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Long-term care residents sad but holding on for delayed COVID-19 vaccines, family visits

Sun Herald - 1/17/2021

Jan. 17—They marked Jan. 6, 2021, on their calendars — the day they could start breaking the bonds of isolation from family and friends, the day residents of their long-term care home would finally be vaccinated for COVID-19.

And then that date was, cruelly, yanked away.

Now, residents of Lighthouse Assisted Living and Memory Care in Ocean Springs are afraid to get their hopes up that the vaccine will arrive Tuesday, the new date they've been given by CVS Pharmacy.

Vaccines were supposed to roll out first to Mississippi's most vulnerable populations, health care workers and long-term care residents and employees.

But pharmacies didn't start inoculating long-term care employees and residents until Dec. 28 — more than a week after they received their first doses, State Health Officer Dr. Thomas Dobbs said.

The vaccine rollout has continued to be slow, with dates scheduled into February for some facilities, although Gov. Tate Reeves promised Friday the pace is about to quicken so that 95% of long-term care facilities will have inoculations by month's end.

The U.S. Department of Health and Human Services announced the federal partnership with pharmacies in October, but pharmacies were still hiring and training staff last week to administer shots, Dobbs said.

Reeves said last week that the program is moving slowly in "virtually every state."

Dobbs said at the same news conference: "We're disappointed that they didn't have folks ready to roll, I'll have to say, and that they're trying to hire right now. We should have had folks earlier.

"We're trying to find ways that we can get the vaccine back, or even work with them on the delivery and logistics pieces. I mean, the nurses in the nursing homes can give the vaccines A lot of it is just red tape stuff that we've got to work around."

Federal-pharmacy partnership governs long-term care vaccines

Under the federal partnership for long-term care facilities, the vaccine must be administered by staff members of participating pharmacies, according to the Centers for Disease Control and Prevention. Long-term care facilities can opt out of the program, but they must select another pharmacy provider that follows federal rules for vaccine storage and reporting.

As pharmacies have begun getting the vaccine into nursing homes, they also are finding that many people — particularly staff members — decline shots. Anecdotally, Reeves is hearing that 80% of residents want the shot, while only 1/3 of employees are willing to be vaccinated.

Dobbs said he understands that personal-care aides in the homes, more so than nurses, are reluctant to take the vaccine. The MSDH wants to better understand resistance to vaccination and increase the number of employees willing to get shots.

"Of all the health care workers in the country who need to have a vaccine more than anybody, it's people working in long-term care," Dobbs said. "So the first thing I'm going to say is, please, if you work in long-term care, your patients' lives depend upon you getting a vaccine."

Long-term care facilities account for less than 4% of total cases in Mississippi but 33.5% of deaths. About 80% of Mississippi's 5,411 fatalities are residents 65 and older, Reeves said.

On Jan. 14, the last update available, MSDH reported 220 active COVID outbreaks in nursing homes.

COVID-19 enters long-term care facilities through the workforce.

At Lighthouse, Executive Director Beth Joachim said about 50 of the 75 employees are ready to get the vaccine.

"It's taken a lot of education and information-sharing with our employees," said Joachim, a registered nurse. "At first, the number was very, very low, but I've done a lot of education trying to point out the benefits of the vaccine."

She said the facility, which includes assisted living and memory care, has five to six nurses on staff at a time who could administer vaccines, if they were allowed to do so.

"We could give them at any time and be done with it in an hour," she said. "We have that many nurses on staff. We could have this done."

Isolation, depression setting in for elderly residents

Lighthouse did not have a COVID outbreak until November and has not had any residents die directly from the virus.

But Joachim says some residents are losing their will to live. The staff can do only so much to keep them going and encourage them to participate in social activities.

"These poor folks have been waiting on this since March 13 when I locked the door," she said, "to have true contact with their families."

Residents were downcast when they learned their vaccine date had been pushed back.

"That made them lose a lot of hope," she said. "The depression really magnified at that time."

For a brief time when cases declined in the summer, the facility was able to let residents and families visit in the courtyard while wearing masks and social distancing, but even that semblance of normalcy had to be taken away when cases rose once again.

Lighthouse also set up indoor visitation for residents and families, who are separated by a wall with a large glass window. Alzheimer's and dementia patients find the visits disorienting. They spend more time wondering why they are separated from their families than they do enjoying their time together.

Even assisted living residents have grown weary of the room. They've missed weddings, the births of grandchildren, Thanksgiving and Christmas with their families.

Many residents have lost weight and withdrawn into their rooms.

Even after they're vaccinated, residents must still wait three to four weeks before they can take the required second doses, and then two weeks beyond that for immunity to build up. At best, they will have spent a year separated from the touch and hug of family members.

"They're just really in a bad state of mind now," Joachim said. "I'm almost afraid to tell them they're going to get (the vaccine) January 19. That day could come and go and what if they don't receive it?"


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