Interview with Bailie Hillman and Leigh Wilson, James L. West Center for Dementia Care – Feb 4, 2021

Regulation | February 04, 2021 | by Jill Schumann

Bailie Hillman, Administrator, and Leigh Wilson, Essential Caregiver Visit Coordinator with the James L. West Center for Dementia, joined the LeadingAge Coronavirus Update Call on February 4, 2021.

Interview with Bailie Hillman and Leigh Wilson, James L. West Center for Dementia Care – Feb 4, 2021

Bailie Hillman, Administrator, and Leigh Wilson, Essential Caregiver Visit Coordinator with the James L. West Center for Dementia, joined the LeadingAge Coronavirus Update Call on February 4, 2021. They responded to questions from Ruth Katz and from callers.

It is important to note that CMS has stated they do not distinguish between visitors designated “essential caregivers” and other visitors. CMS-certified nursing homes must adhere to CMS guidance on visitation

Q: We understand that you have an Essential Caregiver program – please briefly describe that.

A: The state of Texas established an Essential Caregiver program and established guidelines which our program follows. Each resident may have two individuals designated as Essential Caregivers. The POA chooses the two individuals who must then go through training. We jumped at the chance to start the program because our residents have dementia and fare so much better when they have direct engagement with family members.

Q: What are the basic guidelines for Essential Caregivers?

A: We provide an orientation and Zoom session trainings and explain that Essential Caregivers are like staff and must adhere to parameters and guidelines. They are trained in infection control, donning and doffing PPE, distancing, testing, and the logistics of our program. At James L. West we have Essential Caregivers schedule a maximum of two appointments a week for a maximum of two hours for each visit. Currently we use an Excel spreadsheet to manage visits, but we are looking at an online scheduling system so that family members can see the open slots and schedule their own visits. We have set up the appointments so that we can manage the program well – it has to work for us, and 95% of our residents have two essential caregivers.

Q: How do you handle testing Essential Caregivers?

A: We were not able to test them, so we pointed them to public testing programs. Now, we have begun to use rapid tests onsite each time an essential caregiver comes in.

Q: Can Essential Caregivers visit when there is COVID in the building?

A: Yes, in Texas Essential Caregivers can still visit if there is COVID in the building, but not if their resident has COVID.

Q: How are Essential Caregiver visits going?

A: Family members are emotional and we suggest that if they get teary, they emphasize how glad they are to see the person and be able to visit. We have a social worker and counselor on staff to assist if family members have needs. Caregivers often want information from staff or have questions about how their family members is doing. We stress that once escorted to the resident room the caregiver may not leave the resident room until we escort them out. So, we suggest if they want to talk with staff, they do that at a different time by telephone. Essential Caregivers are pleased to be able to visit and the residents are much more engaged now that visits are occurring, even those who are not having visits.

Q: We understand that James L. West is not Medicare or Medicaid certified – are there other nursing homes in Texas with an Essential Caregiver Program?

A: Yes, there are other programs and we have shared with others through the ECHO program. We all find that the extra work is worth it, since the visits are so important to residents. To help us manage staff time, we are also limiting family video conference sessions for those who have Essential Caregivers.

Q: What were the challenges in starting up the program?

A: The program began in early November and we learned quickly that deciding on how many appointments we could manage at what intervals was key. We moved to designating Leigh as the single coordinator of the visits and that has worked well. Our advice is to make sure the program works for staff as well as residents.

Q: Would you speak to whether residents have other visitors, and also what happens to any residents who do not have Essential Caregivers?

A: The only visitors who can come into the building are Essential Caregivers and they can come a maximum of two times per week. Residents who do not have Essential Caregivers can meet with their loved ones by video conference, although this can be difficult for people with dementia, even with staff assistance.

Q: Are Essential Caregivers able to bring food? Can they assist with dining?

A: Yes, they can bring food and can assist with dining. However, they must keep their masks on at all times so they may not eat and must remain distant from other residents.

Q: Are Essential Caregivers actually providing care or are they mostly just visiting?

A: We emphasize the importance of visiting and its role in engaging the resident.