By JULIE MINDA
On a Friday morning in early June, after months of a precautionary lockdown against coronavirus, 40 residents of St. Andre Health Care of Biddeford, Maine, sat, socially distanced, in chairs, benches and wheelchairs around the perimeter of the eldercare facility's parking lot. A long parade of festooned cars wove its way slowly toward them.
Loved ones of this resident of St. Andre Health Care showered her with love, flowers – and silly string – during a car parade in early June. Staff of the Biddeford, Maine, facility had arranged the parade so that residents and their family and friends could see each other in-person, while also social distancing.
More than 100 family members and friends had jumped at the chance to take part in the parade, and they waved enthusiastically as they called out greetings and blew kisses to the loved ones they'd been separated from by the pandemic. The residents responded with glee.
Many families had decked out their cars with balloons, streamers, posters — and in one case, a giant stuffed toy tiger. One family ambushed their beloved grandmother with silly string.
"It was very heartwarming and overwhelming to witness the reactions of the residents and families to one another," says Samantha Beaton, St. Andre recreation therapy director. "They all got so much out of it."
Becky Reichelt, left, executive vice president at St. Paul Elder Services, interviews a resident about her favorite summer memories. The videographer, Sr. Cecilia Joy Kugel, OSF, compiled the responses of several interviewees into a lively video for residents and their families. The activity at the Kaukauna, Wisconsin, long-term care campus is just one effort to keep residents engaged and active.
Beaton and her colleagues spent many hours planning, setting up for and staffing the parade. Like many of their peers in ministry eldercare facilities, the folks in St. Andre's parade crew are determined to ensure that the joyful, stimulating environment that they had cultivated before the pandemic would continue under lockdown. With a lot of imagination and heart, these staff members have pulled off some fun events to keep residents smiling and on their toes.
"Those of us who work in long-term care — we think about what would benefit residents, and how we can make things better for them, and how can we make that happen," says Beaton.
Fun and games
The protocols that long-term care facilities across the U.S. have put in place have been necessary to help prevent coronavirus spread, but they have come at a price, says Sondra Norder, president and chief executive of St. Paul Elder Services of Kaukauna, Wisconsin, part of the Franciscan Sisters of Christian Charity Sponsored Ministries. "We know that isolation is bad for people's health and that socialization is good for people's health. It's part of our mission to keep residents engaged, and it's the right thing to do.
"But we also really enjoy it and know the positive impact it has on people's lives."
When the pandemic hit, St. Paul replaced its usual communal happy hours with a traveling happy hour. Staff members deliver favorite spirits — plus some lively banter — to each resident in their rooms.
Norder says the happy hours are a hit. "Our mission is to enrich lives, and we are dedicated to doing that, even in the pandemic, even in super nonideal circumstances."
A resident of St. Anne's Nursing Center and Residence in Miami shows off the gifts she received on Mother's Day. Staff made an extra effort to make sure the day was meaningful for the facility's moms.
St. Paul staff also have started an interview project that has become very popular. An interviewer asks residents a question related to a lighthearted subject. The videographer, Sr. Cecilia Joy Kugel, OSF, a communications specialist at St. Paul, creates a video montage of the replies. The end product gets shared with residents and their families.
One set of video shorts has residents reliving favorite summertime memories which have included camping, riding bikes, swimming and "fighting with my sister."
To further reassure worried families, St. Paul produced — and uploaded to YouTube — a 19-minute video documentary to show what life is like inside the facility during the lockdown.
St. Mary's d'Youville Pavilion in Lewiston, Maine, which like St. Andre is part of Covenant Health, celebrates theme days. On Bahamas day, staff sported floral attire and served residents tropical smoothies to the boppin' rhythms of beach music. The facility also is doing up birthdays in a bigger way than usual. In addition to songs and treats, St. Mary's staff organized window visits and videoconference chats with their loved ones.
Shelly Katula-Blais, director of St. Mary's therapeutic recreation program, says the entertaining activities are welcomed by staff and residents alike, in part because "they keep our minds off all the negative things going on in the outside world."
Residents of Benedictine Living Community – Winona in play a lively game of "broomball" in the halls of the Winona, Minnesota, senior living facility.
Hearts a pumping
Esther Zimmerman directs recreation therapy at Benedictine Living Community – Winona in Minnesota, a long-term care campus. She's been adjusting physical fitness activities so that they are in line with infection control protocols and finding new activities to replace those that no longer can be done safely.
Gwen Vye, age 99, of St. Mary's d'Youville Pavilion in Lewiston, Maine, enjoys the treats given out during one of the facility's theme days.
Since many residents enjoy getting out in the fresh air, Zimmerman moved many activities outdoors with the onset of Minnesota's spring temperatures. One man who hadn't been doing well under the no-visitors policy, "was the first one out on the patio, and the last one to go back in" when she staged a cardio drumming circle.
Residents socially distanced on the patio and beat out the rhythm of the tune playing in headsets they all wore. The playlist included "Hit the Road Jack" and "Runaround Sue."
"They thoroughly enjoyed it," says Zimmerman. "They were really engaged."
Zimmerman also staged a "giant ax throwing" event — participants hurled a Velcro ax at a target — which she calls a "huge hit." (No pun intended.) She's used Zoom conferencing to host a Family Feud style competition between residents. And she has a few more surprises up her sleeve to keep recreation interesting. She's looking into squirt gun painting and scavenger hunts.
Roberto Salvador is activities director at St. Anne's Nursing Center and Residence in Miami, which is part of Catholic Health Services of Lauderdale Lakes, Florida. He says that knowing what a strain it has been for residents to be cut off from in-person contact with loved ones, he has been investing more time and effort into occasions that are important to residents.
For Mother's Day, he helped residents' families create custom videos and coordinated virtual gatherings for families separated because of visiting restrictions. He handed out flowers and cards to the moms in the facility. He repeated the gestures on Father's Day.
"It's our responsibility to love our residents as our families," he says.
Kind acts from staff help eldercare residents feel loved, valued
To prevent coronavirus contagion, D'Youville Life and Wellness Community in Lowell, Massachusetts — like virtually every other eldercare campus across the U.S. — put in place lockdown and quarantine protocols in March that in effect ended all nonessential visitation for residents.
This shutdown meant that the hairdresser who normally comes to the continuum of care campus to coif residents' locks no longer could do so. Recognizing how much her clients missed the services that helped them feel polished, two certified nurse aides took it upon themselves to set up a rolling salon.
Their cart contains all that Coryn Adams and Caitlin Ashe need to style men's and women's hair. They apply makeup for women who want it. Adams and Ashe wear protective gear as they set and comb.
"We are like a family, and this is how Coryn and Caitlin would want their own family members treated, so that's what they did," says Debbie Scionti, D'Youville director of mission and values.
Throughout eldercare facilities ministry-wide, staff like Adams and Ashe have been finding ways to provide emotional support and lift residents' spirits.
It's amazing to see how the kindnesses impact residents, Scionti says. "They know they are loved."
The protocols put in place nationwide in the spring that allow only essential personnel to enter eldercare facilities, while necessary to help prevent viral spread, have greatly constricted the lives of residents. In some facilities, residents largely have been confined to their rooms or to restricted areas where the number of people is controlled. Residents' socialization, recreation, dining and excursions have been sharply limited to activities that can be done individually or in small groups while maintaining a safe social distance of 6 feet or more.
Kathy O'Connor, an administrative assistant of The Village at Victory Lakes, helped ensure that a resident got a chance to enjoy her 90th birthday celebration. The resident's family members had a car parade for her and gave her gifts. Staff have been assisting in arranging such special moments for residents.
On March 13, the Centers for Medicare and Medicaid Services issued coronavirus infection control guidelines for long-term care facilities nationwide that effectively barred visitation, with the possible exception of limited compassionate visitation at the end-of-life. On May 18, CMS released multi-phased guidelines to enable the safe resumption of visitation. Some nursing homes now allow visits on a narrow basis, with social distancing and other precautions in place.
Pre-pandemic, Bon Secours St. Petersburg Health System in Florida regularly welcomed over 100 visitors daily to its skilled nursing facility. Since March, only staff and people providing essential medical services can enter the building, says Kip F. Corriveau, Bon Secours St. Petersburg director of mission. As Catholic Health World went to press, Gov. Ron Desantis' emergency order restricting visitation by family members remained in effect.
Maria A. Miranda, vice president of public relations for Catholic Health Services of Lauderdale Lakes, Florida, says nursing home staff have made kindness a priority despite having had extra duties added to their responsibilities, including tasks and responsibilities connected with implementing stringent infection control measures. Some long-term care staff are getting weary as the months of lockdown drag on, says D'Youville's Scionti.
Jeanne Heid-Grubman, administrator of The Village at Victory Lakes continuum of care campus in Lindenhurst, Illinois, says she's witnessed profoundly meaningful gestures by the staff of that facility, which is part of Franciscan Ministries of Lemont, Illinois.
In one instance, a nurse aide bought a wedding anniversary card and flowers for the wife of a hospice patient knowing the couple could not mark the occasion together because of the lockdown and that the man would not survive until his next anniversary. The aide had the patient sign the card and made the delivery to the wife at her home. "That card was the last thing his wife had with his signature on it, because he died the week after the anniversary," Heid-Grubman says.
She says, "It's painful for these families to be separated from someone they love more than anyone on earth," and so the aide's kindhearted act "was meaningful beyond what I can imagine, and I'm sure the resident's wife will never forget this."
Annabelle Hara, a resident of Bon Secours Place at St. Petersburg, got a visit from her loved ones on her 94th birthday. Here, she waves to them through a window at the facility. Staff have played a key role in helping visitors pull off such celebrations.
By tradition at Victory Lakes, nurses escort the body of a deceased patient to the funeral home hearse, intoning prayers for their eternal rest. The nurses made a pact with one another to maintain that custom amid the pandemic. So, earlier this year, when a woman was actively dying on a Saturday night, four or five day-shift nurses and nurse aides set up a phone chain so that they could be alerted — when they were home and off the clock — that it was time to come back to the facility and escort the resident's body. All of them came in after getting their phone call, and they waited four hours for the funeral home director's arrival, so that they could join the six or seven associates who were on shift to honor the deceased woman.
Even simple, seemingly mundane acts by staff can have much importance for residents and their families. Corriveau of Bon Secours says Sr. Dolores O'Brien, OSF, a chaplain at that long-term care campus' assisted living facility, has been serving as an informal secretary for residents who can't use email. She prints out greetings and messages from friends and loved ones and reads them to the intended recipient. She writes a short note back to thank the sender, sharing anything the resident said in the reply.
Corriveau says, much like the chaplain, many staff members are "consciously slowing down and taking the time to listen," to residents.
Roberto Salvador, activities director of Catholic Health Services' St. Anne's Nursing Center and Residence of Miami, says he and his colleagues on the activities team visit most residents on a daily basis, and they have been making an extra effort to engage them in longer conversations and to provide them with extra emotional support. He says the visits are "serving a higher purpose, showing God's love to each one of our residents during these rough times."
Corriveau says by paying attention to the individual, staff help residents feel valued. "This fundamentally starts with Catholic identity, and Bon Secours Mercy Health values human dignity. We see each person is precious, each person is an individual with a history and a story."
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