Pam Walker, healthcare navigator with Kettering Health will guide attendees through finding the right healthcare providers and services during a virtual expert series program
The healthcare system has become more complicated, expensive and confusing– especially as people age. Patients are required to identify the best way to start in the healthcare system, to be familiar with a multitude of organizations, to move through the system, and find the right services.
Pam Walker, healthcare navigator with Kettering Health will guide attendees through finding the right healthcare providers and services during a virtual expert series program on Thurs., Oct. 24, from 6:30 – 8 PM.
Registration is required by calling the Alzheimer’s Association 24/7 Helpline at 800.272.3900. Provide an email when registering to receive the Zoom link to participate.
As the featured expert, Ms. Walker will help individuals and families who are overwhelmed with healthcare needs understand how and where to find the right doctor, providers and healthcare services.
“Dementia is a progressive condition, and people with dementia often have individualized needs that change according to the different stages of their condition,” said Dayna Ritchey, program director of the Alzheimer’s Association Greater Cincinnati and Miami Valley Chapters. “As a result, they often require care from multiple health and social care services and providers across diverse settings as they experience transitions in care over the duration of their illness.”
“Unfortunately, dementia care is often fragmented, uncoordinated, and difficult to navigate,” continued Ritchey. “People with dementia and their caregivers often have a lack of knowledge and information about dementia and available support services, as well as limited access to relevant health and social care.”
“We are fortunate to present an expert such as Pam who understands and navigates the healthcare system every day to help patients and families who face serious medical conditions.” said Ritchey. “Attendees will gain confidence in how to effectively advocate for themselves or loved ones.”
There are 236,200 Ohioans 65 and older living with Alzheimer’s disease, according to the Alzheimer’s Association 2024 Alzheimer’s Disease Facts and Figures. More than 4,900 Ohioans died from Alzheimer’s in 2021. A total of 414,000 Ohio caregivers provide 624 million hours of unpaid care each year valued at over $11.4 billion.
To learn more about Alzheimer’s or other dementia and to access free local support and resources, visit alz.org/cincinnati or call the Greater Cincinnati Chapter at 513.721.4284 or the 24/7 Helpline at 800.272.3900.
Cincinnati, Ohio – 2024—2023 was a landmark year for Alzheimer’s disease research, including advancements in treatment, risk factors and diagnosis of Alzheimer’s and other dementias. In this new era of Alzheimer’s treatments, here are five significant discoveries from this year:
There are now three newly approved treatments for Alzheimer’s, with a fourth on the way.
In July 2023, the U.S. Food and Drug Administration (FDA) granted traditional approval for Leqembi for treatment of mild cognitive impairment due to Alzheimer’s and mild Alzheimer’s dementia. This treatment, while not a cure, slows cognitive decline and can give people with early Alzheimer’s more time to maintain their independence.
The FDA granted accelerated approval to Aduhelm for the same purpose in June 2021. At the Alzheimer’s Association International Conference (AAIC) in July 2023, Eli Lilly reported positive results for a third treatment — donanemab — in that same population. The company expects FDA action by the end of 2023.
In May, the FDA approved brexpiprazole for agitation in people with Alzheimer’s disease. This is the first FDA-approved treatment for Alzheimer’s-related agitation, which is experienced by about 45% of Alzheimer’s patients. According to research published in May 2023, there are more than 140 therapies being tested that target multiple aspects of Alzheimer’s.
Hearing aids could slow cognitive decline for at-risk older adults.
In the largest clinical trial to investigate whether a hearing loss treatment intervention can reduce risk of cognitive decline, researchers found that older adults with hearing loss, who were at higher risk of cognitive decline, cut their cognitive decline in half by using hearing aids for three years.
Blood tests for Alzheimer’s are coming soon, and could improve diagnosis and treatment.
Blood tests show promise for improving, and possibly even redefining, future Alzheimer’s diagnosis. Advancements reported for the first time at AAIC 2023 demonstrate the simplicity and value to doctors of blood-based biomarkers for Alzheimer’s.
Blood tests are already being implemented in Alzheimer’s drug trials for further proof of their effectiveness. And they are incorporated into proposed new diagnostic and staging criteria for the disease. Blood tests — once verified, and approved by the FDA — would offer a noninvasive and cost-effective option in identifying blood-based markers for the disease.
First-ever U.S. county-level Alzheimer’s prevalence estimates.
The first-ever county-level estimates of the prevalence of people with Alzheimer’s dementia — in all 3,142 United States counties — were reported at AAIC 2023. For counties with a population of 10,000 or more people 65 or older, researchers estimated the highest Alzheimer’s prevalence rates in Ohio.
The researchers identified certain characteristics that may explain the higher prevalence in these counties, including older average age and higher percentages of Black and Hispanic residents.
According to the Alzheimer’s Association, these stats can help public health officials determine the burden on the health care system, and better pinpoint areas of high risk and high need — for example, for culturally-sensitive health support and caregiver training services.
Chronic constipation is associated with poor cognitive function.
Approximately 16% of the world’s population struggles with constipation. That prevalence is even higher among older adults. This year, researchers reported that less frequent bowel movements were associated with significantly worse cognitive function.
Compared to those with bowel movements once daily, people with bowel movements every three days or more had worse memory and thinking equal to three additional years of cognitive aging. These results stress the importance of clinicians discussing gut health, especially constipation, with their older patients, including how to prevent constipation.
There are 220,000 Ohioans 65 and older living with Alzheimer’s disease, according to the Alzheimer’s Association2023 Alzheimer’s Disease Facts and Figures. That number is expected to hit 250,000 by 2025. A total of 493,000 Ohio caregivers provide 736 million hours of unpaid care each year.
Those concerned about themselves or a loved one can contact the Alzheimer’s Association Greater Cincinnati Chapter at 513.721.4284 to schedule a care consultation and be connected to local resources.
To learn more about Alzheimer’s or other related dementia, or to access free tools and resources, visit alz.org or call the Alzheimer’s Association 24/7 Helpline at 800.272.3900.
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Alzheimer’s Disease Facts and Figures, an annual report released by the Alzheimer’s Association, reveals the burden of Alzheimer’s and dementia on individuals, caregivers, government and the nation’s health care system.
The accompanying special report, The Patient Journey in an Era of New Treatments, examines the importance of conversations about memory at the earliest point of concern, as well as a knowledgeable, accessible care team to diagnose, monitor disease progression and treat when appropriate. This is especially true now, in an era when treatments that change the underlying biology of Alzheimer’s are available.
Erlanger, Ky. – The Cincinnati/Northern Kentucky International Airport (CVG) is making travel more accessible for passengers with hidden disabilities or conditions. The airport is participating in the Sunflower Lanyard Program, a worldwide initiative which aims to raise awareness and support those who have autism, hearing loss, dementia, PTSD, anxiety, or other conditions which may not be readily visible.
Employees and volunteers at many airports, and other public places, identify the sunflower as a symbol that a person may need additional assistance and patience. At CVG, all airlines, concessions, and TSA personnel have received and will continue to receive information about the program and how they can best offer assistance. Wearing a lanyard does not expedite security or other airport processes. Rather, it allows an individual to voluntarily share that they may need a helping hand, more understanding, or more time.
CVG travelers can request a free sunflower lanyard to be mailed to their residence by emailing info@cvgairport.com or by stopping by the information desk on the Baggage Claim level at the airport. CVG is experiencing high passenger volumes this summer and wants to spread awareness and increase utilization of this program.
More than 215 airports across the world participate in the Sunflower Lanyard program, including many CVG has nonstop service to including:
Seattle, WA (SEA)
Tampa, FL (TPA)
Boston (BOS)
Dallas (DFW)
Toronto, Canada (YYZ)
For a list of airports which participate in the program and more information, visit the Hidden Disabilities Sunflower website at hdsunflower.com.
AARP Ohio also asks the General Assembly to support bills that benefit Ohio’s 50 plus population as they age in place
Columbus, Ohio – Today, AARP called on Ohio lawmakers to pass House Bill 23, commonsense legislation that would help Ohio’s family caregivers who have a loved-one with Alzheimer’s Disease or other dementia. The bill would develop education and require training for first responders addressing difficult situations for individuals with dementia.
The bill will
help develop and train the peace officers and specified emergency medical service personnel to recognize the key signs of Alzheimer’s and related dementia
train peace officers and specified emergency medical service personnel to appropriately interact with persons living with dementia
educate peace officers and specified emergency medical service personnel on how to best intervene in situations where these individuals may be at risk of abuse and neglect.
“The symptoms of dementia aren’t always consistent, or even easily recognizable. You know the ones providing care or have provided care for someone with dementia need all of the help and support they can get,” said Veronica McCreary Hall, a retired nurse, an AARP Ohio volunteer and former family caregiver for her father, who was diagnosed with Alzheimer’s Disease. “Ohio’s first responders can play a critical role in keeping them safe and protected.”
There are an estimated 220,000 individuals living with Alzheimer’s disease and dementia in Ohio, with a projection to see nearly a 20% increase in those living with Alzheimer’s and other dementias by 2030. 421,000 family caregivers bear the burden of the disease in Ohio, with 614 million hours of unpaid care.
“Mandatory training for first responders will help protect vulnerable Ohioans with Alzheimer’s Disease or other related dementia, while giving their families peace of mind,” said Holly Holtzen, state director for AARP Ohio. “Passing this legislation is a step in the right direction and could impact hundreds of thousands of lives.”
AARP Ohio also supports additional legislation that will benefit Ohioans and help keep them safe and secure.
House Bill 305/Senate Bill 220 This bipartisan bill would cap the price of insulin at no more than $35 for a 30-day supply.
House Bill 461 House Bill 461 will establish a private room per-day rate to be added to a facility’s daily Medicaid rate. Medicaid will pay facilities an additional reimbursement for each resident housed in a private room. Nursing facilities will be incentivized to offer single-occupancy rooms, ultimately increasing safety in nursing home residents.
House Bill 625/Senate Bill 325 The quality of resident care and nursing home operations and performance is often related to rates and reimbursements. AARP Ohio is urging lawmakers to pass legislation that would increase Medicaid rates in 2023 for nursing homes. The bill would also be a major benefit for nursing facilities, as incentive payments may be related to direct staff retention.
House Bill 419 Elder abuse is on the rise, yet it often goes unreported. AARP urges the passage of this legislation to ensure mandatory reports are filed.
On June 2, “Dementia Village” Founder Eloy Van Hal, of the Netherlands, will join industry leaders including a world-renowned cardiac surgeon, a research scholar in geriatrics, elder law attorneys, and experts in LGBTQ senior care at a new symposium in Loveland. The Cutting Edge of Elder Care: Global Approaches to Serve Elders in Our Own Community will bring together international, national, and local thinkers committed to advancing care for seniors.
“Dementia Village” Founder Eloy Van Hal
Van Hal is a superstar in the field of elder care. For more than 20 years, he managed nursing homes and elder care facilities. In 2009, He co-founded the “Dementia Village” known as Hogeweyk, just outside of Amsterdam. It was a completely new model of personalized dementia care, allowing residents to live in a neighborhood according to their lifestyle with the freedom to walk around instead of being locked in the wing of a stand-alone building. In 2015, Van Hal took on the role of senior managing advisor to help implement communities like the “Dementia Village” around the world. His thought-provoking presentations inspire his audiences to think beyond the status quo, often leaving them astonished by what is possible.
“I am very pleased with this opportunity to speak about the paradigm shift in dementia care,” Van Hal said. “We as founders of the Hogeweyk are working on a global movement to shift the way we think and act when people living with dementia need support and care.”
The Law Practice of Dennison Keller, LLC is organizing the event with the goal of bringing positive change and global perspectives to the tri-state. Keller, past President of the Life Care Planning Law Firms Association (LCPLFA), has over 15 years of expertise as an elder law attorney.
“By 2050, estimates show there will be 84 million people in this country over the age of 65, double our current amount,” Keller said. “We must think morally and logistically about best practices for treating our aging population.”
Dennison Keller’s firm is Cincinnati’s only member of the LCPLFA.
Keller’s firm is Cincinnati’s only member of the LCPLFA, a national association of inter- disciplinary law practices that offer care coordination, family education, and help with financial and health care decisions in addition to legal services. His fourteen-person staff includes two lawyers, two nurses, and four licensed social workers.
Symposium topics include, caring for aging baby boomers, hidden symptoms of dementia, race and religion in long term care settings, technology advances in elder care, new research on helping families better communicate as they care for a parent, and culturally competent care for LGBTQ older adults. The event is open to the public and nurses, social workers, counselors, and marriage and family therapy therapists can earn continuing education credits.
In response to ever-changing practices and laws, Keller added a session to the symposium schedule at the last-minute to include a discussion of Esther’s law, a brand-new Ohio law allowing cameras in nursing home rooms.
In addition to hosting seminars and webinars, Keller teaches at UC’s Osher Lifelong Learning Institute. With the introduction of this symposium, his practice is taking elder care education to the next level.
The Serene Suites Premier Memory Care is the symposium’s Saphire Sponsor; Strawser & Staley Funeral Homes, Spring Grove Funeral Homes and Cremation/Thompson, Hall & Jordan Funeral Home are Diamond Sponsors; Right at Home, Home Care and Assistance, Central Parke Memory Care & Transitional Assisted Living, and Seasons, A Senior Lifestyles Community are Emerald Sponsors.
This article provided to Loveland Magazine was edited by David Miller and is by by Eye on Ohio, the nonprofit, nonpartisan Ohio Center for Journalism. Please join their free mailing list as this helps us provide more public service reporting.
In early March, just as Ohioans were learning about the first cases of novel coronavirus in the state, Anna Bondar’s grandfather fell at his Cleveland home.
Luckily, the 92-year old, who lives with dementia, wasn’t injured badly.
The tight-knit family started to discuss the possibility of a nursing home, though they had serious reservations.
Their tough choice was made even more difficult by mounting fears about the coronavirus. In nearly four months, COVID-19 has infected more than 31,191 people statewide and has proven particularly deadly for residents of long-term care facilities in Ohio.
Seventy percent of the reported deaths in Ohio due to COVID-19 complications have been in long-term care facilities, which is among the highest in the country.
Nationally the portion of COVID-19-related deaths in long-term care facilities has hovered just over 40%, though the amount of testing done in nursing homes varies significantly by state.
Every day, families like Bondar’s are making what can feel like an impossible choice – whether to send a loved one to a nursing home where they will receive around-the-clock specialized care but face a greater risk of contracting COVID-19, or to care for that person at home where risk of transmission is lower but providing care can be more challenging.
Even before the pandemic, sorting through the myriad of quality ratings and measures was daunting enough. Then, COVID-19 deaths started to soar.
Now, families and seniors agonize over what could be life or death choice using confusing numbers on infection “hotspots” and without the ability to visit nursing homes to observe how the staff cares for residents – which is the number one recommendation of most advocates.
Dr. Amy Acton, director of the Department of Health
State officials, including Dr. Amy Acton, the former director of the Department of Health, have emphasized that “congregate” settings like nursing homes are at highest risk of infection. Staff, who often travel between facilities, need to be in close contact with residents to provide care. And residents, who are primarily older and have multiple medical conditions, are more susceptible to COVID-19-related complications.
“All of this makes it high risk. At the same time, it’s really necessary for many patients to be there,” said Dr. Steven Schwartz, a geriatric physician at the Cleveland Clinic who travels to nursing homes as part of the Clinic’s Center for Connected Care.
Ohio National Guardmembers will begin testing all staff members and any residents who likely were exposed to COVID-19 in the state’s nursing homes, Gov. Mike DeWine announced May 27. What are being called Congregate Care Unified Response Teams will focus on facilities where confirmed or assumed positive cases are reported in hopes of reducing the number of COVID-19 cases and deaths in Ohio’s nursing homes, which as of May 27 was 5,324 resident cases and more than 1,442 deaths.
Infection rates in Ohio Nursing Homes
Making an educated decision
Last month, state officials began to release the numbers of reported infections and deaths in long-term care facilities, which include nursing homes, rehabilitation centers, and assisted living centers.
But it’s unclear how much the numbers – which are reported weekly and are also tracked cumulatively – matter for families currently trying to choose a facility.
The state, on its coronavirus website, says the infection and death numbers shouldn’t replace a thoughtful conversation with a nursing facility about infection control practices and that “residents and family members should understand that the presence of COVID-19 at a facility is [in] no way an indicator of a facility that isn’t following proper procedures.”
Yet many in the health care industry say infection information should be considered, along with other factors, when deciding which site to choose.
“If you see a nursing home with a large outbreak, that’s something to worry about. If you see a nursing home with a small outbreak, I’m not sure it means anything but bad luck.”
“If you see a nursing home with a large outbreak, that’s something to worry about. If you see a nursing home with a small outbreak, I’m not sure it means anything but bad luck,” said Dr. James Campbell, department chair of geriatric medicine at MetroHealth.
The infection information provided by the state can be useful, for instance, if a family is choosing between two similar facilities, said Nate Cyrill, a Long Term Care Ombudsman for Cuyahoga, Geauga, Lake, Lorain and Medina counties.
Since information on the virus changes rapidly, most families still rely on the quality measures that were available before COVID-19, including existing state and federal online guides Cyril said.
One of the commonly-used ranking systems, maintained by the Centers for Medicare and Medicaid Services, assigns ratings – from 1 to 5 “stars” – to facilities based on performance on quality measures, staffing and inspections.
The number of “stars” Ohio’s nursing homes received, however, does not appear to have a correlation to the number of infections reported to the state, based on a comparison of the publicly available information. The analysis did not include assisted living facilities.
Cases vs. Star rating
“You want to look for a nursing home that’s four of five stars preferably but even that doesn’t tell you the whole story,” Steven Schwartz said.
There are numerous 1-star rated facilities that have reported few infections, like Whetstone Gardens and Care Center in Columbus, which has reported 9 cases or 8 per 100 residents.
Salem North Healthcare Center
Salem North Healthcare Center in northern Columbiana County had 51 patients test positive for the virus as of May 20, as well as five staff, according to the state. It is rated a 5-star facility, the highest rating from CMS.
It’s one of four 5-star facilities with an infection rate over 50 casesper 100 residents, based on Medicare’s calculation of each facility’s average number of residents. (The rate does not include infections among staff because the number of staff in each facility was not available.)
Since April, the focus on high numbers of reported infections, often referred to as clusters, in long-term care facilities has intensified. In some cases, those numbers are a reflection of the level of testing, said Fred Stratmann, general counsel and chief compliance officer for CommuniCare Health Services. It doesn’t mean all of the residents with a positive test had symptoms of COVID-19. The state infection numbers also don’t show the residents who have recovered from the virus, he said.
CommuniCare, which operates close to 90 health care facilities in seven states has been proactive about testing, Stratmann said. When COVID-19 cases started to appear at the North Salem facility, the company enlisted the state’s “strike team” to proactively test all of the residents. It has since re-tested all of the residents who were initially negative and purchased 3,000 testing kits to supplement what the state could provide.
“We wanted to be certain of the extent of COVID in this center in order to be able to properly treat it and to fight back against it,” Stratmann said. The facility does that by isolating any COVID-19-postive patients in a separate unit with its own dedicated staff and by admitting new residents to an observation unit for 14 days to make sure they have no symptoms of infection, he said.
Restrictions on visits make choices harder
The most effective way to scout out a facility typically is to visit it, preferably unannounced, said Dr. James Campbell, department chair of geriatric medicine at MetroHealth. However, because visitors aren’t permitted in nursing homes right now, the next best thing is to ask detailed questions about care, any COVID-19 cases and infection control measures, he said.
Campbell also suggested turning to hospital staff, who work with nursing homes regularly, for advice. Social workers can place five people in a week, while most individuals face that decision, at most, only a few times in their lives, he said.
Cyrill said his agency can also provide information that can’t be found online for families trying to choose between facilities.
Cyrill said his agency can also provide information that can’t be found online for families trying to choose between facilities.
The agency, along with other similar independent agencies across the state, investigates complaints in long-term care, skilled nursing, group homes and rehabilitation facilities and can share what are called “verified complaints” that aren’t otherwise available publicly.
Most of the complaints investigated in relation to COVID-19, Cyrill said, have been related to visitation or the ability of families to get information on a loved one’s condition.
It’s been harder, though, for Cyrill and his colleagues to investigate complaints with COVID-19 restrictions in place.
It’s been harder, though, for Cyrill and his colleagues to investigate complaints with COVID-19 restrictions in place.
Under normal circumstances, an ombudsperson would go to the facility and talk to patients and could do so without announcing the visit in advance. Since visits are restricted for infection control reasons, they have to work through staff to speak to residents or to ask questions, which isn’t optimal. And they aren’t able to make direct observations.
“It makes our job much more challenging,” Cyrill said.
At the North Salem facility, which has had about a dozen new residents admitted or transfered from other facilities, the staff has given “virtual tours” over the phone to family members or prospective residents who were in the hospital, Stratmann said. The company also invested in technology that won’t replace face-to-face visits but enables more family contact and the ability and for staff to help keep residents’ spirits up by making videos of activities, like dancing and singing, to keep them connected with the local community.
In addition, Stratmann said they walk families through the infection control procedures and share techniques they have implemented to improve health outcomes for patients with COVID-19 including, when appropriate:
Treating residents with anticoagulant medications to reduce the risk of blood clots and strokes, which has been a factor in some COVID-19-related fatalities.
Practicing “proning” or positioning residents, while awake, flat on their belly and chest to reduce the buildup of fluid in lung tissue and reduce the risk of Acute Respiratory Distress Syndrome, which has been associated with many COVID-19 fatalities.
The idea of putting their beloved grandfather in a nursing home was gut-wrenching
Choosing home
For Bondar’s family, the idea of putting their beloved grandfather in a nursing home was gut-wrenching, especially as visitation was curtailed to limit the virus’ spread. He speaks Russian, his native language, and would not have been able to communicate well with the staff caring for him.
“It felt like admitting him [to a facility] would be like saying goodbye,” Bondar said. “Like leaving him to die.”
Bondar’s family ultimately decided to care for her grandfather at home, in his Mayfield Heights senior highrise, where they could limit his exposure to the virus.
Before his fall, an aide visited for about eight hours a week. After the Ohio’s “stay at home” order was put in place March 23, Bondar and her mother were able to work from home and pitch in with care.
The advice of the Clinic’s Steven Schwartz led them to a hospice program, which helped the family find additional aides, including one who speaks Russian, as well as a hospital bed for safer sleeping and a wheelchair.
The home care route isn’t the easiest but Bondar said the family feels like they have more contact and control over the quality of care.
The home care route isn’t the easiest but Bondar said the family feels like they have more contact and control over the quality of care.
“We’ll do this as long as we can manage it,” Bondar said.
Anecdotally, it is a choice more families are making: the decision to use home care or even pull family members out of nursing homes out of fear or because they miss them and can’t visit, Steven Schwartz said.
“Sometimes it’s appropriate. But sometimes, even given everything, it may be safer to have your family member there to get stronger and get the necessary care,” said Steven Schwartz. “I would really try to balance the benefit of going to a nursing home versus the risk.”
Patients with dementia or Alzehimer’s may be unsafe going back home.
Patients with dementia or Alzehimer’s may be unsafe going back home, he said, and families may need to decide if a nursing home really is the safer place.
One of the first orders Ohio put in place to prevent the spread of COVID-19 was to halt in-person visitation in more than 900 nursing and long-term care facilities. The state is not yet ready to lift those restrictions and resume visits in those settings, Gov. Mike DeWine said, but on June 8 will start allowing outdoor visits at assisted living facilities care centers for individuals with disabilities.
“We are not to nursing homes yet and I know that causes anguish for a lot of people who are watching this but we’re trying to do this so that we don’t increase the COVID inside the nursing homes or the assisted living or the immediate care facilities,” DeWine said during a May 28 briefing.
Decisions made harder
Figuring out what kind of care might be best for a patient has become more challenging, too.
Previously, nurses and social workers would visit clients in their homes to assess how they functioned – whether they could independently bathe, cook and grocery shop, said Theresa Foster, a nurse and licensed social worker at Western Reserve Area Office on Aging.
They relied on conversations with clients and family and also observations of the environment in the home and possible risks, said Foster, who runs the agency’s resource center.
Those assessments were used to determine whether a person could safely remain at home with community support or whether they needed facility-level care and what resources, whether subsidized or private, existed to pay for the services.
Now, those assessments are done by phone and can be done successfully, but it is more difficult, Foster said.
At UH’s hospitals, medical staff use a scoring system to determine the best place for a patient being discharged, said Dr. Sean Cannone, UH’s medical director for population health.
Patients are assessed on their ability to perform daily tasks and on their cognitive abilities.
“We’re trying as much as we can to get patients home if at all possible,” he said. The goal is to provide patients with resources so they can receive care in whichever setting they prefer.
The goal is to provide patients with resources so they can receive care in whichever setting they prefer.
“We want to respond to what people really want for their own care,” Cannone said.
The shift started before COVID-19 cases surfaced but has accelerated as more families worry about potential exposure to the virus in congregate living situations.
As technology has advanced, the capabilities of what can be done in a patient’s home has also increased. In March, UH introduced a new patient management system, Massimo SafetyNet, for remote monitoring.
When patients are released from the emergency room or from a COVID-19 floor, providers now put a bluetooth sensor on their wrist — it looks like an Apple Watch — that streams data about a patient’s vitals to a central monitoring center, said Jonathan Sague, UH’s vice president of clinical operations. That way, providers can make sure a patient is safe at home.
Douglas Beach is the chief executive officer at Western Reserve Area Office on Aging
Douglas Beach, chief executive officer at Western Reserve Area Office on Aging, has had firsthand experience weighing care decisions amid COVID-19 worries. His mother is rehabilitating in a nursing home after a six-week hospital stay related to a heart condition.
Not being able to visit her in the hospital or the facility has been hard, Beach said. He and his brother, who is a doctor, had to make all of the arrangements by phone, including figuring the best way to transport her that would have the lowest risk of exposure to the virus.
“Home and community-based services is what I do,” Beach said. Part of his mission is to advocate for the setting that allows for any person, whether they are older adults or live with a disability, to be as independent as possible .
But for his mother, a nursing facility was the right choice because she needed 24-hour care that her family could not provide at home.
Beach said nursing homes have had to deal with an unprecedented set of circumstances: a new virus, initial unknowns about transmission and populations at extremely high risk for complications.
Nursing homes will continue to play a vital role and will remain the best option for people who need more care than can be safely provided at home, Beach said.
For the more than 9,500 clients his agency serves in Cuyahoga, Geauga, Lake, Lorain and Medina counties, delivering care at home, with health aides, nurses and community and family supports, has proven a low risk. As of mid-May only 35 clients had tested positive for the virus, he said. That is roughly 0.3% of clients, though not all clients are tested.
Managing COVID-19
Cuyahoga County nursing homes have been paired with one of the area’s three largest hospital systems during the pandemic, Campbell said. The hospitals help the facilities both prepare for and respond to COVID-19 cases.
“The goal is when you have one patient in a nursing home with COVID is to make sure you don’t end up with 30 patients with COVID,” Campbell said.
UH developed what is being called a playbook for local nursing homes. The playbook gives facilities a plan for how to respond if there’s a COVID-19 outbreak on-site, said Sague, who works as a firefighter and medic on the weekends.
“It can be pretty startling and pretty alarming if they’re not ready for it,” Sague said.
The playbook gives guidelines on screening, triaging, determining exposure, testing and isolating those who test positive, as well as how to get personal protective equipment, increase staffing and to eventually reopen safely, Sague said.
Once a case is identified at a facility, what is known as an intercept team is dispatched — either virtually or in person — to help a nursing home handle it, he said.
Patrick Schwartz, director of strategic communications for LeadingAge Ohio, a long-term care trade association, said access to testing and safety equipment has been a consistent problem for Ohio’s nursing homes.
But in the past month or so, the state has made “a definite shift” and started prioritizing testing at nursing homes, which is helping, he said.
Patrick Schwartz said he hoped the expanded testing would enable facilities to test their entire population— of residents and staff — so they can better limit the spread of the virus.
Throughout Ohio, populations that have received mass testing — health care workers, first responders, those incarcerated and those in nursing homes — have had higher numbers of positive cases. Many people with COVID-19 are asymptomatic, so it is unknown if they have the virus until they are tested.
“Since this pandemic first reared its head, it was clear to long-term care providers that the front lines would be in long-term care,” Patrick Schwartz said. The populations at those congregate living facilities, many of whom are older and have multiple medical conditions, are among the most vulnerable for complications from COVID-19, he said.
In Cuyahoga County, and elsewhere, local health departments have deployed limited testing resources to nursing homes quickly in hopes of limiting spread in and between facilities and given guidance to homes about how to isolate patients and trace exposures between facilities to limit the spread of infection.
Cuyahoga County Health Commissioner Terry Allan said nursing homes try to guard against outbreaks but have varying degrees of resources. The assistance from the National Guard will allow more residents and staff at facilities in Northeast Ohio to be tested, he said.
Support for this project was provided by the Center for Community Solutions.
Questions to ask:
How can family members stay in touch with residents while visiting is restricted?
Does staff facilitate video visits? Is window visiting allowed?
How often will the facility provide updates on a resident’s condition?
How much COVID-19 testing is being done? Is the facility proactively testing patients or only those with symptoms?
Are private rooms available?
Do staffing ratios allow for residents to be taken outside?
Are residents currently restricted to rooms?
Are separate units and staffs used for COVID-19-positive patients and COVID-19-negative patients?
How does the facility work to limit COVID-19 complications?
Use this MAP to find a library in your neighborhood.
EVENTS AND CLASSES
Memory Cafe
The Memory Cafe is a welcoming place for for people with Alzheimer’s or dementia and their care partners.Each month there will be an opportunity to socialize and enjoy music, games or other fun activities.Activities will vary each month.
Registration is recommended.
Blue Ash Branch
Monday, December 02, 2019 10:30 AM – 12:00 PM
Movers and Shakers
You and your child will shake it together! Sing, dance and enjoy music, movement and fun.Recommended for ages 1 – 4. No registration required.
Loveland Branch Meeting Room
Monday, December 02, 2019 10:30 AM – 11:00 AM
Library Babies
Fun for you and your baby with songs, rhymes, stories and movement. Recommended for ages birth – 18 months.
No registration required.
Symmes Township Branch Meeting Room
Monday, December 02, 2019 11:00 AM – 11:30 AM
Preschool Storytime
Enjoy books, songs, activities, and more while learning early literacy skills. For preschoolers and their caregivers. Ages 3-6. No registration required.
Symmes Township Branch Meeting Room
Monday, December 02, 2019 1:30 PM – 02:30 PM
Introduction to Essential Oils: presented by Martha Hill
Please join us for an introduction to Essential Oils with Martha Hill of Nana’s Got Oils, specializing in therapeutic grade essential oils. Martha is the co-owner of Hill’s Compounding/Milford Pharmacy & Wellness Center. Everyone will make a roll-on blend to take home!
Loveland Branch Meeting Room
Monday, December 02, 2019 6:30 PM – 07:30 PM
Library Babies
Fun for you and your baby with songs, rhymes, stories and movement. Recommended for ages birth – 18 months. No registration required.
Blue Ash Branch
Tuesday, December 03, 2019 10:30 AM – 11:30 AM
Preschool Storytime
Enjoy books, songs, activities, and more while learning early literacy skills. For preschoolers and their caregivers. Ages 3-6. No registration required.
Symmes Township Branch Meeting Room
Tuesday, December 03, 2019 10:30 AM – 11:30 AM
Chess Club
Learn strategies & tactics or just play for fun!
No registration required.
Symmes Township Branch Meeting Room
Tuesday, December 03, 2019 6:30 PM – 08:30 PM
Movers & Shakers
You and your child will shake it together! Sing, dance and enjoy music, movement and fun. Recommended for ages 1 – 4. No registration required.
Blue Ash Branch
Wednesday, December 04, 2019 10:15 AM – 10:45 AM
Preschool Storytime
Enjoy books, songs, activities and more, while building early literacy skills. Recommended for ages 3 – 6. No registration required.
Loveland Branch Meeting Room
Wednesday, December 04, 2019 10:30 AM – 11:00 AM
Toddler Storytime
Encourage emerging language skills with books, rhymes, music and fun. Recommended for ages 18 months – 36 months. No registration required.
Symmes Township Branch Meeting Room
Wednesday, December 04, 2019 10:30 AM – 11:00 AM
Movers & Shakers
You and your child will shake it together! Sing, dance and enjoy music, movement and fun. Recommended for ages 1 – 4. No registration required.
Blue Ash Branch
Wednesday, December 04, 2019 11:00 AM – 11:30 AM
Toddler Storytime
Encourage emerging language skills with books, rhymes, music and fun. Recommended for ages 18 months – 36 months. No registration required.
Symmes Township Branch Meeting Room
Wednesday, December 04, 2019 11:30 AM – 12:00 PM
Spanish Club
Learn to speak and read Spanish!
Introduction to Speaking and Writing Spanish (for beginners) @ 1PM
Reading Spanish Literature (for intermediate to advance) @ 2PM
Brush Up Your Spanish: Refresh Your Proficiency (for intermediate to advance) @ 3PM
No registration is required.
Symmes Township Branch Meeting Room
Wednesday, December 04, 2019 1:00 PM – 04:00 PM
An Evening of Jazz
Relax with an evening of impromptu jazz music with Cincy Jazz Train. No registration required.
Symmes Township Branch Meeting Room
Wednesday, December 04, 2019 7:00 PM – 08:30 PM
Preschool Storytime
Enjoy books, songs, activities and more, while building early literacy skills. Recommended for ages 3 – 6. No registration required.
Blue Ash Branch
Thursday, December 05, 2019 10:30 AM – 11:30 AM
Library Babies
Fun for you and your baby with songs, rhymes, stories and movement. Recommended for ages birth – 18 months. No registration required.
Loveland Branch Meeting Room
Thursday, December 05, 2019 10:30 AM – 11:00 AM
Sycamore Book Club
Join us every 3rd Tuesday of the month to discuss and share Genealogy tips and techniques for general Genealogy research.Everyone is welcome from beginners to experts.No Registration is required.
Blue Ash Branch Meeting Room
Thursday, December 05, 2019 1:30 PM – 02:00 PM
Fun with Food
Make a powdered doughnut snowman!
For tweens and tweens ages 10 and up.
Loveland Branch Meeting Room
Thursday, December 05, 2019 4:00 PM – 05:00 PM
Girls and Books @ Blue Ash
Do you love to read fabulous books? Join us for great book discussions and activities.For girls ages 7-9. Registration required.
Blue Ash Branch Meeting Room
Thursday, December 05, 2019 7:00 PM – 08:00 PM
Toddler Storytime
Encourage emerging language skills with books, rhymes, music and fun. Recommended for ages 18 months – 36 months. No registration required.
Blue Ash Branch
Friday, December 06, 2019 10:15 AM – 10:45 AM
Toddler Storytime
Encourage emerging language skills with books, rhymes, music and fun. Recommended for ages 18 months – 36 months. No registration required.
Blue Ash Branch
Friday, December 06, 2019 11:00 AM – 11:30 AM
Amazing Race Library Edition
Calling all Teens for the Amazing Race!Teams of two will race through the Symmes Library to complete a series of thrilling challenges.Do you have what it takes?Sign up and find out!Prizes and giveaways will be awarded! Food and drink provided!
Ages 12-17.
Registration Required
Symmes Township Branch
Saturday, December 07, 2019 6:30 PM – 09:00 PM
LIBRARY NEWS
Igniting a Brighter Future with The Library Foundation
For Sharon Borntrager of Westwood, libraries are a place to connect to big ideas. See how the Library has impacted Sharon’s family. Consider joining her to support your Library by contributing to The Library Foundation.
for passengers with hidden disabilities or conditions. The airport is participating in the Sunflower Lanyard Program, a worldwide initiative which aims to raise awareness and support those who have autism, hearing loss, dementia, PTSD, anxiety, or other conditions which may not be readily visible.
Those assessments were used to determine whether a person could safely remain at home with community support or whether they needed facility-level care and what resources, whether subsidized or private, existed to pay for the services. 
