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The residents and staff of the Jewish Home Family, a group that includes a nursing home and long-term care facility in New Jersey, have been partying. The recent arrival of CVS nurses carrying batches of newly authorized COVID-19 vaccines was cause for celebration.
"We made it very festive,” says Carol Silver Elliott, president and CEO of the facility. “We gave everybody who got their second dose a T-shirt, we had stickers, we had balloons.... We even had piñatas in the shape of the coronavirus; we hung them up on the nursing units and residents and staff took long poles and smashed them, and candy rained all over us.”
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After a devastating year of loss and suffering — almost 180,000 residents and workers in long-term care have died from COVID-19 in the U.S., and more than 1.4 million have been infected — many facilities finally have reason to exhale. The federal program tasked with administering vaccines to almost all long-term care communities is expected to wrap up in a few weeks. COVID-19 infections and deaths in nursing homes have declined significantly since the beginning of the year. And new federal guidance is making it easier for residents to interact with visitors.
"We all feel relieved,” says Silver Elliott, who is also the chair of the board for LeadingAge, a national association representing 5,000 nonprofit aging services providers. “People are walking around saying, ‘I have my COVID superpowers now’ and ‘OK, I'm not as afraid’ … It's starting to feel like life is coming back.”
But while most long-term care residents are now fully vaccinated, most other Americans are not, meaning there are still plenty of opportunities for the virus to reenter facilities. The threat is compounded by vaccine hesitancy among many long-term care workers. And there are unknowns about just how effective the vaccines are in protecting long-term care residents as a specific group.
"It's OK to be optimistic,” says Jennifer Schrack, an associate professor in the epidemiology of aging at the Johns Hopkins Bloomberg School of Public Health. “But we still have to be diligent. This is a new disease. We don't know how it's going to behave. We don't know how the variants are going to behave.… Just because you're vaccinated doesn't mean you can't get it.”
That puts the country's long-term care facilities in an awkward in-between phase. Getting back to a semblance of normal is now possible, but not without continued safety measures. Just how cautious facilities must be is “the million-dollar question,” says Schrack, who predicts that confusion and stumbles are inevitable.
Beach balls in the garden
The Jewish Home Family includes a nursing home and assisted living, where communal activities that were either heavily restricted or completely canceled during the pandemic are starting back up again. Nearly every resident except hospice patients, and around 75 percent of staff are fully vaccinated against COVID-19.
Residents can now eat with each other in the dining rooms, take exercise classes in the boxing gymnasium or rehearse for the upcoming annual musical, The Lion King, which had to be postponed last year.
Infection-control protocols still hold, including wearing masks, social distancing where possible and capping the number of people participating in each activity, in accordance with federal guidelines. But these activities represent some of the first opportunities for socialization that residents have had in months.
"In a lot of ways, we're coming back to ourselves,” says Silver Elliott, who is calling the next few months of programming at the Jewish Home Family “Project Welcome Home.”