BY SUZANNE DUMARESQ
Illustration by: Jon Lezinsky
One of the most heartbreaking effects of the coronavirus pandemic is the toll it's taking on skilled nursing communities. In response to such challenge, the team at Mary Immaculate Health/Care Services, a member of Covenant Health, rose to the call to care for three important populations — residents, staff and the local community — in countless small, important, beautiful and spiritual ways.
HARD HIT BY COVID-19
Mary Immaculate includes a 231-bed nursing center in Lawrence, Massachusetts, a city incredibly hard hit by the virus in Spring 2020. As COVID-19 infiltrated the state, visitors to residents in Mary Immaculate were restricted, and all pertinent Centers for Medicare and Medicaid Services and Centers for Disease Control and Prevention infection control guidelines were stringently enforced. Care was coordinated with the Massachusetts Department of Public Health; the National Guard assisted with testing of all residents and staff. Yet, these efforts were sometimes not enough. By the end of April, 145 residents tested positive, some with mild or moderate symptoms, and 47 of our residents died. We had increased support from hospital nurses when over 60 staff members were not able to come into work because they were quarantined, isolated or recovering at home.
"Each member of our team shared in the anxiety, uncertainty and dread of this virus. We often found ourselves weeping and praying with residents, consoling each other and trying to process the enormity of how COVID-19 had ravaged our community," said Jeanne Leydon, president of Mary Immaculate Health/Care Services. "However, we were driven by the healing ministry of Jesus, which inspired our founders to action — and inspired us to forge on. We called on Catholic social teachings and served with all the dignity, grace and faith we could muster. It was our duty and privilege to care for the vulnerable and those who truly value what differentiates us from other care providers."
COMPASSION FOR RESIDENTS
This scenario is not unique — many other skilled nursing facilities across the nation have had to cope with similar circumstances. What's notable, however, is that the compassionate response from the Mary Immaculate community included more than supporting residents with Facetime/Zoom calls, window visits and car parades so readily shared via social and local media. They embraced the community with:
Daily Prayer "Our community is our residents' home. Typically, the intercom system wouldn't be used for daily announcements. We always felt strongly that interrupting our residents' sense of peace, in their home, wasn't a good idea. However, during the pandemic we sensed our residents needed the interruption, needed to hear a prayer, a poem or even a song to provide a bit of inspiration or maybe a moment to reflect," said Adrienne Cullen, director of mission integration and spiritual care advisor. "Ironically, we quickly learned this daily outreach resonated with residents and staff alike — many have requested we continue the practice."
Rosary in the Hall It's exactly what it sounds like. Given that residents were restricted from gathering, they took to the halls. Residents came out of their rooms in their wheelchairs, or sat in chairs, which were at least six feet from one another, and joined in the rosary. They were longing to feel connected to their faith and fellow residents. Rosary in the hall lifted their spirits and fulfilled a spiritual need. Resident Andrew Begoss shared, "Saying the rosary felt joyful and praying with other residents made it even more special." Staffers found this effort to be especially touching for their memory care patients who seemed to feel consoled by the familiar tradition connecting them to their faith and past.
Spiritual Communion Residents were encouraged to make an Act of Spiritual Communion, which is the recitation of a specific prayer — especially those who watched daily televised Mass. It was an invitation to residents to open their minds and hearts to accepting the Body of Christ in a new way — and it was a very significant ask for many devout residents who longed for the Eucharist. Cullen said, "Our community now offers in-person Communion while observing very strict protocols to do so. Resident reaction has ranged from being deeply grateful to shedding tears of joy." Communion resumed in October. A chaplain remains in the hall with a "Communion cart" while Cullen wears a mask, goggles and gloves to offer it to residents.
Respect for Faith Traditions Approximately 70% of Mary Immaculate's residents are Catholic. A new chaplain, who is Protestant, was recently hired. He will offer Bible study groups for residents who do not pray the rosary or who have a different faith. Separate opportunities for socializing also are offered, such as bingo and trivia.Self-Guided Spiritual Booklets
To help keep residents intellectually and spiritually engaged, Mary Immaculate offered self-guided spiritual booklets, which included a morning gratitude affirmation, a verse from daily Scripture and corresponding reflection, a daily meditation practice such as a "choose one moment of your day that made you happy" exercise and more. Residents said they genuinely appreciated the booklets' meaningful content and daily activity prompts. The booklets, which are created by staff, include New Testament passages as well as poems and aids to meditation that are non-denominational.
Good Day "MI" At Mary Immaculate — commonly called "MI" — there's now Good Day MI. This in-house version of Good Morning America began airing on Monday mornings a couple of months into the pandemic. Good Day MI is hosted by Cullen and one of MI's chaplains. Each week they host a show filled with segments on daily prayers, the week's Sunday Gospel, discussions on saints and feast days, a joke of the day and more. Hosts have even included personal shout outs to residents in need of some cheer, or who are celebrating a birthday that week. Cullen chuckled as she shared, "Many residents were watching quite a bit of television. We thought–let's give them some quality programming to watch that is personalized just for them! It's been so much fun for everyone."
End-of-Life Care Betty Desjardins and her husband, Roger, made the decision to move Betty's father, Leo Bernard, to Mary Immaculate in 2018. He had been diagnosed with dementia and required full-time care. The adjustment to MI went well. Betty Desjardins shared, "The nursing team referred to my Dad as the mayor." When the pandemic hit, Betty and Roger were not concerned with the no-visitors policy. Desjardins said, "I wasn't particularly anxious because I knew how well they took care of him. They cared for him as if he were family." In early April the news came that Leo had tested positive for COVID-19. Desjardins recalled, "My Dad was 89 years old and his dementia was progressing … we connected with the nursing team and agreed to focus on his comfort." Given the end-of-life situation, Desjardins was invited to Mary Immaculate. "I went through all the appropriate screenings. When I arrived at my Dad's room, I saw Chaplain Neven Pesa, in full personal protective equipment (PPE), sitting vigil just outside his door. I was deeply touched." Leo Bernard passed away peacefully on April 6. Desjardins reflected, "Before he passed I was able to reassure him he was loved, safe and cared for. He passed with dignity. It was an experience every family should have."
The Wall of Hope and Road to Resilience During the pandemic, Mary Immaculate's staff worked multiple shifts, seven days a week under difficult circumstances. They needed to feel a sense of hope and they got it — right at the building's staff entrance. The paved walkway was adorned with chalk street art that featured a vibrant butterfly and one word — HOPE. When employees first saw the art, many paused for a moment to take it in. Open the door and employees were met by "The Wall of Hope," a welcoming wall space offering encouraging quotes, Scripture verses and thank you notes from family members. At some point following the initial crisis, the bulletin board's theme morphed into "The Road to Resilience," which shared messages of strength and moving forward.
To provide an encouraging message to staffers arriving around the clock at Mary Immaculate Health/Care Services in Massachusetts, a walkway was marked with chalk art featuring a butterfly and the word HOPE.
Recognizing Loss When Mary Immaculate's staff struggled with processing the loss of so many of their residents who over the years had become extended family, the spiritual care team responded. Mary Immaculate held memorial services on each of the community's floors, so staff could take a moment to honor those who had died. The names of the departed were read, a bell was rung, a moment of silence was observed, Scripture was read, hymns were sung, and everyone prayed. Cullen said, "The loss of life was great, and our staff's suffering was significant. It was important for us to acknowledge the sadness in a meaningful way."
Sustenance Under normal circumstances, Mary Immaculate's employees would bring their lunch to work or order out, but these times were anything but normal. Richard Gibbons, MI's director of dining services, recalled, "Prior to the pandemic, our dining system was decentralized. Our team of 10 served meals in seven different dining rooms. Under the circumstances, we couldn't do that. We literally turned on a dime and implemented a tray line model and delivered meals to residents' rooms to ensure their safety." The dining services team also responded to the needs of their colleagues. Gibbons added, "Given infection control guidelines, staff couldn't have food in the care units, so we made it for them and designated our break room as a hub for much-needed breaks and sustenance." The break room was stocked for every shift with hot, cold and individually-wrapped meals, along with drinks, every day. Gibbons shared, "The response was overwhelming. That break room and food was a message to our team that we understood they were stressed and fatigued — and we wanted to care for them too. Our entire community was experiencing a traumatic situation. Managing it together created a genuine team bond we were all very grateful for."
Transportation Many of Mary Immaculate's certified nursing assistants used a taxi or Uber to commute to work. When the pandemic hit, those services were suspended, and employees were left without a way to get to work. Noemi Quinones, our transportation coordinator for the last 25 years, stepped up and offered to drive CNAs to work for their weekend shifts. Quinones said, "The staff was scared — afraid of losing their jobs, of contracting COVID-19, of watching residents suffer and pass away. I jumped in my bus, which could only accommodate four riders due to social distancing guidelines, picked up employees, dropped them off at work with blessings and got them home safely after what was often an emotional and exhausting shift." Rosita Colon, a CNA at Mary Immaculate who got to work on the bus, explained, "I had a lot on my plate, there was so much happening. I just wanted to help care for residents. In this role, you have to have a big heart – and I knew my residents needed me to be there for them."
CONNECTION TO COMMUNITY
Part of Mary Immaculate's mission is maintaining community connections; many of these were abruptly suspended due to the pandemic. We decided we could build community — with a celebration of National Mac and Cheese Day. MI's Dining Services team whipped up a macaroni and cheese lunch for residents as well as staff, who were also asked to donate a box of macaroni and cheese. Nearly 100 boxes were donated to Lazarus House, a local services program that includes a soup kitchen and food pantry that had been unable to serve meals due to pandemic safety guidelines. This effort drew the community together to help others while they also enjoyed a break from daily challenges with some wonderful comfort food.
PRIDE IN BEING DIFFERENT
"Our entire team, from administrators and clinicians to activity staff and kitchen crew take pride in our unwavering focus on compassionate care and our sincere dedication to mission," said Leydon, president of Mary Immaculate Health/Care Services. "I'm genuinely proud of how our entire team leaned into our Catholic faith and values to make a real difference when faced with extraordinary challenge. As always, the approach served us well. It is why Catholic health care is different."
SUZANNE DUMARESQ is a communications manager at Covenant Health, based in Tewksbury, Massachusetts, which is one of New England's largest nonprofit post-acute care providers.