Winter 2021 | Volume 102, Number 1
CHARLES E. BOUCHARD, OP, STD, and ALEC ARNOLD, PhD(c)
We are in the midst of an unprecedented public health crisis that is changing our personal lives, our economy and our health care system. This is particularly true of elder care, which has been described as "ground zero" for the COVID-19 virus.
The COVID-19 pandemic did not cause the crisis in long-term care, but it did exacerbate it and expose many of its latent flaws. Society as a whole must face this problem, but we believe that sponsors in Catholic health care should ask themselves whether a crisis of this magnitude is a call to rethink their role and their responsibility.
SR. JULIA UPTON, RSM, PhD, MPH
Years ago, a friend and I went to see the Broadway production of Stephen Sondheim's musical Into the Woods. The first act ends with all the fairy-tale characters' complicated situations resolved in a "happily ever after" style.
The COVID-19 pandemic has been a tragedy for hundreds of thousands of older adults in the U.S. and their families. It has amplified and exposed the nation's already deeply flawed system of long-term supports and services (LTSS). Yet it also has created a historic opportunity to rethink our model for caring for frail older adults and younger people with disabilities.
Say a prayer for the venerable Catholic nursing home, often many decades old, challenged to stay up to date, and at the mercy of a financial model that doesn't cover the cost of doing business. Its biggest source of revenue, the Medicaid program, pays as little as 73% of the cost of care, a recent analysis shows.1
Its best bet for profitable business — post-hospital therapy and rehabilitation paid by Medicare — increasingly skips past the nursing home stop and directly to home health care. The patients that nursing homes do receive often have more complex needs than in previous times, eating into Medicare margins. Specialized managers and direct-care workers alike are hard to find and afford.
One of the most heartbreaking effects of the coronavirus pandemic is the toll it's taking on skilled nursing communities. In response to such challenge, the team at Mary Immaculate Health/Care Services, a member of Covenant Health, rose to the call to care for three important populations — residents, staff and the local community — in countless small, important, beautiful and spiritual ways..
RUTH E. KATZ
It has become abundantly clear that the long-term care "system" in one of the richest countries on the planet is not a system at all, but rather a patchwork quilt of solutions that have evolved to accommodate changing demographics. Even if the system had been fully functional and available to all who need help before the coronavirus pandemic, it is facing some tough challenges now. Why, and what can be done to get the country on track with an aging services system consistent with increasing numbers of older people?
SHAWN M. BLOOM
The COVID-19 pandemic has been devastating for older adults, especially those with significant and complex medical conditions. Individuals over the age of 65 account for 16% of the U.S. population, yet so far, they have accounted for over 80% of all U.S. deaths due to COVID-19. Especially hard hit have been residents of long-term care facilities: they have made up 45% of these deaths in the U.S. as of Sept. 1, 2020.
MSGR. CHARLES J. FAHEY
All living things have a life span. And underlying the human journey is our physiological makeup. Cells are in a constant state of flux; some are wearing out and others replacing them. In the latter part of human life, replication does not keep up with decline. Those of us who dare try to fathom Divine Providence, who have an appreciation for all of creation, might consider we are co-creators in an ongoing evolutionary process. Even from early catechism, we learn God made us to know, love and serve Him in this world as well as to be happy with Him forever in Heaven.
BRIAN P. SMITH, MS, MA, MDiv
The role of the mission leader in Catholic health care in the United States was created in the mid-1970s. The responsibilities and skills of those early mission leaders varied greatly, and it was soon recognized that in order for the mission leader position to be relevant and successful, a set of standard competencies was necessary.
The impact of the COVID-19 pandemic reaches far beyond sick people. Everyone is disrupted; everyone is struggling with loss and uncertainty and grief for the way things used to be. In the health care universe, the job that is best suited to treat those feelings is the chaplain, but the pandemic has forced changes in how they do their work.