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Safety Measures at Assisted Living Communities

The reasons for placing a loved one in an assisted living facility often boil down to one word: safety. When a sick or frail individual no longer can care for him or herself, the safest place may be such a community, where both medical care and physical safety can be assured.

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Assisted living communities have numerous tools – some mandated by state and federal guidelines, some by individual rules – to protect their residents. There are numerous safety concerns, but the top three are:

  • Falls.
  • Wandering.
  • Infections, including COVID-19.

Keeping residents safe while allowing them some freedom isn’t easy, and safety programs do not follow a one-size-fits-all approach, says John Mastronardi, executive director of The Nathaniel Witherell, a short-term rehab and skilled nursing care center in Greenwich, Connecticut. Each resident has a personalized care plan because “they still have a personality and preferences you want to pay attention to that can inform and drive the care plan. The crux of this is getting to the core of that person’s preferences if you possibly can, then tailoring a plan of care so that they can thrive as best they can, safely.”


The Centers for Disease Control and Prevention names falls as one of the leading causes of fatal and nonfatal injuries among people age 65 and older. In the past, those at high risk for falls were often restrained from moving, but the Centers for Medicare and Medicaid Services now precludes using restraints except where medically necessary.

Fall prevention begins at admittance, when the resident is screened for his or her risk of falling. The Agency for Healthcare Research and Quality also recommends rescreening quarterly, annually and when health conditions change.

To minimize risk, assisted living facilities:

  • Adjust medication to minimize side effects like dizziness and drowsiness. “We have a consulting pharmacist look at their meds, and at least monthly we try to trim them when we can,” says Dr. Elaine Healy, medical director and vice president of medical affairs at United Hebrew in New Rochelle, a senior living campus in Westchester County, New York.
  • Manage chronic and acute medical conditions carefully. Conditions like low blood pressure, Parkinson’s disease, arthritis, diabetes and many others increase fall risk. “Most falls occur near the bed and in the bedroom. They might have low blood sugar, don’t realize it, get up too fast and end up falling,” Mastronardi says.
  • Schedule bathroom breaks and other potentially unsafe behaviors. “We look at residents’ habits. If they are an early riser, we would anticipate them being active early and make sure their needs are met for eating and toileting, and engage them in activities to keep them busy and not want to move around,” Healy says.
  • Provide physical and occupational therapy. This can help residents work on balance, walking gait and strength.
  • Fix, adjust or remove environmental hazards, such as beds, walkers, flooring, furniture and clutter. For example, “We may use a raised-perimeter mattress to keep them from rolling off the bed or trying

Pubs shut in Liverpool as UK tightens virus control measures

British Prime Minister Boris Johnson on Monday ordered pubs in Liverpool to shut as part of a new strategy to tackle a surge in coronavirus cases, as staff at three field hospitals across the country were told to prepare for a wave of admissions.

The northwest English city is the first to be placed at “very high risk” under a new three-tiered system designed to bring order what has become a complex web of local restrictions.

Johnson, heavily criticised for his government’s response to the outbreak, said he did not want to impose a new nationwide lockdown.

But said he could not allow Covid-19 to “let rip” and risk the death toll — the highest in Europe at almost 43,000 — spiralling even higher.

“This is not how we want to live our lives,” the Conservative leader, who himself was hospitalised with coronavirus in April, told the House of Commons.

“But this is the narrow path we have to tread between the social and economic trauma of a full lockdown and the massive human and economic cost of an uncontained epidemic.”

Inter-household mixing will be banned indoors and in private gardens while pubs, bars, gyms, betting shops and casinos will close from Wednesday in Liverpool, which has a population of about 1.5 million.

Johnson said businesses forced to close would be supported under a new government programme to fund two-thirds of an employee’s monthly wages, as well as extra support for local contact tracing and enforcement.

Other areas of England will be classed either as “medium”, in which current nationwide rules limiting social gatherings to six will apply, or “high”, where different households are banned from mixing indoors.

Whole swathes of northern England already facing local restrictions will automatically enter the “high” risk tier.

Earlier, the state-run National Health Service (NHS) announced that three field hospitals across northern England, in Manchester, Sunderland and Harrogate, would be mobilised to accept new patients.

They are among a string of temporary hospitals, named after nursing pioneer Florence Nightingale, put up by the military in conference centres and stadia coronavirus as swept across the UK earlier this year.

Testing for hospital staff is also being stepped up in high-risk areas, as health officials warned infection rates were rising across the country and in all age ranges, not just the young.

Almost 14,000 new coronavirus cases were reported across the UK on Monday, with 50 further deaths. 

“The number of cases has quadrupled in the last three weeks. There are now more people in hospital with Covid than when we went into lockdown on March 23,” Johnson said.

– ‘Wholly disproportionate’ –

A UK-wide stay-at-home order was lifted in June but England, whose health policy is controlled by the UK government, and the devolved administrations in Wales, Scotland and Northern Ireland have all since imposed new measures to stop the spread of the virus.

They include blanket restrictions on social gatherings, in addition to more localised measures. 

Pubs in England must shut at

Czechs to Tighten Coronavirus Measures as Infections Soar: PM | World News

PRAGUE (Reuters) – The Czech government will tighten coronavirus measures from Wednesday to curb soaring infections and hospitalisations but will seek to avoid the kind of blanket lockdown imposed in the spring, government officials said on Sunday.

The nation of 10.7 million has recorded Europe’s fastest rate of growth in new cases per capita in recent weeks after authorities eased most restrictions during the summer following a tough lockdown at the start of the pandemic.

“We have to decide on further measures, that will happen on Monday at the government session, and the measures will be effective from Wednesday,” Prime Minister Andrej Babis said in a video message on YouTube.

He did not give any details on the measures.

Finance Minister Alena Schillerova said earlier on Sunday that the government sought to avoid the complete lockdown the country experienced in spring.

“We don’t want to switch off the economy. We want to have it (the measures) more targetted… We will limit contacts and gatherings of people,” she said.

So far in October, the Czech Republic has reported more than 43,000 cases, the same number as for the whole of September. The number of hospitalised patients jumped by 76% to 2,085 in the past week, raising concerns that hospitals may soon be overwhelmed.

Some hospitals have started postponing planned procedures to make space for COVID-19 patients, while the Czech Medical Chamber warned last Sunday that the number of infected doctors, nurses and other medical staff was rising rapidly.

(Reporting by Robert Muller; Editing by Michael Kahn, Gareth Jones and Frances Kerry)

Copyright 2020 Thomson Reuters.

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Families of coronavirus victims are organizing online to push politicians for more strict health measures

Angela Kender saw it just before bed, and right then made a plan to confront her state’s lawmakers with pictures of local virus victims, including her mother. An old friend sent it to Fiana Tulip. She was furious about her mom’s death; maybe she could channel her rage like Urquiza had. And Rosemary Rangel Gutierrez’s sisters told her about the obituary after their father died. She sounds like you, they said.

“This man is the most dangerous person on the planet,” Urquiza said this week after Trump told Americans on video not to be afraid of covid-19. “I’m counting down the minutes until his referendum comes on November 3rd and we can end this nightmare and protect ourselves and our families.”

The loose support group Urquiza formed has tightened into organized activism. They have pushed politicians, especially Republicans, to enact more serious public health measures. This week, across the country, they have led vigils, memorials and funeral processions to grieve the more than 213,000 lives lost in the United States. The national week of mourning is likely the largest collective recognition of the country’s coronavirus toll.

Powerful grass-roots groups often have started this way, even before the days of organizing through social media. They began with personal anguish, with individuals grieving their dead alone, trying to transform their anger into action, policy or change. It’s the story of Mothers Against Drunk Driving and the AIDS Coalition to Unleash Power, of the Sandy Hook Promise and Never Again MSD, of Black Lives Matter and Mothers of the Movement.

Urquiza named her group Marked by Covid. She founded it in the days after her father died, with some of his last words to her reverberating. He said he felt betrayed by Arizona’s governor and Trump, politicians he once supported. Urquiza, 39 and a recent graduate of a master’s program in public policy, decided then she would be the voice of a constituency that grows larger by the day: Americans who have lost loved ones to the pandemic and who are fed up with their elected officials.

“I hope that my small actions can start a movement,” she said in July, less than two weeks after her dad died.

It’s too early to know how influential the group, or others like it, will become. Some of Urquiza’s fellow organizers joined her as a way to process loss, and it’s unclear how Marked by Covid will define itself when the pandemic ends. But part of Urquiza’s ambitious vision is to advocate for policies that address the racial and economic inequalities exacerbated by the virus.

Urquiza and Marked by Covid have attracted national attention and more than 50,000 followers across their social media accounts. More than 1,000 people have donated $30,000 to the group, Urquiza said, and they’re using the money to place more honest obituaries online and in newspapers.

The Joe Biden campaign has taken notice. Urquiza spoke at the Democratic National Convention in August, appears in anti-Trump ads and sat in the