The Age Guide: Perspectives on the Aging Journey

Through the Looking Glass: An Ombudsman's View of the Long Term Care Lockdown Part 1

• Age Guide • Season 1 • Episode 4

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Welcome to the first of our 3-episode mini-series, where we’ll bring you the first-hand stories and experiences of a special type of advocate, an Ombudsman.  An Ombudsman advocates for older adults living in assisted living and skilled nursing facilities.  You will hear from 3 different Ombudsmen in this series, all of whom were on the front lines during the COVID outbreak. Our goal in this series is to hear their stories, spread awareness about the work of an Ombudsman, and learn how we can all help protect residents’ rights in the future. In this first episode in the series, we will hear from Suzanne Courtheoux, supervisory attorney of the Ombudsman Project at Legal Aide Chicago. Let’s listen in as Suzanne tells us about what she saw and heard from residents in long-term care during the COVID-19 lockdown. #theageguidepodcast #COVID-19 #Pandemic #LongTermCare #Advocacy #ILOlderAdults #OlderAdultAdvocacy #OmbudsmanAdvocacy 

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SPEAKER_00:

Hello, and welcome to The Age Guide, perspectives on the aging journey. We are here to be your personal age guide and enhance your quality of life on the road ahead. At Age Guide, it's our mission to be a vital resource and advocate for people as we age by providing thoughtful guidance, supportive services, and meaningful connections. This podcast is about putting a face on aging and giving a voice to older adults and caregivers by highlighting their experiences and stories. We want to provide a window into the struggles and joys of aging to dispel myths and combat ageism. Welcome to the first of our three-episode miniseries, where we will bring you firsthand stories and experiences of a special type of advocate and ombudsman. An ombudsman advocates for older adults living in assisted living and skilled nursing facilities. You will hear from three different types of ombudsmen in the series, all of whom were on the front lines during the COVID-19 outbreak. Our goal in the series is to hear the stories, spread awareness of the work of an ombudsman, and learn how we can all help to protect residents' rights in the future. In this episode in the series, we will hear from Suzanne Cortoux, a supervisory attorney of the Ombudsman Project at Legal Aid Chicago. Let's listen in as Suzanne tells us what she saw and heard from residents in long-term care during the COVID-19 lockdown.

SPEAKER_02:

Can you just explain to the listeners a little bit about what your job is and what an ombudsman is? Sure.

SPEAKER_01:

My job is to supervise our program and the community ombudsman paralegals who go out into facilities on a regular basis as ombudsmen. Ombudsmen, long-term care ombudsmen are resident advocates in facilities. We are not affiliated with the facilities. We are independent and our job is to be resident directed. So no matter who makes a complaint to us, we only take action if the resident wants us to, and we only advocate as the resident wants us to. As part of that, we advocate for what the resident wants rather than what's in the resident's best interest. As long as the resident can direct us, we advocate for what the resident wants. And even if that's not necessarily what's going to be in their best interest.

SPEAKER_02:

That's interesting. I bet a lot of people have trouble understanding that, especially if a caregiver or a family member contacts you because they're concerned about their loved one. That could be frustrating, I'm sure. We

SPEAKER_01:

had one case where we got a call. My mother is being sexually abused in her facility by another resident. You need to go and take care of it. And the ombudsman went in and met with the mom. And she said, oh my God, that's my boyfriend. My daughter is having a conniption fit. And we said, thank you for your time, ma'am. May we tell your daughter that you don't want our help? She said, I'll tell her myself, but you can tell her too.

SPEAKER_02:

Interesting. Yes. And it's really important that we remember that older adults are are people and they have rights too, and they wanna be able to direct their own lives. So that's one of the wonderful things about the Ombudsman Program as much as that might be frustrating for some people, it's really wonderful.

SPEAKER_01:

And it's very easy for people in long-term care facilities who are dealing with medical personnel who are always trying to convince them to do the thing that's in their best interest all the time to have someone to speak up for what they want. Because, you know, we all make some decisions that we know are not the best thing for us, but they're the thing we want.

SPEAKER_02:

Right, right. And we don't want somebody telling us that we can't do that.

UNKNOWN:

Right.

SPEAKER_02:

We're grown. We can make our own decisions. So we have been focusing in these podcasts on what happened in long-term care during the pandemic with the lockdown. So can you kind of help paint a picture of what happened to long-term care in March of 2020 when facilities went on lockdown due to COVID-19?

SPEAKER_01:

Sure, well, I can paint a picture as much as I'm able because as of March 16th, 2020, the state ombudsman decided that the ombudsman program throughout the state was not going into facilities based on the pandemic. So you couldn't

SPEAKER_02:

go inside at all.

SPEAKER_01:

We could not go inside at all prior to that.

SPEAKER_02:

Starting on the 16th.

SPEAKER_01:

Starting on the 16th. Prior to that, our staff was in the facilities you know, usually three days a week, multiple facilities a day, investigating complaints, just talking to residents, dealing with care issues, you know, all the things we normally do. And then it stopped. And so that was, a hugely jarring thing for our program and for our residents. I mean, residents, I think they cared less about the fact that the ombudsman couldn't come in than the fact that their families couldn't come in. And so- That's right,

SPEAKER_02:

no one could go in.

SPEAKER_01:

No one could go in. And at most facilities, residents were confined to their rooms. And at that time, you know, COVID was rampant in facilities. So people were really scared because residents were dying. Residents were going to the hospital. You know, we lost several longtime beloved clients to COVID and, you know, I don't know how many more we don't know died of COVID just because when we finish a case, we don't always keep up with everybody that we've worked with. We tend to see them again when we're in facilities, but people move to different facilities or go home and we don't necessarily keep up. So the residents were very scared. And all of a sudden, a lot of the rights that residents had in facilities were waived. So facilities were moving people's rooms constantly. And that was for a good reason. They were trying to cohort the COVID cases. But you know, from what we were hearing from our work, trying to keep up with our work over the phone, facilities were also just moving residents willy-nilly and moving them all the time. So they would have a roommate for a week and maybe they would get along and maybe they wouldn't, and then they would be moved again. And It was very disruptive, especially when you're stuck in your room at all times. And moving rooms sometimes means changing caregivers. And so everything was kind of in flux right then. And people were really scared and really lonely. As far as our work goes, we tried to start doing as much as we could by phone to the extent we could by video conference and things like that. But if we didn't have a personal cell phone number for a resident, it was often difficult to get through, especially at the facilities that we're having more stresses. So, you know, we would call in and we would try to reach a resident and you get transferred to the nurse's station and maybe they try and see if the resident's available. Maybe they say they're sleeping. Are they sleeping or not? These residents seem to always be sleeping. Yeah,

SPEAKER_02:

you don't know. You can't get in there to see

SPEAKER_01:

what's really going on. Maybe we just get hung up on and try again. There were some nursing facility groups that decided to try and make certain facilities, particularly COVID facilities. And so a lot of COVID residents would get transferred to this other facility that they were not familiar with.

SPEAKER_02:

So not just moving rooms, but some people were actually getting moved from the facility that they had maybe been in for a long time even. Yeah.

SPEAKER_01:

Yes. And so we tried to call as many people as we could at that facility. And we broke it up among our staff and we realized we had to set times because there were only so many phones and we were all trying to call and we were taking away time. We couldn't get through because somebody else was using the phone to talk to them, but also we were taking up valuable nursing staff time. So we We set it so only one ombudsman would call at a time. Oh,

SPEAKER_02:

so you had like your window of time to try to call people. Gosh.

SPEAKER_01:

But for most facilities, we only have one ombudsman assigned to a particular facility. So that isn't usually a problem. But it was easier to keep up with people we had open cases for or people we already knew. But anyone we didn't have a relationship with, you don't even know that they're there. Usually when we walk into a facility, we ask for a roster and we're allowed to have that as the ombudsman program. But trying to get a roster to start calling people was almost impossible. It was

SPEAKER_02:

just- Who knows if they even had a good roster for themselves. I hope

SPEAKER_01:

they had

SPEAKER_02:

good roster for themselves. It's kind of scary. Yes. So, wow, there was a lot going on for everybody during that time. Did you get a lot of referrals and a lot of new cases during the lockdown? No.

SPEAKER_01:

We had some residents who knew about our program calling us themselves, often people who had had prior cases or already met an ombudsman when we were allowed to be in. We got a lot of calls from family members trying to figure out what was going on in facilities. They weren't getting good information. And in May of 2020, the feds put out a regulation that the facilities had to let families know when someone, when their relative had COVID had to let the families of everyone in the facility know if the, how many cases there were in the facility, that kind of thing. But, you know, that was two months in.

SPEAKER_02:

Wow. So prior to that, even if somebody's family member in the facility had COVID, they might not have found out.

SPEAKER_01:

Facilities were supposed to tell them. And, you know, if they went to the, if they went to the hospital, they were supposed to find out, but there were a lot of things that were falling through the cracks and a lot of family members who were trying to get through. Sometimes family members were trying to get through and the facility was legitimately not giving them information because facilities aren't supposed to give health information unless they have consent of the resident.

SPEAKER_02:

So

SPEAKER_01:

if they didn't have a POA on file and the facility didn't try to get consent or the resident couldn't consent, they're not supposed to give that information

SPEAKER_02:

Wow. So the telephone was not really a good method for families to get information, especially like you said, if they didn't have a power of attorney on file for them to talk.

UNKNOWN:

Yeah.

SPEAKER_01:

I mean, so there were lots of issues with family members trying to find out what was going on with their loved one. There were a lot of issues with residents who declined greatly, especially if they were used to their family members coming. There were a lot of dementia residents who didn't understand what was going on. They just knew that their daughter had come to visit every day and suddenly she wasn't coming. from what we heard that led to a lot of behaviors among dementia residents because they were upset and especially dementia residents Some could understand, you know, doing a FaceTime or a Skype call with a loved one and some could not. It, you know, it just depends on the person with dementia, whether that can work for them. Right. And some facilities, facilities, many facilities tried to get some tablets and have the ability to have these calls, but the calls involved staff time to set it up and for some residents to supervise it, to help them with the technical aspects of it. And so that was very hit and miss, the video conference calls.

SPEAKER_02:

Yes, I've heard that that was extremely challenging, especially like you said, for those with dementia, they don't understand why this person is not there in the room with them. It's almost like teasing them to see this video picture of their loved one. And that's frustrating. So did you guys find other creative ways to get around the barriers of not being allowed in the facilities and to see what was going on? Did you work out some strategies? Yes.

SPEAKER_01:

Well, we checked in with the administration much more often. We did a lot of contacting staff to figure out what their policies were at that time and things like that. We'd rather be talking to residents than staff, but we found that if we were emailing the staff we knew at a facility, they would usually eventually get back to us. We can be very persistent. You're good at that. So we were working much more on making sure that they had policies in place that were conforming to what the policies were at the time, which there were a lot of rights that were waived, but still making sure that they were taking care of residents.

SPEAKER_02:

Okay. What kind of rights were waived?

SPEAKER_01:

So very early in the pandemic, the The right to notice before your room was changed was waived. The right to have visitors was waived. The right to... what other rights were waived. There was a huge list of rights that CMS waived or regulations that CMS waived temporarily. And it included requirements for training for staff.

SPEAKER_02:

So

SPEAKER_01:

facilities could bring in staff and not make sure they went through the required training to become a CNA within the prescribed timeframe. So there there were a huge number of rights that were waived at that time. And as time has gone on, those waivers have been canceled or expired and very few of them are left at this point.

SPEAKER_02:

Okay. All right. But at the time, were any of the basic care needs waived? I mean, I've heard a lot of reports of people not getting changed, not getting to use the bathroom, not being moved out of the dining room or moved from their bed to their chair. Did any of that actually change in terms of the guidelines or was that just staffing issues?

UNKNOWN:

Yeah.

SPEAKER_01:

I'm trying to remember exactly what the waivers were. Most of it was staffing issues, but there are certain things like once we were able to get back into facilities, I heard from a number of people how at many facilities, everybody's hair was long and shaggy. The grooming was really not where it had been, especially since... So that was something that, you know, facilities couldn't let the, the hairdressers, the hairdressers in and they, you know, I argued that under Medicaid, people have a right to be groomed that includes basic hair care. And, you know, you're not going to, you're not going to get your perm and blow out, but. Right. So you should get basic washing

SPEAKER_02:

and trimming and.

SPEAKER_01:

Yes. And especially for the men who need to, uh, to be shaved and to be, but specifically to have, you know, very simple haircuts, uh, Facilities said they weren't allowed to do it and you know, the way I read the licensure laws for barbershops and hairdressers, there's an exception that people in long-term care facilities can have those things done by people who are not licensed barbers or hairdressers. But the Department of Public Health said, no, they should be having licensed people do it. So, you know, that has a huge effect on, on your mental health to feel like you're, you know, you're ungroomed and you're, you know, it, it just doesn't feel good. And when you're already kind of confined and, and and lonely and, you know, everybody's mental health suffered.

SPEAKER_02:

Yes. That can be a really serious thing. Yeah. But that can be a serious thing for people's morale and their sense of dignity and pride. So I see what you're saying. So it sounds like you do.

SPEAKER_01:

Oh, go ahead. I, we got a surprising number of when can the hairdressers come back? Yes.

SPEAKER_02:

Yes. And we were just in a facility recently and they still hadn't gotten their haircut. Are you still hearing that? I

SPEAKER_01:

haven't been hearing that. And if you send that to us, we'll go talk to you.

UNKNOWN:

Okay, good.

SPEAKER_02:

You can take care of that. It sounds like you do all kinds of advocacy besides just working with the facility. You're going to the Department of Public Health. You're working with CMS guidelines. You do a lot of things.

SPEAKER_01:

Yeah. I mean, we're looking at the CMS regs and guidelines to be able to, you know, we want to know what the facility's requirements are. So we're not asking them to do something that they're legally not allowed to do. And on the flip side, you know, if they say, oh, we're not legally allowed to do that because no, actually the reg says you are, or the regulation says you're required to do that.

SPEAKER_02:

Right. But there is some interpretation that goes on there. So it helps that you are coming from a legal background and you know what things you can challenge and how to make the case for people.

SPEAKER_01:

That's something that's very useful in our program. I will say that we are the only program in the state that's housed in a legal aid organization. And there are many ombudsmen who are not lawyers who have learned to at least understand what the regulations are and still advocate even if they're not lawyers. Okay.

SPEAKER_02:

That's interesting though. You have that unique perspective and that can be a benefit. Good. So I interrupted you though, when you were talking about how you were able to still see folks in the facility, did you guys end up doing any like window visits or did you have any video visits that help at all?

SPEAKER_01:

So we, we did start doing window visits in about July of 2020. A few of our staff did, you know, at some places it wasn't worth it. If you've got a, you know, five-story facility where you can only see the people on the

SPEAKER_02:

bottom floor.

SPEAKER_01:

Right. So, so we started doing some of those. Those were good for seeing residents. We didn't get a huge number of It was hard to get substance done on window visits because you're talking on the phone and looking through the window. And

SPEAKER_02:

again, people with dementia, I understand, were very confused about that. I'm talking to you and I'm seeing you out in the parking lot. What is going on?

SPEAKER_01:

Yes. So in the fall of 2020, we were allowed to go back into facilities and we did so very cautiously. We had, you know, full PPE and we were not requiring our staff to go into any facility that was in outbreak status, which meant that they had, you know, at least one facility onset case at the time. They kept changing the definition about status but at one point that was the definition and you know there were there were rules about how many staff uh were in outbreak and when they had been there and things like that um so our staff slowly started going back into facilities and we started doing it mostly for cases where we knew we had to, where it wasn't working to talk to the resident on the phone. So we were going in or we were hearing that things were particularly egregious at a facility and we felt like we had to go in. And gradually things opened back up more. And we were allowed to get vaccinated in group 1A, but nobody else knew that. So we took a lot of doing to get everybody vaccinated. But as people got vaccinated, we started going in much more. Okay.

SPEAKER_02:

Yeah.

SPEAKER_01:

And that was not just for our protection. It was also for the residents' protection. Throughout all of this, none of us ever wanted to be the ones that brought COVID into a facility or to one of our residents. So my first staff who started going into facilities regularly, we didn't have any requirements for our staff to test on a regular basis. And she was getting... The person who was going in the most in the fall of 2020 was getting herself tested on her own accord every week because she was young and healthy and could have gotten an asymptomatic case and never wanted to bring COVID to her residence.

SPEAKER_02:

That's a lot of responsibility because nobody else was really getting in yet. You guys were going in. You had to make sure you were healthy when you went in there.

SPEAKER_01:

And, you know, we still have requirements in place to, you know, before anyone goes out to facilities, even now, the state ombudsman has requirements in place that they have to fill out a form, you know, about if they're having any symptoms, what their temperature is that day. Yeah. you know, we really want to make sure that we are not harming our residents.

SPEAKER_02:

Right. So then that probably affects the rest of your life as well, because I know, I mean, I think all of us around the country, across the world are trying to keep track of who we're in contact with, what situations we should be masking in now and where we don't need to. There's so many, it feels like life or death situations that you make every day, just about going to the grocery store, letting your child go to attend a party And you guys being on the front lines as ombudsmen really had to be constantly making those personal decisions about, should I go here? Can I go there if I have to go to work tomorrow and I need to go see a resident in a facility? So that had to be incredibly challenging for you guys. I give you guys a lot of credit.

SPEAKER_01:

Thank you.

SPEAKER_02:

So what... were the greatest challenges that you guys saw during COVID? Like if you had to kind of pick maybe your top three things that residents were facing or challenges that you guys were bumping up against, what would you say? You

SPEAKER_01:

know, one of the big things that we saw was people who were Family members were supposed to be able to see residents at the end of life, even when other people weren't getting in. And everybody had a different interpretation. And, you know, family members were trying to come in from far away. And, you know, the facility would say, no, you can't come in because your relative isn't actively dying. And, you know, what actively dying is, I don't know. Who decides that? Yeah. And there was also a movement for facilities to start allowing essential caregivers in, to let one family member in who could help with the care, who could come in and help feed a resident and help get them dressed every day and things like that. And there were some allowances for that, and it was very difficult to... facilities were very inconsistent on how it was applied even within the facility. So those issues were very difficult. It was very difficult to see residents declining. You know, we would talk to a resident one month and check back in with them the next month and they weren't making as much sense. And, you know, with people with early dementia, sometimes you get a good day, sometimes you get a bad day, but I think people were declining faster.

SPEAKER_02:

Definitely, yes. And then physically too, if they were in there for rehab and they weren't getting any rehab,

SPEAKER_01:

Oh, that was something that was almost impossible to deal with. It was the amount of rehab happening during COVID was, again, very inconsistent. And sometimes it would start when the facility was not in outbreak status and then stop again because they were in outbreak status. And, you know, one of the other challenges was just keeping up with all the rules because, you know, CMS would put out new guidance, you know, every few weeks or, you know, or a couple months. And then the Department of Public Health would put out guidance after that to implement it in Illinois. And so the rules were just constantly changing. You had to

SPEAKER_02:

stay up on that to know what you were supposed to be following up on and enforcing. And wow.

SPEAKER_01:

Yeah. And, you know, if the rules changed in a way that was good for residents, we wanted to make sure the facilities knew about it and were implementing it.

SPEAKER_02:

Right, right. And everything was changing all the time for everyone, but especially those rules for those vulnerable populations, like you said, through CMS. So that had to be Hard to keep up with. Those are good examples. We interviewed several residents who are still living in long-term care for some of our earlier podcast episodes, and we got their firsthand perspectives on what life was like during the lockdown, but that was just a small sampling, whereas you saw and talked to hundreds of residents in many different facilities. What were some common themes or challenges that you were seeing and hearing?

SPEAKER_01:

Common themes, understaffing was a hugely common theme. People were very frustrated with having their rooms moved around a lot. People were very frustrated with the lack of visitation. People were bored.

SPEAKER_02:

Just being stuck in a small room with several roommates, possibly, or maybe just by yourself.

SPEAKER_01:

We had a lot of people who wanted to be able to go outside, even just on the grounds of the facility, and the facility would say no. There for brief periods, there would be facilities that would only let the smokers go outside. So then everyone wanted to start smoking. Those are

SPEAKER_02:

frightening words, yeah.

SPEAKER_01:

They realized, oh wait, that's not a good idea. So, but... you know, there, there were facilities that would have that in place for like a month. And you'd be amazed how many people start smoking when, when the only way to get fresh air is smoking.

SPEAKER_02:

Is to be a smoker. Yeah. Sign me up. I need to get out of here. I need to get outside. If the smokers are going out, I'm going out.

SPEAKER_01:

And, you know, trying to make trying to have facilities make that a priority because there were a lot of people that were like, I just need some fresh air. I need to, you know, I need to see someone other than my roommate and my CNA. Right. Yeah.

SPEAKER_02:

I mean, all of us, you know, were stuck at home and we thought that was difficult, but during that first summer and even in the spring, we were all able to go outside. People were walking their neighborhoods. You know, we were all still getting out. I can't imagine being forced to stay inside for that long.

SPEAKER_01:

Yeah.

SPEAKER_02:

It's pretty amazing that people survived that really.

SPEAKER_01:

And a lot of them didn't. And then a lot of them

SPEAKER_02:

didn't. Yeah. Yeah. That's unfortunate. And then did you hear a lot? We heard about people's stuff getting lost quite a bit. Important things.

UNKNOWN:

Yeah.

SPEAKER_01:

And that was part, I think a lot of that was part of the consequence of moving a lot because the residents didn't get to pack up their stuff. The facility would pack up their stuff. Somebody else

SPEAKER_02:

just threw their stuff in boxes and it didn't get to them all the time. Or

SPEAKER_01:

if someone would go to the hospital, you know, their stuff would get packed up and, you know, it would... go over like the over in a corner and they would lose track of where it was. They were moving so many people so often that a lot of stuff got lost and the facility, some facilities took more care than others and some were more willing to replace things than others.

SPEAKER_02:

But yeah. And some of those things were very important like glasses and dentures and Hearing

SPEAKER_01:

aids, IDs, so many IDs got lost and, you know, trying to get any of us trying to get a new ID during the pandemic was a problem. And, you know, if someone was trying to get out of the facility to get an apartment, you need your ID. And, you know, so it

SPEAKER_02:

was missing. Right. Right. Yes. So at the same time that there were sort of these common challenges going on in facilities, we know that each person's experience during this was unique and there were some really unique situations. Are there any stories that you can share with us or unique individual experiences that you could share just to kind of give the listeners a taste of what it was like in these facilities?

SPEAKER_01:

Sure. So we had one... one experience was Mr. C who moved from one facility in a, in a nursing home group to a sister facility that was about an hour and a half away. And they moved him on very short notice and without his prosthetics, as well as a bunch of other things. And, you know, he, he talked to our ombudsman about it first when it had been about three weeks and he had been called

SPEAKER_02:

his prosthetics.

SPEAKER_01:

And he had called the administrator and it was going nowhere. And so my ombudsman for the facility he was in started calling the administrator, the ombudsman for the old facility went and visited the administrator. And he said, oh, I'll do it, but I don't have it arranged. And then he started ducking our call. The administrator started ducking our calls. What was

SPEAKER_02:

going

SPEAKER_01:

on?

SPEAKER_02:

Yeah.

SPEAKER_01:

He didn't want to spend the money to have it couriered or send a staff person. I mean, finally we had to call the general counsel of the company and after letting the general counsel of the company know the man had his prosthetics back in a day, but I mean, that was after six weeks.

SPEAKER_02:

He

SPEAKER_01:

shouldn't have been without his prosthetics and his belongings for six weeks. I mean, talking about a man's

SPEAKER_02:

legs. Right. That is just unacceptable. And then if it takes them that long to get something that essential to somebody, I can't imagine how long it takes when they feel like it's not quite as essential. And maybe it's really essential to an individual, right? Or it's a hearing aid or it's the dentures or it's an item of clothing that means something to somebody. Or

SPEAKER_01:

their power wheelchair, which helps them get around. I mean, and Medicaid has very strict rules about when you can get a new power wheelchair. Right. Just because it got lost doesn't mean that you're allowed to have a new one if you're on Medicaid or Medicare.

SPEAKER_02:

Right. How those... get misplaced, I don't understand, but that is why not they're one of those challenges. So

SPEAKER_01:

yeah, there were things like that. We also had someone very early in the pandemic who had gone, he was in independent living and he had gone to a skilled nursing facility for rehab and he finished his rehab in April of 2020 and his independent living facility said, no, you can't come back. And the family tried to work with them and they kept saying, no, you can't come back.

SPEAKER_02:

Were they just not letting anyone come back because of COVID?

SPEAKER_01:

They didn't want him coming from a skilled nursing facility because they were afraid he would bring COVID with him. And, you know, we were, when we got involved, we asked them what basis they had for saying that this man couldn't come back to his leased apartment.

SPEAKER_02:

His home. Yeah.

SPEAKER_01:

his home. And they were not a facility that could say you can't come in because of a medical thing. And they didn't have an answer. So we ended up agreeing that he would isolate for two weeks. And he was was someone who didn't go out a lot anyway. But we got him back in, but they, oh, they also tried to say he couldn't have home care in the facility if he came back. And then his daughter went and called the families of other people who lived there and they were all having home care. So like, well, everybody else is having their home care companies come in. She's like, Well, those are these specific companies. I said, we will arrange from those specific companies.

SPEAKER_02:

Wow. It's like the people were just putting up barriers out of fear or something. It just caused everyone to go crazy with that.

SPEAKER_01:

Everybody was afraid and everyone was especially afraid of skilled nursing facilities.

SPEAKER_02:

Yeah. And, you know, you can understand to some extent when you look at the numbers that But like you said, there's things that you can do. You can isolate for a while. You can be safe and careful. That was his home. All of his stuff was probably there, right? All of his furniture and belongings

SPEAKER_01:

were all in his apartment. And his family was still paying his rent. Good grief.

UNKNOWN:

Yeah.

SPEAKER_01:

We actually negotiated for his rent for the month they wouldn't let him in.

SPEAKER_02:

Good. Good for you guys. I

SPEAKER_01:

think we even got some of the cost of keeping him in the skilled nursing facility after his Medicare days ended reimbursed.

SPEAKER_02:

Good. Good for you guys. I don't know where these... people and families would have been without ombudsman. It really speaks to the importance of the job that you do, Suzanne, because it's hard to advocate for these things on your own. And you, like I said, you're a lawyer, you know how to go up the chain and talk to the legal counsel and you can get people to respond to you. It's unfortunate that they have to do that though.

SPEAKER_01:

Yeah, and it's hard enough to know all the rules when it's not a pandemic, but when it is a pandemic and the rules are changing all the time, it was tough for us to know all the rules. Yeah. So it makes it even tougher to advocate for yourself. But many people did a very good job of advocating for themselves.

SPEAKER_02:

It's really hard. Very good. And probably even just some of the interactions that they had had with ombudsmen in the past sort of trained them that that's what you're going to have to do and you need to speak up for yourself. And the families probably learned that as well. So that's, again, a testament to the work of the ombudsman program.

SPEAKER_00:

Now that we have learned about our guests and who they are, we want them to walk up the steps. Grab a microphone and get on our age stage. This segment allows a soapbox-like platform to speak to the aging community on any topic they want to shine a light on. Suzanne will be covering what she believes needs to change to make the aging world a better place, and comments on a lot of the problems that were there before COVID-19 and why they still exist today. Let's listen in.

SPEAKER_02:

So, I mean, we're talking about these like large systemic problems, and I feel like some of these problems already existed before COVID. You guys already had your hands full and had plenty of allegations and concerns and challenges to investigate. before COVID, right? And then COVID just kind of like blew up this whole long-term care crisis and made it in some ways more obvious to everyone. And in some ways it just made the problems even worse. What do you, I mean, I know that it's not your job to solve the world's problems by any means, but if you had a magic wand, what do you think we can do as a society to make sure that this does not happen again?

SPEAKER_01:

Well, I think having a better understanding of the balance between cutting off visitation and infection control. The facilities were very bad on infection control before COVID. And we know this. We know how much they were being cited and facilities were repeatedly cited for infection control issues before COVID. And then COVID blew it up and showed how bad it was. And

SPEAKER_02:

without that infection control, COVID just ripped through those facilities. Yeah.

SPEAKER_01:

So I think now everybody has a better understanding of how you can implement infection control, even with people coming in from outside, because the staff were coming in from outside every day, unless you're going to create a true bubble, right? You know, the virus has abilities to come in. So let's do the best we can with infection control and understand that there's a balance here, that the Losing touch with your loved ones not having that, you know, face to face time or, you know, even for some people getting cut off from regular phone contact with their loved ones because it was difficult to get access to a phone in their facility is hugely detrimental in many, many ways, especially to residents' mental health, but also to their physical health. Right. In part, because there's no one who knows them and is seeing how much they're declining on a regular basis. Because, I mean, one of the huge problems that we haven't solved right now that came up during COVID was staffing shortages and, you know, use of agency staff who come in for a day or a week. And so they don't know that this is not normal for someone when they're slurring their speech.

SPEAKER_02:

But if

SPEAKER_01:

somebody who knows them, who knows that this person did not slur their speech yesterday, sees them slurring their speech, that's a huge signal. We need to do something now. And so I think... we need a better balance. And there are lots of states, including Illinois that have, that are considering or passing legislation about making sure that visitors can always come in.

SPEAKER_02:

Yes.

SPEAKER_01:

And, you know, but it's all a balance. We want, we don't want people being able to come in and get everybody in the facility sick. Right. It's, it's, it's very difficult but it has to be better than what happened this time

SPEAKER_00:

thank you for listening to the age guide perspectives on the aging journey we hope you learned something new on this podcast because we all have a stake in promoting a high quality of life for people on their aging journey age guide coordinates and administers many services for older adults in northeastern illinois We serve DuPage, Grundy, Kane, Kankakee, Kendall, Lake, McHenry, and Will Counties. Our specially trained professionals are available to answer questions and connect you with local service providers and resources such as Adult Protective Services Program, which responds to and investigates reports of abuse, neglect, and financial exploitation of people 60 plus and adults with disabilities aged 18 to 59 who live in the community. The Long-Term Care Ombudsman Program, which advocates for residents of nursing homes, board and care home, and assisted living facilities. They are trained to resolve problems and can assist with complaints of residents living in long-term care facilities. If you are interested in these services or want to learn more, go to our website at ageguide.org. Please follow our podcasts so when we post our monthly podcast, you are notified on your streaming account. Thank you, and we will see you next time on The Age Guide, Perspectives on the Aging Journey.