When it comes to perceptions of assisted living and nursing homes — especially during the COVID-19 pandemic — communication is everything, according to an online survey of families.

A research team at Miami University’s Scripps Gerontology Center launched an online survey — The Family Experience in Long-Term Care During the COVID-19 Visitation Restriction — on April 29 to gather family perspectives on the ways that assisted living communities and nursing homes are addressing the COVID-19 pandemic. They learned that perceptions varied depending on a facility’s communication regarding care for a family member.

Although most respondents had positive perceptions about a facility, those perceptions were colored by communication levels. Perceptions were lowest among families that did not know whether there were COVID-19 cases in a facility. Six in ten (60.8%) respondents who said there were no cases in a resident’s facility were very confident they would be informed about COVID-19 cases, compared with 23.3% who did not know whether COVID-19 was present in a facility.

Those who had a more favorable opinion of a facility reported receiving more frequent communication and anecdotes about how their family members spent their time. Mass emails, daily robocalls providing facility updates, and regular telephone calls were mentioned by families as effective communication strategies.

Researchers suggested training direct care staff to regularly send texts or record case notes, which “can go a long way toward reassuring families that things are going as well as can be expected.”

“The more specific details of the resident’s daily life the families are given, the more likely families are to perceive they are getting the right amount of information,” according to the study. “Where families don’t know the status of COVID-19 in the facility, or don’t have confidence in facility communications, their perceptions of the facility are lower.” 

Among the top concerns from families and friends, researchers said, are worries about residents passing away alone (32.8%), loneliness and isolation (63.1%), and residents receiving care family members used to offer (31.8%). Several respondents reported declines among residents since restrictions had been in place, including depression, anxiety and increasing confusion.

Aligned with having multiple concerns, 40.6% of respondents had considered moving a resident out of a facility. Among the factors respondents listed for not moving a loved one were a lack of skills or resources to care for the resident at home (54.8%), doubt that changing facilities would improve the situation (31.5%), and an inability for the resident to return to the same facility post-COVID-19 (27.4%). Another 23.3% reported concern over infecting a loved one with coronavirus if the resident were brought home. 

At the same time, many respondents expressed confidence and appreciation for how facilities are handling the crisis, as well as acknowledged the “busy and overworked” staff. 

“As policy makers and facilities try to determine the right balance between safety and socialization, it is clear from these findings that targeted and timely communication with involved family members and friends should be a key management strategy,” the report reads, adding that policies about communicating COVID-19 cases are a step in the right direction. “We are in uncharted territory, and it will take knowledge, trust and cooperation to realize the best possible outcomes for residents, families and stuff in our long-term care settings.”

The survey was completed by 198 family members or friends of someone living in an assisted living community (57.9%) or nursing home (47.1%). Respondents were recruited from 21 states through social media posts, with the majority from Ohio and other Midwest states (52.1%), 37.9% from the West, and the remainder spread across nine other states.

In other coronavirus-related news:

  • The coronavirus pandemic has taken a financial toll on almost every sector of life, and long-term care facilities are no exception. Skyrocketing costs related to the purchase of personal protective equipment, the need to quarantine COVID-19-positive residents, and the demand for increased staffing levels, coupled with loss of revenue and limited relief assistance, have left North Dakota and Minnesota senior services facilities with an uncertain financial future, according to this media report.
  • California Advocates for Nursing Home Reform are asking the state to end what they call the trauma of “solitary confinement” of residents at senior living and care facilities by allowing them at least one designated visitor. 
  • Massachusetts entered Phase 3 of its coronavirus reopening plan Monday. At long-term care facilities, such as nursing homes and assisted living communities, visitation guidelines will be updated in Phase 3. 
  • Some assisted living communities are citing the lack of state and federal financial support in assessing COVID-19 fees to residents. 
  • California is urging laboratories to prioritize testing turnaround for individuals most at risk of spreading COVID-19 to others, including those who are hospitalized or in assisted living communities and nursing homes. 
  • Phil Fogg Jr., president and CEO of Marquis Companies, which owns and operates 25 assisted living facilities in Oregon, Nevada and California, said aggressive testing and a heroic staff were keys to combating a coronavirus outbreak at Marquis Hope Village in Oregon.
  • Communal dining and activities has resumed at assisted living and other long-term care communities, so Rhode Island will allow visitors beginning July 8 as long as strict infection control measures are in place.
  • A recent Harris Poll shows that one-third of Americans, including older Americans, are considering moving to less populated areas because of the pandemic. But some experts say escaping to rural or suburban areas actually may create more problems for older people due to a lack of necessary infrastructure.
  • A COVID-19 testing lab representative says that several Tennessee assisted living communities are refusing to test their employees, even though the tests are free, because it is a hassle. Gov. Bill Lee signed an order requiring all nursing homes to test their residents and staff members by the end of June. Assisted living communities are not required to test employees, but they can be fully reimbursed.
  • South Carolina Gov. Henry McMaster is pumping the brakes on allowing limited visitation at assisted living communities and nursing homes as new cases of COVID-19 increase across the state. Just last week, the state was putting together guidelines to lift some restrictions, but the state now is postponing releasing its guidelines.
  • Four law firms have dropped a joint federal lawsuit against the Pennsylvania Department of Health since the state “substantially” implemented actions sought in the suit, including universal testing protocols to identify asymptomatic individuals and the public release of long-term care facility-level infection and death data.
  • Arkansas assisted living facilities where staff members and residents test negative for COVID-19 can move into a new phase of reopening in July, which will allow outdoor visitation.
  • Coronavirus tests taken at Brighton Gardens, an assisted living community in Chevy Chase, MD, were processed at a lab that was shut down by the Maryland Department of Health for not having the right certification to do the testing. Officials are investigating how it happened.
  • After issuing a state of emergency for long-term care facilities related to the coronavirus outbreak in March, Washington state Gov. Jay Inslee extended statutory waivers and suspensions through Aug. 1, affecting visitation and worker shortages.