Elderly Care in the COVID-19 Era
It’s no secret that life-affirming human contact was hit hard by the distancing and safety requirements of the COVID-19 pandemic.
Being cut off from loved ones could be especially hard on seniors. Missing an anticipated visit from the grandkids or regular social activities can lead to feelings of isolation and loneliness, causing depression and other health worries.
“The limits on family and social interaction have, to me, been the hardest thing about the pandemic in long-term care and people who serve,” says Rachel Bunch, Arkansas Health Care Association executive director.
Guidelines and requirements were changed and amended, while long-term care personnel and communities creatively put seniors in touch with the important people in their lives.
“We want to provide as much family visits as we can while working within those guidelines. That’s our goal,” Bunch says.
A long-term care facility includes nursing homes, assisted living facilities, intermediate care facilities, residential care facilities, post-acute head injury retraining and residential care facilities and any other facility that provides long-term medical or personal care.
Facilities are regulated by the Arkansas Department of Human Services (DHS) and the Arkansas Department of Health (ADH). During the pandemic, regulatory agency guidelines changed for everything from visitation screenings to quarantine and isolation guidance for staff and residents and what activities could and couldn't take place in facilities.
Home health care agencies have staff to meet the medical and non-medical needs of clients and are licensed and regulated by the ADH. Private care agencies offer only non-medical in-home care and are also ADH licensed and regulated.
According to information provided by Brandi Schneider, director of aging services and administration at UAMS Schmieding Center-Springdale, home and private care agencies had to follow pandemic-related precautions including screening questions, temperature checks and wearing personal protective equipment inside a client's home.
“Certainly we want to keep our clients and our caregivers safe. People, they need us there,” says Mike Martin, owner and director of living assistance service Visiting Angels of Central Arkansas.
Private duty nursing is individual care provided by a registered nurse or licensed licensed practical nurse and the care, both medical and non-medical, can be provided in a patient’s home or long-term facility. Private duty home care is offered by either agencies or individuals who provide companion care, non-medical or nursing services in the home.
The ADH offered technical help for expanded visitation and recommended visitation and activities be held outdoors, as well as plexiglass visitation booths and weather protected structures like courtyards, patios and tents.
Platforms like Zoom, FaceTime and Google allowed seniors to visually communicate with their loved ones. Window visits became safe and popular alternatives.
Regulations require facilities to have an activities director charged with organizing a variety of scheduled programs and events to keep residents active and involved. This proved difficult, Bunch says, but not impossible.
Hallway bingo, for example, using the intercom to call out numbers while residents played from doorways, became popular. With hairdresser facilities closed, long-term care facilities had staff members step up to do manicures and perms.
Melissa Curry, CEO of Methodist Village Senior Living in Fort Smith, says the facility worked with the Department of Human Services to expedite retention of a license to open an emergency daycare for staff, so they wouldn't have to quit or leave work to care for their children out of school.
Methodist Village obtained a grant to buy iPads for residents and its Life Enrichment staff devised a back-to-school theme for residents with “homework,“ a yearbook and prizes for top grades and completed work.
Silver Oaks Health & Rehabilitation in Camden, unable initially to go out and buy bingo prizes, put out a Facebook plea that “went global," administrator Kathy Beevers Langley said.
Silver Oaks was inundated with shipped gifts that included snacks, books, puzzles and even Estee Lauder lipstick for every resident.
“That was probably one of the neatest things we did,” Beevers Langley said.
The Ridgemere Senior Living Center in Conway held a multi-day, drive-thru Easter egg hunt for residents. WWII veteran Lucian Cato was honored with a 95th birthday parade comprised of police, fire departments and motorcycle groups at Conway's Brookdale Senior Living Center.
For in-home caregivers, phone and video calls and personal letters were recommended. Book or movie groups by phone or video chat proved good for stimulating conversation and contact, as well as garage visits and virtual group meetings, events and classes.
Voice assisted technology like Constant Companion responds to medical alerts and could be used to send messages to loved ones. It includes an optional video chat and other useful features.
Martin notes that people receiving home care are already isolated. A home care specialist, therefore, also provides needed companionship and human interaction.
“Part of what families pay for is to have someone there,“ Martin says.
Staying in touch with those under care, like just about everything else, has been made more difficult by the COVID-19 pandemic, but that makes it important, Bunch says for the families to stay in touch with the caregivers.
“Communication with staff is key,“ Bunch said. “Communicating with them to ask about what opportunities are available for interaction. What would their suggestions be to engage at the highest level allowed?”