An Urgent Need for Public “Perception” Reform

Media outlets are frequently reporting about the disproportionally large number of COVID-19 cases and deaths in nursing homes. Most discussions understandably seem to focus on an urgency “get something done” fix this problem. In response, multiple potential policy reforms for long-term care industry have been recently proposed. Missing from public discussion is need “public perception reform” homes home health professionals. Effective LTC reform cannot occur a society where facilities often perceived as “dirty,” “depressing” places most vulnerable individuals “neglected.” The fact that virus transmitted into facility COVID-positive staff or residents admitted local hospitals reinforces misguided concerns not doing enough protect their residents. Even before pandemic, careers were held low regard compared with office-based hospital-based (Health Aff [Millwood] 2010;29:109–115). average salary registered nurses lower than who work setting (Houston Chronicle, May 18, 2020; https://bit.ly/35KwTcY). However, pandemic offers opportunity change perceptions because we can see numerous examples hard work, courage, dedication, compassion by staff. These heroes provide 24-hour-a-day despite fear becoming ill exposing own family members potentially fatal illness. While term “heroes” being used (rightfully so) describe emergency department hospital workers, may be showing even greater bravery they persons less support fewer resources (personal protective equipment, negative-pressure rooms, etc.). Similarly, there very few areas besides settings single nurse nurse’s aide will many simultaneously. Without families community volunteers, also front line address escalating mental issues among Social isolation increase behavioral symptoms population high incidence dementia (Vital Health Stat 2019;3[43]; https://bit.ly/36MThlr) major depression (Int Psychogeriatr 2010;22:1025–1039). On top this, room restrictions, donning doffing personal equipment residents, lack communal dining activities hampers efficiency at monitor assess As struggle complex, individualized, interprofessional care, falls, dementia-related abnormalities, unintentional weight loss unavoidable. Nursing bearing disproportionate share burden. Forgotten crisis collegial psychological facing extreme emotional physical fatigue while caring during prolonged outbreak. all institutions should look opportunities improve infection control quality processes, it imperative avoid easy path tagging punitive measures against outbreaks. Guidelines prevention entirely applicable staffing resources, dementia, different regulations acute systems. professionals applauded given respect deserve. National organizations such AMDA – Society Post-Acute Long-Term Care Medicine, American Geriatric Society, Gerontological Advanced Practice Nurses Association, America could serve initial platform highlight outstanding service Dr. Golden geriatrician Orlando VA Healthcare Center professor Department Internal Medicine UCF. content manuscript does represent views United States Government.