'Til Death Do Us Part: The COVID-19 Struggle to Stay Together

The COVID-19 virus is erupting through communities in the United States and a serious conflict is emerging as patients are increasingly caught in the crossfire between the competing interests of hospitals and nursing homes.

All the patient and his supportive wife of 45 years wanted was a return to home.

In a previous life I was a discharge planner at University Hospitals. Prior to that I was a social worker and admissions coordinator for nursing homes. Fortunately, based on my experience, I knew exactly how to advocate for an 88-year-old couple who longed to be back together in the middle of a nationwide lockdown. It took a village to move the mountain but, in the end, the couple was able to unite so they could live their last days of life together.

«While the hospitals need to clear out patients who no longer need acute care, nursing homes don’t want to take patients discharged from hospitals for fear they’ll bring the coronavirus with them.»

Nursing homes across the country have locked down for fear of losing their patients. In most states, directives prevent any and all outside visitors from entering these facilities. The average age of a nursing home patient is 80 years old and most have co-morbidities and multiple diagnoses including pulmonary and heart issues.

Hospitals have been preparing for the tidal wave or “top of the curve” moment for COVID-19 admissions to peak, doing their best to cautiously admit patients, while only providing a COVID-19 test for those who present with symptoms. These tests are being held like gold and administered only after careful evaluation. Family members, or anyone else for that matter, are not allowed to enter the hospital to provide support, encouragement or advocacy for the patient.

While the hospitals need to clear out patients who no longer need acute care, nursing homes don’t want to take patients discharged from hospitals for fear they’ll bring the coronavirus with them. Where does this leave the older adult who is in the hospital and needs to be placed in a nursing center for rehabilitation or continued care?

«As a Geriatric Care Manager, my hope is that all older adults are able to find the support of a qualified professional who can advocate for them and assist them in times such as these.»

So, when I became involved with this 88 year-old couple, the situation was exactly as described above. My hospitalized client was deemed medically stable so the hospital was insistent that dischagre was appropriate and required. But the nursing home that sent him there would not take him back. Both facilities insisted on different protocols and everything was at a standstill. Calls were placed to State Representatives and to the Governor's office. We involved our state's Department of Health and sought the assistance of the Ombudsman’s Office. Finally, I called the President of the Hospital and the Corporate office of the Nursing Home Chain. It was interesting but not surprising that neither entity was willing to bend until I became involved.

All the patient and his supportive wife of 45 years wanted was a return to home. As a Geriatric Care Manager, my hope is that all older adults are able to find the support of a qualified professional who can advocate for them and assist them in times such as these. In the end, the wishes of the clients were honored and the couple who spent a lifetime together were reunited for their final, remaining days.