Overcrowding is a common problem and complaint at many nursing home facilities. These facilities house large numbers of elderly residents, often in close proximity to each other, creating the ideal environment for dangerous outbreaks of communicable diseases. Communicable diseases are diseases that spread from person to person (contagious, infectious). These diseases are caused by germs (fungi, viruses, bacteria, and parasites).
Communicable diseases are spread by organisms that live in the soil, water, and air. They can be spread by:
- Sexual contact
- Insect bites
Our bodies have numerous microorganisms that live both in and on our bodies without causing problems. However, for people with compromised or weakened immune systems, opportunistic diseases and infections can occur. The elderly are particularly vulnerable to these diseases. The most effective tool in combating communicable diseases is prevention. Many elderly nursing home residents are already weak or ill, and their systems cannot fight any new diseases or infections as well as when they were well.
Nursing homes must take precautions to prevent dangerous communicable diseases and protect their residents. Unfortunately, nursing homes are the ideal environment for these infections. This is because residents live in close proximity to each other with limited common areas, shared meal areas, and shared sources of food, water, and air. Furthermore, there is a constant stream of new residents, staff, and visitors entering and leaving the facility, transporting pathogens as they move.
Steps To Prevent Disease In Nursing Homes
In order to prevent communicable diseases, nursing homes should:
- Keep residents and staff up to date on vaccinations
- Ensure that the facility is regularly cleaned and surfaces sterilized
- Require nurses and other staff members to change gloves for each new task, especially after touching a resident
- Frequent hand washing
- Wear protective clothing and masks when dealing with contagious situation
- If a resident is sick, limit their exposure to other residents and common areas
- If necessary, isolate the sick resident or even quarantine residents who have been exposed
Bacterial infections can be treated with antibiotics. Viral infections, on the other hand, cannot be treated with antibiotics, but there are some antiviral treatments available. And, anti-fungals can be used to treat fungal infections.
Some states, such as Illinois require nursing homes to report disease outbreaks. The Illinois Department of Public Health (IDPH) requires that some communicable diseases be reported to a local health department or IDPH (Reportable Communicable Disease Cases, 2000-2008). This is so the state can help prevent dangerous outbreaks, put people on notice, and provide proper treatment.
Proper hand washing techniques
Proper hand washing technique is one easy and effective tool to help prevent the spread of germs, disease, and contamination. Hand washing procedures:
- Use a paper towel to turn on the water (avoid touching any surfaces that might be contaminated)
- Wet your hands and forearms
- Apply soap to your hands and lather
- Rub hands together and over forearms for at least fifteen seconds (make sure to wash around nails)
- Rinse hands under stream of water with hands pointing down so they don’t drip toward elbows
- Using a clean paper towel, dry hands
- Use paper towel to turn faucet off
- If no hand washing facilities are available, use antiseptic gel or towelettes
Types of Communicable Disease
Communicable diseases can be caused by bacterial, viral, or fungal organisms, or even parasites.
Common bacterial diseases:
- The common cold
- MRSA (Methicillin-Resistant Staphylococcus Aureus)
- Botulism (foodborne)
- Clostridium difficile (C. difficile / c. diff)
The common cold is spread by direct contact or breathing in droplets of nose/throat secretions. When a nursing home resident has a cold, it is important to monitor the resident to ensure that they cover their nose and mouth when sneezing or coughing. In addition, staff members should ensure that tissues or other soiled materials are properly disposed of, and that any surfaces that the resident touches are properly sterilized.
MRSA is a bacterial infection that is often resistant to multiple antibiotics. This infection is most common in hospital settings, but is also a significant problem in nursing home facilities. This infection is spread through direct contact, often by the hands of a health care worker who touched an infected patient. Therefore, proper hand washing is especially important in preventing MRSA. (See “MRSA In Nursing Homes On The Rise Amongst Residents and Staff”)
C. difficile is another infection that is common in hospitals and long-term care facilities. Older adults are more at risk for this infection, especially after undergoing antibiotic therapy. (See “Left Untreated, Stomach Aches Can Be Deadly For Elderly Nursing Home Patients”)
Common viral diseases:
- Hepatitis A, B, C
- Infectious mononucleosis
Influenza or the flu is a common illness, but for the elderly, it can prove fatal. Adults over 50 years old are at most risk for influenza-related complications. Older adults can develop ear infections, acute sinusitis, bronchitis, pneumonia, and encephalitis. Pneumococcal pneumonia can be deadly for elderly nursing home residents. Health care workers and people with certain chronic diseases should be vaccinated each year. Unfortunately, flu shots are less effective in older adults, but the vaccine is still recommended for people over 50.
Hepatitis A is spread by fecal-oral contamination or by a contaminated food handler. If a nursing home staff member contracts Hepatitis A, it is important to ensure that they do not return to the facility for one week after onset of symptoms; if they handle food, they should not return to work for two weeks.
Common fungal infections:
- Ringworm (reddish ringlike rash caused by direct or indirect contact with items contaminated with fungus from skin, hair, or scalp)
- Head lice
Head lice are parasitic insects that feed off human blood and lay eggs in the scalp. Lice is extremely contagious. Therefore, if one resident has head lice, all residents should be examined. Nursing home staff must ensure that grooming tools, hats, scarves, etc are not shared and are stored separately.
Nursing homes must take precautions to prevent communicable diseases because elderly nursing home residents are vulnerable to dangerous complications. Many residents already suffer from various diseases, infections, and conditions, and their bodies are weakened. Older adults are already at higher risk for certain infections, such as the flu. And, they are more at risk for dangerous complications, such as pneumonia.
Proper hygiene and cleanliness can go a long way to prevent these communicable diseases. If you or a loved one suffered injury from a communicable disease at a nursing home because of unsafe practices or inadequate precautions, you may be entitled to compensation from the facility where the illness originated.
Special thanks to Heather Keil, J.D. for her assistance with this Nursing Homes Abuse Blog Entry