The flu started in the personal care center at Masonic Village in Elizabethtown, Pa., then moved to the nursing home. Within a few days, seven older adults had taken ill.
Administrators moved quickly: they shut down two floors of the buildings and told all visitors to stay away. All social activities stopped, and residents were asked to stay in their rooms.
The phones began to ring. “How is my wife doing?” an older spouse would ask. “What’s Mom eating?” a concerned daughter would inquire.
As the flu sweeps across the country, all kinds of issues are arising as institutions serving the elderly cope with outbreaks and nurses, home health aides and family members fall ill and can’t attend to the older people under their care.
One of the residents of Masonic Village was the mother-in-law of Joyce Heisey, director of nursing at this continuing care retirement community. She had come to the nursing home after a nasty fall and a subsequent hospitalization for rehabilitation.
“It was hard for her because she wasn’t accustomed to being in this kind of setting, and my father-in-law couldn’t visit,” said Ms. Heisey, who talked to her in-laws about their experiences. They declined to speak directly to a reporter.
Worried about isolation, the home sent recreation therapists into residents’ rooms for a few minutes each day and directed physical therapists to continue working with those undergoing rehabilitation, again in their rooms when possible.
In Collinsville, Ill., a city of about 42,000 that is 23 miles east of St. Louis, 20 percent of the staff at Home Instead Senior Care have called in sick, either struck by the flu themselves or at home taking care of a sick child.
“We’ve never seen it as bad as it is this year,” said Skip Brown, the agency’s owner. In previous years, about 5 percent of the staff have taken ill during flu season.
“It’s really hard for our clients, most of whom are elderly,” Mr. Brown said. “All of a sudden you have another person coming in to your home that you’re not familiar with. That’s really hard for seniors, and we have to make sure they’re comfortable.”
One client, a 92-year-old woman with diabetes, was insistent that a stranger not come to help when her usual caregiver became sick and stayed home.
“The problem that we’re always concerned with is, what if an older person doesn’t eat and what if they don’t take their medication?” Mr. Brown said. Concerned, he called his client’s out-of-town daughter, who called an elderly neighbor, who agreed to accompany someone from the agency to make sure the older woman was all right.
As it turned out, she hadn’t taken insulin for a full day and was at risk of a diabetic crisis, which was averted when the agency worker intervened.
Things got bad so fast that after the second week of December, Mr. Brown required all staff members to get flu shots – and still they became ill. This year, the flu shot is effective about 62 percent of the time, the Centers for Disease Control and Prevention said on Friday.
Nationally, about 60 percent of health care workers get flu vaccines, which are voluntary in most hospitals, nursing homes and assisted-living facilities, according to Dr. Gregory Poland, director of the Mayo Clinic Vaccine Research Group. And when workers are struck by the flu, infections among residents can follow.
“The disruptions, the costs, the complications from this virus, no one should confuse it with a minor illness,” said Dr. Poland, who has advocated for mandatory immunizations for health care workers.
According to New York’s statewide influenza report for the week ended Jan. 5, 179 outbreaks have hit nursing homes this flu season — 57 of them during the week covered by the report alone. The state health department defines an outbreak as one confirmed case or two suspected cases of flu that are contracted in a nursing home.
Allison Chisholm, a nurse with Partners in Care, a home care agency operated by the Visiting Nurse Service of New York, had a flu shot on Dec. 27 and a week later took to bed with a fever and chills.
“It was so bad, my toenails were hurting. I had no appetite. I couldn’t move, I was so sore,” she said. “I knew it was the flu because I’m not a sickly person. I’ve never felt like that for 30 years.”
Ms. Chisholm had been seeing a woman in her 70s every day since October to treat a bone infection with intravenous antibiotics. “When I called her she could hear immediately that something was wrong,” Ms. Chisholm said. “She was concerned and said, ‘If you’re sick like that, don’t come – I don’t want to get what you have.’ ” A week later, the nurse said she got a phone call from the older woman checking in to see if she was better.
In this case, the client was due to end treatment the day after Ms. Chisholm fell ill, and she agreed to have a worker from the company that supplied her intravenous supplies administer her last IV therapy.
At the Martha Stewart Living Center, an outpatient center for older patients at Mount Sinai Medical Center, Dr. Audrey Chun, medical director, has been telling caregivers and other people who have any kind of upper respiratory problems — a cough, constant sniffles – to stay away from older people’s homes because of the risk of passing on an infection.
But do be sure to call in regularly to ask how your older relative or friend is feeling and whether they have unusual lethargy, breathing problems or disabling fatigue, said Jennifer Leeflang, senior director of private care services for Partners in Care. The agency has been getting about 10 requests a week for flu shots for homebound elderly ($100 for the visit and the shot). Other hospitals, like Montefiore Medical Center in the Bronx, are providing a similar service for home care agency patients.
New data released Friday by the federal Centers for Disease Control and Prevention underscores how vulnerable older adults are to flu and how many are being affected by the current outbreak. In the week ended Jan. 5, the rate of flu-related hospitalizations for people 65 and older was 53.4 per 100,000, more than twice that of another vulnerable group, newborns and children up to 4 years old. Hospitalizations are an indicator of the most serious flu cases.
That’s a big jump from the week before, when the rate of flu-related hospitalizations for people 65 and older stood at 29.3 per 100,000.
How has flu season affected your ability to provide — or get care — for your elderly relative? Share your experiences and advice here.
The New Old Age Blog: As Flu Rages, Caregiving Suffers
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