulnerable to legal action, but it also increases the likelihood of contagion. This issue has been present for years, with senior care facilities presenting high levels of infectious diseases, a problem that has only exacerbated during the COVID-19 pandemic.
• Training the current personnel as well as recruiting new personnel is among the measures proposed to manage this. Hiring new personnel is considered as an option because of the possibility of having a shortage of employees if some of them become infected. This could be worsened by the fact that their co-workers might have to be quarantined as a precautionary measure.

Legal Risks

• A serious concern for senior care facilities is the possibility of legal actions against them, which could be initiated by residents or their relatives. The argument for deficient quality of care could be made if facilities are found to have taken insufficient measures to prevent and react to COVID-19. Testing, providing personal protection equipment, properly training employees for the management of infectious diseases, and how lockdown measures were implemented could all come into question during legal action. This risk exists not only for facilities in which there have been COVID-19 cases and fatalities but also facilities that have not reported cases. Another subject that could be put under the microscope is how the facility managed the need for emotional support and if adjustments were made to ensure there were sufficient workers to provide the quality of care usually offered by the facility.

Summary of Findings

• During this initial hour of research, we focused on assessing the availability of the information identifying challenges, providing them in the requested summary format. While we were able to find information about general challenges, religious-specific challenges could not be identified in the context of senior care facilities.