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We have been at our wits end for a few weeks now and had an appt scheduled this week with her physician to go over some things and discuss the decline but with all the virus stuff going on that cancelled. I've left numerous messages with nurses, Dr's etc and am getting no where. All the agencies who can help are closed and I really do not know where else to turn. Since she lives with us there is no escaping any of it and we are pretty all on stay at home orders so other than going outside there is no where to go...

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I don't believe it is going o be possible at this time. Nor even easy. Perhaps there is someone at an Aged Care Place on call to answer any of your questions. For now, Please, Take care and just Bear.
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Firstly, there may actually be no person at the physical address/building of the doctor's office. Many of them are closed due to the Novel Coronavirus. There may only be a virtual office. That said, try your town's COA (Council on Aging), who may have on staff a social worker as well as a dedicated elder care individual.
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Just read in newspaper that Pennsylvania, New Jersey, and New York are under government guidelines to accept admissions from hospitals to skilled nursing facilities. This order was given to free up hospital beds for new admissions due to the coronavirus. Have you contacted the admission directors of the facilities you are interested In? Many facilities require an application to be completed as well as paperwork completed by the primary care physician. Given the situation we all are experiencing, the facility may want your loved one tested for coronavirus. That will require a physician's order. Since the physician visit was cancelled, is it possible to schedule a telemedicine appointment? That may help you to get the process going. Good luck.
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My mom's nursing home is not accepting new admissions. There are many empty rooms on the first floor as they send home rehab patients. I am hoping they are thus creating a wing for the residents that get Covid away from the ones who are still uninfected. As another person said, it must vary according to where you live.
This is in Baltimore, MD.
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Igloo:  "The whole testing debacle in the US is beyond astounding. This should have been pipelined in by end of January or by Feb 10 using WHO test. First world health care in the US, yeah sure, my Covid-15+ lbs. size butt."

You are soooo right!   

And the widespread shutdowns are in some measure a reflection of the lack of recognition and action when it became obvious there was a pandemic taking place.  Now we're ALL  required to compromise, except the idiots who defy the shutdowns (and I hope they're either jailed or fined).

Of the multiple changes, recognitions, plans and whatever hopefully come out of this, one has got to address seniors, who in so many ways are more vulnerable than people who are running around, partying on spring breaks, getting together and foolishly and irresponsibly spreading the virus.  

End of rant.  Off my soapbox now, other than to observe that I'm so glad my now deceased relatives didn't have to go through this; it was challenging enough w/o the many anxieties,  worries and decisions caregivers are now facing.
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I would wait a couple of months and try again to get your elder placed. I think it would be dangerous to try to put anyone in a facility at this point. They probably will get Covid-19. You and any other family members won’t be able to visit and monitor their care on a daily basis. There is a staff shortage in facilities. Their belongings will be misplaced or stolen. Medication and nutrition care would be questionable at this point. Other patients will have access to their rooms putting your elder at risk for many things. If you can’t go in and monitor them closely everyday I wouldn’t do it. They could die alone and not understand what is happening to them. Sorry to be blunt but when my Father was in dementia care I saw things that made me question the safety of the industry on a good day.
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Maine, You’ve been one AC for quite a while, right? So I’m guessing that caregiving for her has truly gotten beyond the level of care y’all can do at home and that she’s at skilled nursing care needed, so it’s a NH placement. Is that it? If so, I’ll echo what Daughterof1930 & MedicaidMaze posted, that it will be doable if she’s private pay and you are prepared to have her enter as a “drop off”. The facilities need residents there and paying in order to stay open, if she has the ability to private pay at least 6 months, you’ll find one who will take her. I’d like to add, if her health care needs can be done via TeleMed and she’s somewhat current on her labs and has 30 days of RXs, that will make her a more “attractive” new resident.

On the drop off, I’d suggest you get her stuff together now so it’s at the ready. Like wash 2-3 weeks of clothing, undies, shoes and have them labeled and all folded and in big ziplocks with her name on the zippie in sharpie marker. Ditto for personal care stuff, like soap, shampoo, lotions. A radio, tv and couple of extension cords. Few Books or stack of magazines, those maze coloring books and colored pencils, a couple of photos. Everything into like the 1 gallon or 2 gallon Ziplocks - so staff knows all are ok to open and touch. Get a couple of flip crates and shove all her gear into them. If you’ve ever sent a kid off to camp, it’s that playbook to use. No jewelry! For the bigger stuff, try to put those into those big twisty top clear garbage bags - like the kind you use to bag leaves in. Everybody is worried about “fomites” to some degree. Placing her gear into zippies helps abate that worry. Comprende?

as a preemptive, I’d suggest if at all possible to get her tested. Are they doing any drive thru testing where you are? If so, please try to figure out how to get her to one of these to get a swab done. Hopefully your area is actually getting test results back quickly. Having her tested will give everyone a baseline as to where she is and where you & the facility is on risk. A lot of places are using the “T2 plus 14” plan for being determined Covid positive or negative. T is test day, 2 as in 2 days to process & get lab results and 14 days quarantine. It’s a 16 day wrap.

As an aside on this, where it am - New Orleans area - the federal & military & city partnership drive thru testing sites rollout has been truly beyond a total clusterF; taking like 7-12 days to get back at best and the contractor (LabCorp) has a backlog of thousands; all 3 sites have been consolidated to 1 site now limited to 500 per day. (source WWL) Basically all those tests are useless to identify positives early, stop spread or figure out contact as too too much lag time. The 2 big hospital groups (Oschner & Tulane) are now doing in-house testing with 24 hr test results for their folks. Thanks goodness but for everyone else it’s still a crapshoot. The whole testing debacle in the US is beyond astounding. This should have been pipelined in by end of January or by Feb 10 using WHO test. First world health care in the US, yeah sure, my Covid-15+ lbs. size butt.
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My wife had a freak accident in a local E/R and broke her C1 & C2 vertebrae just after New Years, coded, was brought back and after a couple of weeks in ICU in a trauma center was transferred to a nursing home as she was a quadriplegic at that point and there were little to no expectations of her recovery. I was still hoping praying that she could though.

After a few weeks at the home, she started recovering and the physical therapy department at the home started working with her, but by the end of February, they'd done pretty much what they could do with her and she "plateaued" there. From the start, I was spending the days and early evenings doing what I could to keep her progressing, but the home wouldn't allow me to work with her beyond a certain point and it was obvious that if someone would work with her, she could do so much more. So my wife asked me to dig around and see about getting her moved somewhere else. Then the state shut down all visitation at nursing homes because of COVID 19.

Shortly after COVID hit hard and they isolated the nursing homes, I called a nearby inpatient physical rehab facility that has the reputation of being boot camp intensive with excellent results to see if she could be transferred there. (when we left the trauma center, we were told she wouldn't be physically capable of being in their program) The rehab hospital had me have the nursing home send them a referral on a Friday.

On Wednesday evening a week ago with the transfer having been approved, I went to the home, loaded her into the car and drove her to the rehab hospital where she has picked up her progress and they're talking of her release in a few weeks being able to take care of herself. If she had stayed in the nursing home, she'd have been in one for the rest of her life as there was little to no interest there in her recovering enough to be able to take care of herself.

So, that's how I got my wife transferred to another facility during this pandemic. I still can't visit with her, but she's getting the care she needs, I do get to make laundry pickup/delivery runs every few days and I can talk to her through her room window, on the phone and on Facebook messenger via her laptop. Sometimes, you just have to snatch up the ball yourself and run with it. That nursing home was just going to let her stay there.
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soninlaw58 Apr 2020
I forgot to add that she's determined to make the most of the rehab hospital, they're impressed with her and she's making great progress. She's starting to get up out of bed by herself and walking with a platform walker. She can type one fingered on her laptop, and use Siri to call on her iphone. All of which she wasn't allowed to try to do at the nursing home because of fear of her falling.
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There’s a lot of pressure on SNFs to accept recovering COVID patients from hospitals. It may even become mandatory in some places, so you’re probably going to have better luck at an AL community. Many are taking new residents on a case by case basis. And there will be a strict isolation period.
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Assisted living and memory care places are easier to get into than skilled nursing facilities. Is your elder medically qualified for skilled nursing or is that what you wanted the doctor to help you determine?
Relatives were able to have someone evaluated for placement into memory care by a geriatric physician using Telemedicine. The memory care facility near the person is accepting new residents and putting them in private rooms for 14 days. The family decided to keep the person at home right now, but I believe there was a path to getting them into a facility if that's what they wanted to do.
You could call a memory care facility and ask them if they could arrange an evaluation. If you feel your elder needs skilled nursing, the hospital is the fastest route to that placement.
This assumes you have the money for private pay. If you need government assistance with her placement, I think you are sort of stuck right now. It's not easy in the best of times.
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Oklahoma Apr 2020
Putting them in private rooms for 14 days means locking your family member in a room and being at the mercy of a skeleton staff.
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We barely got in to a new facility on March 16. The past and current place had already gone to lock down. Old place said If I take sis out at all I could not bring her back. I could not bring her home-I was concerned she would think she was going to stay with me permanently-so I did not want to do that either get her hopes up, safety issues etc.

-New place said I could bring her to the facility but could not go to her room, unpack, kiss goodby etc. It has been really tough on both sides. Sis was mad "why am I here, where are you, why don't you come to see me?" I told her bad flu going around-now staff wearing masks so maybe she understands now-it is a real thing-not something I would say as an excuse.

I coordinated with PT staff to come "watch from the window" sis PT session. This helped me a lot to see sis hanging in there. Gave her lots of thumbs up and big smiles.-something I can continue to cheer her on about being strong etc. as the lock down continues. I hope I am just now seeing " a show" for my benefit.

I visited frequently at the old place-I wanted to in the first place and had to due to bad care there was always something happening to sis. Lots of horrible stuff happened at the old place-sis would not be able to tell me if staff is being good/nice or not. I will file complaint with state-not sure they will do much due to lock down.

One day at a time.
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Call the places you are interested in. I am in the process of looking for work in one of those facilities. All office personnel are working from home, so it is taking longer for every application process.
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Our state is under order to accept new nursing home residents. They will be isolated for fourteen days upon admission. Call the places you’re interested in and check their current policies, nursing homes are a business with bills to pay, they don’t like empty spaces if it can be helped
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The answer to that is going to vary depending on where you live, some places are still accepting new admissions. Have you tried speaking directly with your preferred nursing home?
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