Karen Van Dyke is the owner of Senior Care By Design, a senior placement agency in San Diego. Karen helps families find the most appropriate housing options available for their loved ones while keeping activities of daily living, medical, social and financial needs in mind. Her mission is to “offer peace of mind, turning housing concerns into living solutions”. In this month’s guest post, we asked Karen some questions about how the residential care homes and assisted living and memory care communities she works with are keeping caregivers and residents safe and healthy during the COVID-19 crisis in San Diego.

Are the caregivers at San Diego’s senior living communities considered essential?

Yes, the workers providing healthcare in San Diego’s residential care homes, assisted living and memory care communities are absolutely doing essential healthcare work as defined by federal, state, and local guidelines. The work I do is also essential. I carry a letter when I travel that explains my work and its essential nature. The coronavirus is rightfully on all of our minds right now, but we need to remember that seniors are still managing the same variety of illnesses, conditions and living situations that they were before COVID-19.  This is why my services are essential.

How are the caregivers and healthcare workers in San Diego’s senior living communities protecting themselves from COVID-19?

Caregivers and other employees of senior living communities in San Diego are following the same infection control protocols that the doctors and nurses we see on the news are following. They are trying to protect their residents and their families at the same time, while managing the available supply of masks, gloves, and any other supplies they might need. At the same time, the flow of PPE can fluctuate.  I’ve seen communities who don’t wait for the PPE supplies from the County and instead fund supplies themselves.  In this way they can be more assured of not running out.

How are communities and their healthcare workers protecting residents from COVID-19?

While I am currently working with families who need to find a new living arrangement for their loved one, not all senior living communities are accepting new residents during the quarantine. If your loved one urgently needs to make this kind of move right now, you do have options. And for safety, any community will put every new resident in isolation for seven to fourteen days to prevent bringing infection into the larger group.  And with some of the communities a COVID-19 test is required before moving in.

How do I find the right senior living community?

Before you start your search, it’s important to be clear about your choices. Skilled nursing facilities fall under the medical model and are typically the next step someone would take if they were discharged from the hospital for further rehabilitation.  Assisted living along with memory care are social models and focus on providing support with activities of daily living (ADLs), which is where I specialize.  Skilled nursing is paid for through Medicare and assisted living/memory care is private pay. Assisted living and memory care come in two options.  They both must follow CDC protocols. The fact is that the coronavirus comes from people bringing it in from the outside, and each type of community may have a different set of criteria for accessing their residents.

What are my parent’s assisted living options in San Diego?

Let me explain the two types of communities that I work with in more detail.  We have approximately 600 senior living communities to choose from in San Diego County.  All of them are licensed through the Department of Social Services. Naturally, not all of them will be a good fit and shouldn’t be.

First, there are smaller residential care homes that provide service for up to six residents in a residential setting. San Diego County has about 400 of these types of homes that you might find right in your own neighborhood. All assisted living communities are for seniors who aren’t able or willing to live alone but who don’t need nursing care. They can be called residential care homes or board and care homes. One or more caregivers is always on site to offer personalized service, like meals and help with daily living including medication management.

The smaller group size, smaller number of workers, and consistent roster of employees that interact in a small group setting means that everyone is at lower risk of contracting the virus. Families are not allowed to enter the homes, but can visit through a window, or from front porch to sidewalk. If socially distant options are not available, caregivers are doing their best to keep residents connected with family and friends by phone, by video like Zoom or online.

Assisted living communities, which may also have small memory care areas, are much larger, and offer services such as robust calendars providing social programs. For example, one local San Diego community has 200 beds, 30 of which are in their memory care area. They offer meals, along with dementia programming, exercise programs, and several levels of assistance with daily living. There are many more residents collectively at assisted living communities, with a correlating increase in the number of caregivers and other employees.

Family members, for the most part, are not permitted to enter assisted living or memory care communities right now, with one exception. Remember, these communities have been quarantined as long as the rest of us. The essential employees who come and go are professionals who abide by strict infection control precautions. The only exception to this rule is a compassion visit to the resident who has entered hospice. One family member is allowed inside, as long as they wear full PPE.  This is a heartbreaking situation for families who can’t say goodbye to their loved ones by surrounding them with people who love them, in person.

Should I move my parent from a larger community to a smaller one?

This is a call only the family can make.  Consider that your loved one might be better right where they are because the risks associated with a move are high. I did receive calls from some families a couple of weeks into the quarantine who thought a smaller home would be safer than a larger one. First, senior living communities are accepting new residents on a case by case basis. Some are closed to new residents, although I am beginning to see glimmers of lifting conditions. If your loved one is accepted, the community will have them in isolation for seven to fourteen days to protect their current residents. Isolation like that, in unfamiliar surroundings, can cause depression and stress. Then they have to assimilate into a new home while everyone is either confined to their rooms (larger facilities) or is already a close-knit group (small residential homes) under stress. Fortunately, we are beginning to see senior living communities slowly lifting some of the isolation protocols internally for residents as we continue through Phase II. Assisted living and memory care are in Phase III as far as Covid-19 restrictions and reopening.

How can I check on my loved one’s health right now?

I know it’s tough to worry about loved ones during this crisis without being able to see them for yourself. The healthcare workers at residential care homes and assisted living / memory care communities are under tremendous pressure right now to strictly observe infection control protocols for themselves, your loved ones, and their loved ones. Doing the work to keep everyone safe and healthy is time-consuming, and communities who have an established communication plan should be reaching out to the families one to two times a week minimum. Caregivers are helping family members find ways to stay informed about their loved ones and the community as a whole. Some communities send daily emails, and some are using other online tools to share as much information as they can in an efficient way. Be as patient as you can and know that these caregivers take their responsibility to your family member very seriously.

For more information about how Karen helps her clients in San Diego, take a look at her website www.seniorcarebydesign.com. She can be reached directly at karen[at]seniorcarebydesign.com.