Opinion | Shopping for a Nursing Home in a Pandemic

Even without a deadly virus, finding the right place for my sister felt like facing a slate of rotten choices.

By Stacy Torres

Ms. Torres is an assistant professor of sociology at the University of California, San Francisco. She specializes in research on health, urban communities, aging and the life course and is currently writing a book about urban aging. She is the eldest of four sisters and a longtime caregiver for multiple family members.

I never imagined my sister, who has long had trouble with her mobility, would move to a nursing home in a global pandemic. At 37, she is relatively young. But this fall, she developed a serious infection that worsened her health problems. So I found myself shopping for a facility that can provide her with the care she needs to recover.

Like many Americans, I had long been under the optimistic delusion that I was years away from needing to consider nursing home care. I always thought, I’ll cross that bridge when I get to it.

Well, I’m here. In a pandemic.

At the pandemic’s onset, my three sisters and I worried about our 78-year-old father, with his emphysema, high blood pressure and history of cancer. But like so many other families, we now fear that the place that provides my sister with round-the-clock skilled nursing and physical therapy could also put her at risk for dying from Covid if another outbreak were to occur. As it is, since March, my sister’s 120-bed facility in New York City has reported five confirmed and seven presumed Covid-19 deaths.

I’m not normally a fan of euphemism, but calling her nursing home a “facility” somehow makes me feel better. Euphemism also dulls my terror of pandemic math: The virus has killed over 313,000 Americans, more than 106,000 of whom were nursing home residents and staff.

Even without a deadly virus, finding the right facility for my sister felt like facing a slate of rotten choices. My sister’s medical issues, including serious mental illness and morbid obesity, complicated her placement. None of the facilities in Manhattan, closer to home, would take her. So her hospital social worker applied to every nursing home in the city, as if she were entering my sister into some bizarre college admissions process.

Facing some pressure to expedite her discharge from the hospital, we had a day and a half to select a facility, sight unseen, where my sister might live for weeks, months or years. Any relief I felt when her acceptances rolled in evaporated when I scrolled through Medicare inspection reports and online reviews from family members, residents and workers. Another sister helped me sift through complaints ranging from abusive and neglectful (sexual abuse, scores of miserable workers) to lower-grade (dirty floors, bad food).

We eventually selected a facility in the Rockaways with mostly lower-level complaints — with the exception of one resident who was charged with murdering his roommate in 2013, an incident we had no choice but to hope was an isolated tragedy. After I had a good conversation with the director, the hospital social worker processed the paperwork. My sister was admitted the day before Halloween.

In the time since, I have made the long subway ride from Chelsea to the Rockaways, with its old-school pizzerias and salty breeze, to drop off things for her: underwear, art supplies, shampoo, fuzzy socks. With three staff Covid cases since my sister’s admission, I’ve only been able to see her through her bedroom window.

My sister’s comfort with this transition has made the situation more bearable. She says repeatedly, “I think I want to stay a while.” She cannot leave the building because of Covid restrictions but keeps “very busy” with her art, physical therapy and friendly chats with other residents and staff. I smile at her newfound sociability, a welcome reprieve from the debilitating isolation she experienced earlier in the year.

In early December, I brought a small Christmas tree and a few items my sister wanted to give to “people who don’t have anyone to bring them anything” — holiday cards, perfume, chocolate coins for an old man who celebrates Hanukkah. We talked on the phone as I stood outside under my umbrella, waves churning behind me. From her second-floor window, she chuckled that I look like a forecaster from the weather channel and entertained me with dispatches from her new world, telling me about a nurse’s patience with an agitated Russian-speaking woman. It was hard to wave goodbye.

Walking past a line of nursing homes along the boardwalk as I headed back home, I wished I could deliver my sister more than meager holiday cheer.

What I really want for my sister, and the 1.3 million or so nursing home residents in America, is large-scale reform that can help improve care, reduce infection spread and save lives. I want increased funding for Medicare and Medicaid, major payers for long-term care. I want better pay and benefits for workers, sufficient Personal Protective Equipment and staffing.

Based on the Centers for Disease Control and Prevention recommendations for vaccine priority, my sister could be among the first to receive a shot. But the vaccine isn’t a cure-all for the long-term care crisis. This pandemic has revealed just how little we value the lives of the old, sick and disabled, and the increasingly burned-out workers — many people of color — who care for them.

From the difficult choices we faced searching for a nursing home to the strain many nursing home workers face, I’ve seen how our health care system runs more like a business that in its quest to pinch pennies, hemorrhages dollars and precious lives.

Health care ought to be a sacred and inalienable right. Above all, I wish we’d treat it that way.

Stacy Torres is an assistant professor of sociology at the University of California, San Francisco. She specializes in research on health, urban communities, aging and the life course, and is currently writing a book about urban aging for the University of California Press.

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