May 27, 2020
WASHINGTON--The National Council on Disability (NCD) has issued the following statement regarding direct support professionals and COVID-19 hospital visit rules:
NCD urges all state and local chief executives to issue rules and guidance allowing for visitation by direct support professionals (DSP) for patients with intellectual and developmental disabilities (I/DD), patients with dementia, and other patients in need of DSPs admitted into hospitals for COVID-19.
As the coronavirus continues to spread across the country, some governors have begun issuing a rule that hospitals must no longer permit visitors, as a means of restricting further contagion. NCD agrees this to be a prudent rule. There is no doubt that the virus is extremely efficient at spreading, but, aside from pediatric patients that require a parent to be permitted entry, an exception must also be made for patients with I/DD and/or dementia by states and local governments that have not yet done so. Unfortunately, while some state and local government executives have provided Guidance to this effect, others have not, and with quite foreseeable ramifications.
There are over 7.3 million people with I/DD in the United States. Even absent the chaos associated with the current pandemic, a hospital visit for a person with I/DD can be quite challenging. Patients checked into hospitals are typically tended to by hospitalists that have little knowledge of the patients in their care. The issue is further complicated by the fact that disability competency training is not sufficiently required for all medical students in the U.S., thus many doctors are not very comfortable treating people with I/DD to begin with.
“These patients need their DSPs with them for a multitude of reasons including relaying patient history, translating body language, and diffusing anxiety when a patient’s sensory issues manifest, if those are present,” said NCD Vice Chair James T. Brett.
A DSP’s role is crucial and helps avoid misdiagnosis, improper prescriptions, prolonged hospital stays or even an early release that results in a readmittance due to costly and otherwise preventable medical complications.
An estimated 5.8 million Americans age 65 and older are living with Alzheimer’s dementia in 2020. As is also the case with patients with I/DD, many patients with dementia require DSPs to relay patient history and help calm the patient during moments of anxiety and confusion. Here too, the presence of a DSP is a crucial component in avoiding unnecessary and costly complications.
The policy of permitting DSPs is certainly more effective than any alternatives, including the use of health cards that note health history but would not have the same comforting effect that a trusted and familiar support professional would have. States already hard hit by COVID-19, including New York and New Jersey, have issued such guidance for the hospital visitation rule. Other states and local governments would be wise to do the same. Allowing in DSPs in hospitals with COVID-19 patients despite the no visitors rule is a policy that must occur broadly, state-by-state, and locality-by-locality. It is paramount that such guidance not be ignored by hospitals.