The Indiana National Guard regularly responds to provide aid in emergency situations, but their newest mission is unlike any one they’ve had before.
Thousands of troops are reporting to Indiana nursing homes, but caregivers say state priorities are misaligned.
Last week, the first 400 reported to Camp Atterbury in south central Indiana to get their orders.
The guard has been helping with the state’s pandemic response since March – they’ve worked at food banks, distributed supplies, and helped increase testing capacity. But this mission is different.
Soldiers are being sent to all 435 long-term care facilities across the state.
“We started to recognize the data that was showing this upward trend,” Brigadier General Dale Lyles said.
The National Guard started coordinating with the Indiana State Department of Health about one month ago. “So, we started to put the strategy together in that week and that has led to the actual dispatch of the solders,” he said.
The tasks they’ll complete are still unclear and largely undefined. Guardsmen at the training were told to prepare for the unexpected and that their tasks at each facility would be different.
The Indiana State Department of Health declined an interview, but provided a brief statement on the goals of the deployment.
“Guardsmen will assist with infection control, COVID-19 prevention checklists, data entry, registration for testing and staff, and visitor screening and wellness checks,” the department wrote.
It did not return multiple follow-up emails for information about how facilities were selected or if prioritization lists posted by other media organizations were correct.
Statewide Surge Leading To More Spread In Nursing Homes
Facilities are products of their communities—as cases surge like they are across the state more infections should be expected.
Friday, Indiana logged its third straight day of record COVID-19 infections, and more Hoosiers have spent time in hospitals with the virus than at any point in the pandemic.
Positive cases among nursing and long-term care residents has increased fourfold since the end of August. Now, the seven-day rolling average is around 100 cases per day. Despite those surges, Indiana Governor Eric Holcomb has resisted calls to re-implement mitigation strategies that were in place earlier this year.
The state’s Chief Medical Officer, Dr. Lindsay Weaver, last month said a department survey completed over the last several weeks revealed cases in long term care facilities were increasing and showed how.
“Through this effort we identified several themes where long-term care facilities could use additional support. Number one was staffing,” Weaver said. “Of all the additional measures that must be in place to protect residents from COVID does require extra time from our staff. Staff members have to isolate or quarantine because of community exposures and all of these things have brought additional stress to those on the front line.”
Guardsmen won’t be caring for patients. However, they will be lessening the workload for nurses and other workers by handling administrative duties.
Desire For Staffing Support Is Not New
Since the first days of the pandemic long-term care facilities have identified staff as a challenge.
The President of Indiana Health Care Association, Zachary Cattell, penned an op-ed in The Indianapolis Star identifying the problem in March.
When the state announced they were sending the National Guard in, it was the first many had heard of the move.
But Cattell insists that’s not necessarily a negative.
“I think it's also a matter of when other deployments and that capacity for available Guard members comes around,” he said. “You know, I think clearly, we see the cases rising across the state, and as we've continued to communicate, the exhaustion of our staff, is real.”
Cattell says he and facility members are thankful for the state’s support, “I wouldn't equate advanced notice to a negative or positive experience,” he said.
Yet for the majority of caregivers, policy decisions like these are misaligned.
Mary Charleson is the primary caregiver for her mother, Mary Katheryn, who’s a resident of Ben Hur Health & Rehabilitation in Crawfordsville.
She wasn’t aware of the National Guard deployment, but wishes more time and resources would be allocated to help families return to their loved one’s facilities.
“If the National Guard knows what to wear, into come in, to protect, why can't we wear their stuff and just come in and see our loved ones instead?” she asked.
Charleson was visiting three times per day before the pandemic. With the facility only being three miles from her home it was easy to run over between her school bus routes.
“I'll never forget the day that they told me ‘If you leave now, this is your last visit. You don't get to come back.’”
Charleson said she, “turned around and went back in and stayed even longer.”
According to Charleson she leaves her heart in her care when visiting. She’s noticed her mom’s overall health decline, but doesn’t blame the facility. She understands why infection protocols are in place. Yet, struggles to understand why more isn’t being done to enhance the quality of life of seniors like her mom.
In-person, socially distanced visits resumed briefly after the facility’s outbreak, but now because of new active COVID-19 cases, they’ve been shuttered again.
The Indiana State Department of Health continues to reiterate that visitors like Charleson haven’t contributed to outbreaks.
“When there’s an outbreak in a facility often it starts with the staff and several staff members spread it to each other,” Weaver said. “And then of course, ultimately it could end up spreading amongst residents.”
Cattell understands the struggle and says facilities are often caught in the middle.
“They are supposed to be homelike environments, skilled nursing facilities and nursing facilities as regulated by federal law, that language home like environment is part of our regulatory structure,” he said. “So, there is this push pull between really good infection control and public health guardrails.”
He admits that negotiation is “difficult to reconcile.”
But caregivers are less concerned with the threat of spreading disease. Charleson’s mother has already beat COVID-19, and worries there might not be a routine visit again.
“My mom reaches out with open arms and wanting a hug,” she says fighting back tears. “They say it's to protect the residents, but to protect the residents from what? What's next in their life? Where are they really going after they leave the nursing home?”
Caregivers say they’re not aware of policymakers that understand or are fighting for their access to return to facilities.
Charleson’s assessment was stark.
“They're protecting them from loved ones. From our hugs.”
