Assisted living, long term care, nursing, and residential care facilities enacted new policies aimed at protecting their residents, who are particularly vulnerable to the effects of the COVID-19 virus.
All the state’s nursing homes and assisted and living facilities have been closed to visitors since March 16. Peterborough’s Summerhill, Scott-Farrar and RiverMead have each taken measures to prevent residents and staff from contracting the virus, and have devised plans for what to do if a resident were to get sick.
“This is our third week of quarantine. The first two weeks were no visitors, nobody except essential coming in, the residents were able to move about on their own. Last week we initiated full quarantine,” Summerhill Executive Director Mary Pat Jackson said last week. Residents now stay in their apartments, and staff bring meals, treats, activities, and nursing services to them, Jackson said. “None of us can predict what kind of health we’re in until it’s too late,” she said, and ultimately that uncertainty fueled the additional precautions. Residents have responded well, Jackson said. “Many will honestly tell us, we’ve been through World War II, we get it, this is what you’re doing to protect our safety,” Jackson said. “It makes you find the strength to keep on going with this.”
“It’s hard on the residents to not see each other,” Scott-Farrar Executive Director Lara Shea said. Scott-Farrar residents are also staying in their apartments, and can go outside if they stay six feet away from one another. Staff now bring treats and activities to residents in assisted as well as independent living apartments, who usually would not receive regular visits from staff. Residents are offered coffee and pastries in the morning and an assortment of games, puzzles, word searches or trivia, and popcorn or milkshakes in the evening, Shea said. Staff help residents with virtual tasks, like finding a church service on Facebook or Skyping with their family. “Some have really got into painting,” Shea said, and the whole-house bingo game is getting competitive. “With the seriousness of all this, we’re trying to keep it light and fun,” she said. Shea’s own grandmother lives at the facility, and when she turned 95 recently, Shea’s husband made a visit from outside the window.
“We can’t stop a resident from getting in their car and going somewhere,” CEO Bill James said of residents living independently at RiverMead, but residents have been discouraged from going out, congregating too closely in areas like the centralized mailroom in the community center, and from getting together to play bridge or other close socialization with other residents. Staff deliver 200 dinners a night to residents who would otherwise go to the now-closed dining center, James said, and residents are encouraged to take deliveries from local grocers and pharmacies. No visitors are allowed in the health center, where residents who require assisted living, nursing, or memory care stay, but staff are attempting to accommodate their spouses, James said.
“Most people are taking it very seriously,” RiverMead resident Martha Manley said. Residents have been encouraged to reach out to one another with phone calls. Manley said she recently called a resident whose husband may be in the early stages of Alzheimers. “She’s very protective of him and knows he’s at high risk, you don’t see her,” Manley said. “She very much appreciates being involved and included,” through phone calls, however. “That makes a huge difference.”
The RiverMead community remains intact, Manley said. She still sees people in the halls, and talks to people in the courtyard from a respectful distance. Manley’s fitness instructor has organized residents into virtual teams so they can compete by logging exercises – with extra points for reaching out to someone else, of course. Residents now receive the RiverMead Daily newsletter, and the art room and even the pool is open, although only two people are allowed in a room at a time. “If you’re going to be somewhere these days, RiverMead’s a wonderful place to be,” she said.
All three facilities follow the latest CDC and Department of Public Health guidelines and directives. As of last week, no resident or staff member at any facility had tested positive for COVID-19. Staff members at all three facilities are encouraged to monitor for symptoms at home and get their temperatures taken at the door, and regularly complete health questionnaires about who they’ve been in contact with, and quarantine at home when appropriate. Vendors and visiting professionals are also screened upon arrival.
“The per diem pool is tending to shrink because things might be happening in other places,” Summerhill Resident Care Director Patricia Pepin said. Many of the staff members who work per diem for the facility work at two or more different facilities in the area, she said, and she and her staff keep track of potential cases in the other facilities to safeguard Summerhill staff and residents. “We’re really knocking on wood like everybody else is that we can keep it out,” James said.
All facilities also have a plan to contain exposure if a resident were to become infected. The RiverMead health department can treat cases on site, and Scott-Farrar and Summerhill are prepared to treat a patient’s symptoms on site for as long as possible, while communicating with Monadnock Community Hospital. An infected resident would have a dedicated nursing staff who would isolate from other staffers. Each facility is stocked with personal protective equipment and has received information from the CDC about how to appropriately extend the life of some one-time use materials.
At Summerhill, Pepin said she is proactively addressing worst-case scenarios with some residents and their families, including what to do if a patient on hospice comes down with the virus, or if an infected resident requires a ventilator during a shortage at the hospital.
“Conversations that people don’t want to have, [aren’t] prepared to have with their parents,” she said. “We’re trying to get all the questions cleared up,” she said. In the meantime, she said that she and her “task force,” four nurses and three aides, are prepared to move into the building if necessary. There’s a room ready for them to isolate in and shower. “We’re ready to do whatever we have to do,” she said.