Published in the Portland Press Herald on June 24,2020.

Headlines about the alarming levels of coronavirus infections and deaths at nursing homes around the country and in Maine have left families of elderly loved ones shaken, confused and worried. How safe are senior care facilities for Maine’s growing elderly population, and what is being done to ensure the health and safety of the residents?

Today, over 1 million American seniors are living in nursing homes, nearly 6,000 in Maine. The coronavirus pandemic has taken an unimaginable toll: More than 40,600 long-term care residents and workers in the U.S. have died of COVID-19 – about 40 percent of the nation’s total coronavirus deaths, according to data gathered by USA TODAY. This gruesome figure is higher than the 26,000 deaths estimated by the Centers for Medicare and Medicaid Services, which includes only federally regulated nursing homes, not assisted living facilities.

In Maine, nursing homes account for more than 20 percent of COVID-19 cases and more than half the deaths. The reasons why are clear. Elderly people, especially those with multiple underlying health conditions, are especially susceptible to the virus. Combine that with the sometimes crowded conditions and frequent close contact in a nursing facility, and you have a perfect environment for the spread of infectious diseases.

But there is another, often-overlooked reason why senior care facilities are particularly vulnerable to the coronavirus: the high number of patients with dementia. In most senior communities, more than 60 percent of residents have some form of cognitive impairment, including Alzheimer’s. Many of these patients don’t have the ability to understand – or simply don’t remember – the need for hand washing, covering their nose or mouth, or social distancing.

Even the simple act of testing a dementia client for COVID can be difficult. The newer saliva swabs, although less unpleasant than nasal swabs, tend to go far down the back of the throat and can cause gagging. The challenges that ensue dealing with patients afflicted by dementia are obvious.

All of this makes nursing homes an unchecked breeding ground for the spread of this incurable disease, especially if safety protocols ignore the needs and capabilities of this vulnerable population.

Fortunately, over the past few months, senior living communities in Maine and New Hampshire have been following updated federal Centers for Disease Control and Prevention safety standards to help head off COVID-19. And they’ve discovered creative “best practices” that go beyond federal guidelines. One facility has its staff wear T-shirts with slogans such as “Remember 6 Feet Apart” and “Been Social Distancing Since March 2020” to remind residents of the need for space between themselves and others. Facilities are following new intake requirements, termed “Cautious Admissions,” whereby applicants must agree to strict and targeted rules, such as testing negative for the COVID-19 virus twice and an initial two-week quarantine. Other safety measures include delivering mail and meals to residents’ rooms with no personal contact. Even family members bringing medication or other items must leave them by the door for staffers to pick up. In addition, Maine recently required nursing homes to perform more wide-scale testing when a single case of COVID-19 is detected (previously it was three cases).

All of these measures appear to be working. Active cases have significantly decreased in Maine senior communities that had outbreaks. In fact, the site of Maine’s largest COVID outbreak, a nursing home in Augusta, has had no new outbreaks since mid-May.

In a very short time, we have all learned a lot about this deadly pandemic, and how to confront it. But at this point with the implementation of safe and best practices at Maine’s senior living facilities, a visit to a nursing home should be safer than visiting the local grocery store. Families looking to place their elderly relatives in long-term care environments should be confident that their loved ones will receive the care and safety they need.