Nursing home deaths in Connecticut now represent nearly 60 percent of deaths statewide linked to the Covid-19 pandemic. According to new numbers released by the state this week, a total of 1,627 Connecticut nursing home residents who had confirmed positive tests or symptoms of Covid-19, have died. As of May 6, there have been 2,797 Covid-19-associated deaths statewide.

Immediate action is critical, and a group of concerned experts — in gerontology, end-of-life care, and the quality of life in long-term care institutions across the state — led by Fairfield University Associate Professor Alison Kris PhD, RN, FGSA, with Quinnipiac University nursing colleague Sheila Molony, PhD, APRN, GNP-BC, FGSA, FAAN, and Yale University's Dena Schulman-Green, PhD, are making policy recommendations to prevent widespread death, suffering, and trauma for vulnerable nursing home residents, their families, and facilities’ staff. 

Targeted recommendations for Connecticut nursing homes include:

• comprehensive, widespread testing of all nursing home residents, staff, and visitors;
• priority distribution of Personal Protective Equipment (PPE) as nursing homes continue to struggle to access supplies, including N95 masks and gowns;
• increased staffing to provide adequate care for Covid-19 positive patients, whose needs exceed usual care standards, as well as compensation for high levels of staff absenteeism due to illness;
• and focus on comprehensive palliative care, in response to depression and loneliness that patients suffer because of visitation restrictions, through provision of adequate PPE for visiting family members and chaplains.

Palliative care providers can also assist with advance care planning and goals of support via online and mobile technologies, but devices need to be available to deliver this support. Recommendations also address inadequate financial support in light of staggering financial challenges to nursing homes, and establishment of Covid-19-only post-acute care facilities.

In the early days of the Covid-19 crisis, Dr. Kris pointed out that hospitals were the initial focus and received PPE shipments, extra nursing support, and test kits, which resulted in fewer resources for nursing homes. At a recent press conference hosted by Connecticut Association of Healthcare Facilities and Leading Age Connecticut, Dr. Kris said, “The focus now needs to shift to long-term care institutions as they begin to work with more and more residents who are also battling this disease.” 

She underscored how critical staffing, PPE, and testing are. “Early on, once a patient was in the disease state, we quarantined them and no families would be allowed in or out. Now, we are endorsing a switch, where we can hopefully allow visitors in — chaplains and families — but in order for that to happen they need to have PPE and we need more widespread testing.”

With the support of groups such as Connecticut Coalition of End of Life Care, the Connecticut Association of Healthcare Facilities, and Leading Age Connecticut, Dr. Kris said the initiative is gaining traction in states such as Utah, which will be using their policy recommendations as guidance. The Gerontological Association (GSA) has also responded positively.

“We must act now to mitigate the unprecedented national tragedy unfolding in our nursing homes," she said. "A measure of a country’s morality is how it treats its elderly citizens. We cannot fail in this obligation.”