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Long-Term Care

Long-term care is an umbrella term for facilities that provide care to patients or clients for more than a few months. Long-term care can be temporary, permanent, or even hospice, and the care can be for either medical or rehabilitation purposes. Long-term care can also refer to a residential setting with varying levels of assistance. The sizes of long-term care facilities vary according to their purpose, their clientele, and their location.

There are some risks associated with living in a long-term care facility, and importantly, the possibility of an increased risk of infection, which could lead to sepsis.

Sometimes incorrectly called blood poisoning, sepsis is the body’s often deadly response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Sepsis kills and disables millions and requires early suspicion and treatment for survival.

Sepsis and septic shock can result from an infection anywhere in the body, such as pneumoniainfluenza, or urinary tract infections. Bacterial infections are the most common cause of sepsis. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue,  organ dysfunction (organs don’t work properly), and/or amputations.

How infections spread in long-term care

Living in a long-term care facility provides you with opportunities to interact with many people, from other residents and visitors to the facility employees. However, the more people who come and go, the more chances there are for certain types of illnesses to be brought into and spread throughout the facility. Infections developed within a hospital or long-term care facility are called healthcare-acquired infections, or HAIs.

Common types of bugs that cause infections in long-term care facilities can include:

Infections that may occur within a facility can include

  • Gastroenteritis
  • Influenza
  • Colds

When people reside in long-term care facilities, they may need to be transported and/or admitted to a hospital if they become too ill for the long-term care facility to handle. The five most common infections that require a transfer and admission to the hospital are:

  1. Pneumonia
  2. Urinary tract infections
  3. Wound infections
  4. Meningitis
  5. Endocarditis

Other ways to get infections in long-term care

People who are in long-term care facilities may be at increased risk for infections because of the treatments they receive. They may have a long-term or indwelling urinary catheter, which can cause a urinary tract infection. Other chronic invasive devices, such as a ventilator tube, a port, or an IV site can also lead to infection. These devices introduce openings into the body which can allow germs to enter, causing an infection.

Those residents with frail skin may develop scratches, skin tears, or other wounds, or pressure ulcers (bed sores), any of which may become infected. Wound infection, especially in a pressure ulcer, is one of the most common sources of infection among nursing home residents. People with difficulty swallowing could aspirate (inhale) food or drink, and this could cause aspiration pneumonia.

There are several ways an infection could occur so vigilance is vital to both prevent infection when possible and to treat it early when it does occur.

Infection prevention

People who work or volunteer in long-term care facilities should be aware of infection prevention practices. These include:

  • Washing hands when moving between patients or residents to provide care.
  • Observing isolation protocols (gloves, gowns, and/or masks), when necessary.
  • Cleaning rooms and objects as per facility’s protocol.
  • Isolating patients or residents if they show signs of illness.

But people who visit these facilities have a role to play in infection prevention as well. This includes:

  • Not visiting when ill, even if it’s “just a cold.”
  • Washing hands upon entering the facility and each time you return to the patient or resident.
  • Reporting to the staff any signs of open wounds, infection, or illness the patient or resident may have.
  • Receiving appropriate vaccinations.

While sepsis can affect anyone, people who are older or who are already ill are at higher risk and are a vulnerable population. Infection prevention is the best way to reduce the risk of infections and sepsis.

If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.” 

Updated July 12, 2021.