Article by Beth Weeks, RN
Co-Founder, Senior Living Consultants of New York
“Thank God I didn’t move into that assisted living with how affected they were.”
This is just one out of the dozens of similar misconceptions spoken to me when discussing senior living options with clients and their families in July and August of 2020.
I found myself explaining the difference between Skilled Nursing Facilities (referred to as nursing homes or SNFs) and senior living communities (assisted living and memory care) so regularly that I basically developed a script.
Never has it been more important to underscore what separates an SNF from a senior living residence. To be fair and clear, this is not an indictment on nursing homes and their policies or their extremely hard working and dedicated staff; this is an opportunity to educate and better understand the difference between the two care models.
Let’s start with the facts as of September 16, 2020. The New York State Department of Health reports the number of confirmed COVID-related deaths in nursing homes in all five boroughs of New York City comes to 1,408 while adult care facilities had a total of 28. Westchester County reported lower numbers, but the stark difference between the two care models still exists there: 260 confirmed COVID-related deaths in nursing homes versus 26 deaths in adult care facilities.
SNFs often have hundreds of patients, many of whom are chronically ill, multiple patients to a room in most cases, and a high volume of staff. Assisted living communities tend to house 200 or fewer residents in private apartments (residents in memory care are more likely to have a shared apartment) and those residents are not dealing with the same severity of health complications that many long-term patients of nursing homes experience. Finally, in many assisted living communities you will find many independent and very active seniors who require little to no assistance. Therefore, the staffing numbers are quite different, with fewer individuals coming in an out of the building on a daily basis. According to a report released by the New York State Department of Health on July 6, 2020, nursing home patient COVID-19 fatalities were largely due to infected staff.
This leads to my next point. The response by many assisted living communities in New York to not only protect and educate their residents, but also to protect and educate their staff, directly led to the significantly lower death toll we saw. Sheridan Daniel, Vice President of Operations and Product Development for Atria Senior Living, Signature East, shared with me that his company began taking steps to address the virus as early as February 27, 2020, when there were only 24 documented COVID-19 cases in the United States. Early measures were taken to screen residents, staff and visitors. As of late August, one of the communities that Mr. Daniel oversees, Atria West 86 in New York City, had only one documented case of COVID-19 among their residents and only five among their staff, none of which resulted in death.
Other leaders in the industry reported similar efforts to keep their communities safe early on. “Given that our assisted living population is active, and the residents are generally aware, the first step was education for the residents. We conducted educational in-services for the residents related to the information about the virus that was available at that time and again our infection-control practices, and same process for the staff,” said Faraz Kayani, Executive Director of 305 West End Assisted Living in New York City.
To be fair, there obviously were reported COVID-19 cases in assisted living communities among residents and staff. I also am not asserting that senior living is the right choice for everyone – it comes down to one’s needs, resources, and, of course, personal choice.
Last but not least, another side effect of COVID-19 has been a lapse in routine or maintenance medical care. Due to the resources and support staff available in assisted living, community leaders ensured that their residents had safe access to visiting physicians, nurse practitioners, dentists, podiatrists and mental health providers without disruption. “We abided by the New York State Department of Health guidelines when it came to visitation into our community – any essential visitor had to go through a symptoms checklist process including having their temperature taken,” said Mr. Kayani of 305 West End.
The point I’d like to make is this: assisted living communities were and continue to be a safe option for seniors, even during a pandemic. It is important to take the time to review the facts from reliable sources, ask questions and make decisions based on yours or your loved one’s needs. And, finally, consider reaching out to a professional senior resource (i.e. senior placement experts, geriatric care managers, elder law attorneys, etc.) to help you navigate this complex system.