Amid the political bickering over Gov. Andrew M. Cuomo’s order regarding nursing homes and the coronavirus, there has been little attention paid to improving the quality of life in nursing homes. If only the residents could get as much attention when there is not a pandemic.
Long before the coronavirus, there were serious problems at nursing homes, including low staff pay, high employee turnover and a lack of supplies and protective equipment, and the view that nursing homes could be "profit centers."
When the investigations and the politics are over, the best way to honor the 15,000 nursing home residents who died of COVID-19 in homes or hospitals is to reform care. A package of bills in the State Legislature that would increase staffing, repeal immunity for operators, require greater infection control, tighten control of for-profit companies and other reforms should be approved.
The path to quality care has been implemented in other places. The Pioneer Network in Rochester, for instance, has promoted culture changes in nursing homes that include a resident-centered model in a home environment in which residents have meals together, take part in activities, and get up when they want rather than be on an institutional clock. There is more satisfaction and less turnover among staff. These home-like facilities began in 2003 and exist in New York and in more than 25 other states.
Early data indicate these facilities had far fewer COVID-19-related deaths than more traditional institutional homes. AARP reported that one study of 256 nursing homes by the Green House Project, a nonprofit for alternative living, "found only 28 COVID-19 cases and three related deaths among residents — and 95 percent of homes were COVID-19-free. Data from January through July shows 32.5 confirmed cases per thousand residents, compared with 146 cases per thousand residents in all certified skilled nursing homes."
Ninety-two years ago, in his first year as governor, Franklin Roosevelt spent the summer months touring the state by car, visiting local communities and state-run health institutions. These were often inspection tours. Eleanor Roosevelt went with him and she was his eyes and ears since he could not walk through the facilities easily. She wrote in her biography about the trips: "The head of the institution that we were visiting usually got into the car with my husband and drove around the grounds, pointing out what new buildings were needed." Eleanor would go inside many of the state facilities with questions. FDR would tell her to check everything out. Eleanor wrote: "At first my reports were highly unsatisfactory to him. I would tell him what was on the menu for the day and he would ask, ‘Did you look to see whether the inmates actually were getting that food?’ "
We could use more politicians with the interest and attention that Franklin and Eleanor gave to those living in state-run or regulated facilities.
Michael Burgess was director of the New York State Office for the Aging (2007-2010).