But the 56-bed Fox Subacute nursing home has a limited number of phones to go around. “It's so hard to get those portal phones from the nurses, because they need it. And somebody else might have it, or they have to charge it,” Ehrhart says. “You can't always get it when you want it. So I don't ask for it that often."
She uses the phone only once every 10 days or so. Ehrhart doesn't have much family, but she is close friends with a former pastor who lives in Montana. Ehrhart hasn't been able to speak with him in well over two weeks.
But she should soon find it easier to stay in touch with him and with members of her church in nearby York County, who would visit her during normal times. Her facility is one of nearly 50 nursing homes across the state set to receive new smartphones, thanks to funding for virtual visits from a government-nonprofit partnership.
The Pennsylvania Department of Aging, AARP Pennsylvania and the Pennsylvania Association of Area Agencies on Aging have bought six tablets and more than 100 phones for 49 nursing homes across the state. Bill Johnston-Walsh, director of AARP's Pennsylvania office, hopes the devices will be a game changer for residents, their friends and family members.
"We were hearing early on — and it was pretty sad — people would call us and say they had no idea what was happening with their parents,” Johnston-Walsh says. “We're hoping this alleviates some of that frustration and allows families to talk to their loved ones."
The federal Centers for Medicare & Medicaid Services effectively banned nursing home visits three months ago, at the start of the pandemic, except for end-of-life situations. AARP and other advocates for nursing home residents have been pushing for federal and state rules requiring facilities to offer virtual visits with loved ones, which they say can mean the difference between life and death for some residents.
But with limited budgets in long-term care facilities, phones and tablets are often in short supply. “I've heard of some facilities that have just one phone they pass around to residents,” says Robert Torres, Pennsylvania's secretary of aging. “We're hoping that this jump-starts additional support."
As the pandemic continues, advocates across the country are finding ways to keep nursing home residents better connected with the outside world. The federal government announced guidance in late May for reopening the facilities to visitors, but it urged extreme caution in doing so. The process could take months, making virtual visits the only option for most residents for the foreseeable future.
Turning fines into phones
More than two dozen AARP state offices have called on lawmakers to better facilitate virtual visitation options for long-term care residents. Oregon's AARP office worked with the state's Department of Human Services to draft guidance requiring virtual visitation at long-term care facilities. AARP is pushing for the same requirement at the federal level.
In Alaska, AARP's state office worked with the Centers for Medicare and Medicaid Services to allow a portion of fines nursing homes have paid for care or sanitation violations to be directed toward buying them technology for virtual visits. Individual facilities can use up to $3,000 in money redirected from fines. The new guidelines are making a difference, particularly for smaller facilities, says Teresa Holt, the director of the AARP Alaska office and the state's former long-term care ombudsman.
"It works great if you have a small facility and you only need like three iPads. But if you have 100 people and you need 10 to 15 iPads, it's probably not sufficient,” says Holt, who wants to raise the $3,000 threshold for larger operations.
AARP's Texas office worked with state officials on a similar policy. Gov. Greg Abbott and the Texas Health and Human Services Commission last month announced a pool of $3.6 million from fines and penalties for facilities to purchase communication equipment for residents.
In Pennsylvania, the $10,000 for new technology and paid phone minutes came from AARP's state office. The office coordinated with the state government to determine which facilities needed the technology, while the Pennsylvania Association of Area Agencies on Aging purchased the phones and tablets.
Johnston-Walsh, the state AARP director, hopes for more donations and funding mechanisms to allow the program to expand to more of Pennsylvania's 699 nursing homes in weeks ahead.
Because of the potential risk of spreading coronavirus through shared devices, many facilities are hoping for more technology to go around.
"If every resident was able to get a tablet, that would be ideal in a situation like this,” says Rachel Reeves, director of communication at the National Center for Assisted Living.
The National Center for Assisted Living and the American Health Care Association, which represents the nursing home industry, are directing donations of tablets and technology, along with puzzles, games, hand sanitizer, gloves and other supplies, to long-term care facilities through their #CareNotCovid campaign.
The groups launched a social media campaign in which people can record and upload short videos and messages of encouragement that can be shared with nursing home residents and staff. “This is a potentially isolating time for residents,” Reeves said. “We know that so many people were stepping up and asking how else they can help."
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Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care, has heard of residents “feeling abandoned” and “giving up the will to live” during the pandemic.
Nothing can replace an in-person visit with a loved one, she says. But her group supports expanding virtual visitations while visits remain unsafe and off limits: “It's heartbreaking to hear about the increasing number of residents whose health has declined or who have died over these past two months as a result of the loneliness and isolation."
And with on-site visits from inspectors and long-term care ombudsmen also on hold, virtual visits also offer a measure of transparency.
"Family members are oftentimes the ones who can detect if something is wrong with their loved ones or say that something is just not right with this facility,” says Elaine Ryan, vice president of state advocacy and office integration at AARP. She says that getting phones and tablets to residents is “not only a nice thing to do, but it's an opportunity for families and loved ones to be able to check in and hear how things are going, see their loved ones — and, if needed, report any incidents to ombudsmen who are banned from these facilities."
With in-person visitation indefinitely restricted, Ehrhart says her facility's phone shipment from AARP Pennsylvania and the state's Department of Aging will “make a difference” in keeping her connected with the outside world. Ehrhart has periodically lost her voice in recent years to bouts of pneumonia. But now that she has a working speaking valve, she is eager to reconnect with friends she's lost touch with since the pandemic began.
Her first call will be to her pastor friend in Montana, she says.
"When I got my voice back, he was the very first person I called. And he was so delighted to hear my voice,” says Ehrhart. “We've always been very close to each other."