Residential Care Centers Fight COVID-19 with Array of Protective Measures
By LisaMarie Martinez, MSN
To vaccinate or not to vaccinate, to mask up and maintain social distance, or to be isolated and unseen by friends and loved ones. These are the dilemmas faced by most people since the beginning of the pandemic in 2020. When it comes to managing the lives of those who depend on others for their daily needs, such dilemmas are redefined.
For facilities that provide services for individuals with varied health and wellness needs, their work was heavily impacted by the continuing unknowns surrounding COVID-19 and the vaccines. As critical service providers, the staff took on new roles during the pandemic to support and maintain the health, safety and the psychosocial needs of the residents they serve.
Vaccinations Key to Protection at Care Center
Forest Street Compassionate Care Center is a quaint 60-bed skilled nursing residence, with a memory-support section, located in the residential community of Park Hill. The center serves residents in northeast Denver and the surrounding communities, who are mainly African American but also other races and ethnicities.
When interviewed in early August, 100% of their residents were fully vaccinated, 92% of their staff was fully vaccinated, and there were no active COVID-19 cases among its residents or workers. They attributed their ability to vaccinate all residents to providing education about COVID-19 and the vaccines, and their ability to prevent COVID-19 outbreaks to the vaccine. They had plans to continue to encourage their unvaccinated staff to become fully vaccinated.
Nursing Home Administrator Grace Nailing said, “We are doing everything we can to protect our residents and team members. All staff members, family members, visitors and providers are required to wear a mask. We screen all team members, visitors, family members and providers upon entrance. We follow the infection control guidelines.”
In addition, she said that their community works to ensure there is enough personal protective equipment (PPE) available to residents and staff.
Certified nurse aides Brenda and Carlos said it is less hard to protect their residents from getting COVID-19 now that all their residents are fully vaccinated. They said efforts to protect them are ongoing, such as staff wearing masks, properly hand washing between resident visits, disinfecting all surfaces on a regular basis, and checking staff vital signs every shift.
Keeping their residents happy and safe at the same time involves flexibility in operations. Activities Director Beverly Canaday said, “Currently, fully vaccinated family members can enter the center and visit with their loved ones face to face while wearing masks, and unvaccinated family members can visit by making an appointment and visiting with their loved ones in a designated area.”
She said the center makes changes to fulfill whatever health requirements they must meet, to keep their residents safe. If they are required to maintain social distance, the staff does so by keeping the residents six feet apart from each other when in group activities, offering more one-to-one activities in residents’ suites, and having families schedule visitations through a glass door. Previously, all family members were entering through an alternate building entrance and had to sit six feet apart while being in the same room as their loved ones.
Administrator Nailing said, “We work hard to provide for our residents the way we would want our family members cared for. We believe our residents deserve the best.”
To better fight COVID-19 she wants see more people getting fully vaccinated and for all organizations to always have enough PPE supplies.
Caring Policies and Procedures to Prevent a Return to 2020
Located in the city of Westminster is Greenridge Place, a memory care community operated by Anthem, which provides highly specialized care for individuals affected by Alzheimer’s and other dementias including Lewy Body, vascular and Parkinson’s dementias. Greenridge Place serves a variety of races and ethnicities and is one of four Anthem memory care communities located in the Denver metro area.
In early August, Executive Director Lisa Anderson said 100% of the community’s residents were fully vaccinated and 69% of their team members were fully vaccinated. She said they have a vaccination roll out, which requires all their unvaccinated team members to receive their first vaccination by Sept. 1, and to receive the second dose so they would be fully vaccinated, or to provide documentation of religious, medical, or allergy that would prevent them from receiving it. New hires would be mandated to be fully vaccinated, also. Greenridge Place uses education to approach the topic of vaccination with residents who are hesitant or unwilling to get fully vaccinated.
Anderson said, “We partnered with our preferred pharmacy provider, Medication Management Partners, and asked their pharmacist, Patrice Johnson, Rph, PMP, if she could possibly provide Anthem Communities with an educational presentation filled with factual and statistical information.”
Residents are also provided with the expertise and guidance she receives from local, state, and national authorities to ensure guidelines are understood and followed, Anderson said.
There were no active positive cases of COVID-19 amongst her residents or team members at the time she was being interviewed. Her community requires weekly surveillance testing of team members and residents, and unvaccinated team members or team members who are out of the building for 24 hours or more have to produce a negative COVID-19 test result through rapid testing prior to caring for residents. Masks are required of all team members, residents wear masks when in direct contact with team members, and masks are to be worn by the resident when with visitors. Visitors are required to pass a pre-screening questionnaire, wash their hands, wear a mask, and socially distance while in their community. Greenridge Place offers its residents outdoor, window, virtual, and indoor scheduled visitations. Third-party providers are required to show a negative COVID-19 test result from the past seven days prior to entering the community.
One of the challenges faced by Anderson is the ability to keep up with the sometimes conflicting, guidance and mandatory policies and procedures put out by the local, state and national authorities, as well as the multiple updates throughout the day that change prior practices, despite the timely responses and clarity she receives at the local and state levels. Nevertheless, she said, “We just want to keep our residents and team members safe and healthy by whatever the means possible.”
Caregivers Lina Weaver and Susan Teer were among the fully vaccinated team members. Weaver said, “I was willing to get vaccinated after having COVID and seeing firsthand how residents and compromised individuals suffered from the virus were affected. I wanted to do my part to help prevent and not spread the virus.”
According to Teer and Weaver, caring for cognitively-impaired residents requires extra time and effort to keep them safe during the pandemic. Teer explained, “For me, the hardest situations to manage were keeping residents out of other resident rooms and discouraging or redirecting residents to maintain social distancing.”
Weaver added, “Our population is made up of residents who are cognitively impaired with diseases such as dementia and Alzheimer’s. It has been very challenging to encourage them to wear masks and to practice social distancing. I think all the care providers wearing masks and full PPE also frightened some residents since it was not a normal practice in the past to see care providers dressed in this sort of protective wear.”
Psychosocial wellbeing is in the forefront of Life Enrichment Director Michelle Meyer’s mind, even more so during the pandemic. “With 100% of our elder population vaccinated, we have noticed a significant change in participation and socialization in day-to-day activities. Our elders are appreciating the fact that they can now travel to both wings of the community freely and interact with their peers. They are also enjoying family and friend visits regularly. Our activities department is now able to offer a variety of social activities throughout the day, which differed prior to the vaccine, and put a large focus on one-to-one activities and small group clusters, mindful of social distancing, throughout the day,” she said,
She said families express gratitude for the ability to sign up for both daily and weekly visits with their loved ones through Greenridge Place’s online portal, and its ability to keep their loved ones safe and protected throughout this pandemic.
Anderson concluded, “No one wants another version of 2020 to arise when at this point, it can be prevented.”
Just for Seniors
Just a few miles away from Sloan’s Lake, located on the northwest side of Denver, is the Just for Seniors care home. This assisted living residence is licensed to have eight residents. It serves as a home to individuals of all races and ethnicities, which include veterans, people with mental health needs, and many individuals who could not make it on their own. “The staff and residents here do not consider it a facility, they consider it their home,” said House Manager Wendy Mitchell
Mitchell said that Just for Seniors works to follow the national guidelines regarding the pandemic, and 100% of the residents are fully vaccinated. Staff members receive weekly COVID-19 tests due to being out in the community, and so do any residents who leave the property.
In late July and early August, daily COVID-19 screenings and temperature checks were being implemented prior to allowing any visitor to enter the home, and visitors and staff were required to wear masks. Screening logs are documented, and safety plans are in place in case of a COVID-19 exposure. The residence was on lock down for safety reasons, but made sure residents were seen by a doctor every month and a psychiatric doctor for mental issues.
All residents are happy to be fully vaccinated, so they can spend time and dine together, she said, and all staff is willing to get fully vaccinated.
“We give a home to the ones that feel alone and forgotten. Birthdays and holidays are special, celebrated with joy and love,” she said.
Editor’s note: This article and the comments included in it reflect a snapshot of three residential care centers and their situations in late July and early August. While they provide insight into conditions in care centers related to COVID-19 and the vaccines, the writer would like to point out that they may not represent other center’s situations.