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Addressing Refusal or Reluctance to COVID-19 Modifications

CMS Logo displaying those letters in bold blue text surrounded by a blue and yellow semi-circleThe Centers for Medicare and Medicaid Services (CMS) has released an important resource: CMS Guidance for Infection Control in Communities Serving Individuals with Behavioral Health, Psychiatric and Cognitive Impairment Issues. Though this resource is written as a resource for individuals in Psychiatric and Intermediate Care Facilities, it includes some important tips for addressing refusal or reluctance to COVID-19 modifications that could be helpful in any setting. 

Some of these include: 

  • Consistently remind the person of the broader community-oriented goals for using PPE (e.g. using PPE can help to protect them, and their friends, family, caregivers, and others including residents/clients/staff from infection) Help the person use distraction, relaxation, and mindfulness techniques while wearing PPE. 
  • Try to understand the reasons for not wanting or not consenting to a test (e.g., stigma, loss of freedom, not having an area to shelter in place, fear of testing procedure), and respond to the person’s expressed concerns.
  • Provide education about COVID-19 including risks of transmission to others, benefits of early identification, and treatment where needed (check the Centers for Disease Control and Prevention website for the most current information on these topics). 
  • Offer several selections for face masks such as a change in texture, fashion, and type.
  • Consider establishing peer support groups for residents/clients struggling with pandemic-related constraints, where individuals can share stories to help build resilience, or establish peer “buddies” who can interact virtually. 
  • Implement targeted educational strategies including games, planning, and counseling to help individuals better understand why testing and screening is critical to everyone’s safety.
  • Encourage social distancing through posters, signage, television scrolls, and other posted reminders.

Hope this resource and tips help you support those that may continue to struggle with current restrictions and requirements. Remember to always consider health disparities and use culturally and linguistically tailored materials, and tailored staff assignments when providing this support (and always!). 

Please send any suggestions or questions related to this article or requests for additional resources to RA-basprovidersupprt@pa.gov.