Nursing home residents adapt to new normal

Nursing homes and assisted living centers have all but closed their doors to the outside world, with most allowing only essential workers to enter.

This has required their residents to accept a new norm of limited contact with their friends and family. However, nursing home administrators in southeast Iowa largely agree that their residents have adapted well to social distancing, and are finding ways to interact without getting too close to their neighbors.

SunnyBrook Assisted Living in Fairfield's marketing director Ginny Hughes said that her company was told to stop all inside activities when Iowa Gov. Kim Reynolds recommended people keep a distance of six feet. SunnyBrook has not eliminated activities altogether, but it has had to modify them to ensure residents stay apart.

The residents no longer gather in the lounge or dining hall to play bingo.

'We don't want them touching the bingo cards,” Hughes said. 'We're sanitizing everything three or four times a day.”

Easter

The residents wanted to do something special for Easter, but it was tricky to find an activity that didn't involve big groups. Instead, Hughes had residents gather in groups of no more than 10 in a room where they could watch a local Easter service on a television set. She was able to find three different services to offer the residents.

Though family members can't come in close contact with the residents, that hasn't stopped them from throwing parties for their special occasions. The family of Leonard and Joan Buch made signs and decorated their cars to celebrate the couple's 70th wedding anniversary. The couple sat on a bench outside the building and waved to their family members who drove by to wish them a happy anniversary. The anniversary isn't until April 22, but the family wanted to hold it as soon as possible in case the rules changed and they were no longer permitted to travel between counties.

Halcyon stops window meetings

Chris Marshall, executive director of Halcyon House in Washington, said her company once invited family members to have 'window meetings” with residents, but has gotten away from that recently.

'We realized that people ended up being closer than six feet,” she said. 'And they had to have their windows open because otherwise they couldn't hear each other.”

Marshall said residents have largely switched to communicating with their family over programs like FaceTime and ZOOM where they can see and talk to them.

Halcyon House is divided into four households, one of which is assisted living while the other three are skilled nursing. In all, the building houses 166 residents, with about half of those living independently, 27 in assisted living and 54 in its health care section. Marshall said each of the four households has a Chromebook and an iPad so that residents can make video calls to their family.

Playing from the doorway

Marshall said Halcyon has not done away with group bingo, but it has modified it so that now residents play from their doorways and listen to a caller who sits down the hall from them. This allows them to play without getting too close to each other.

Another fun activity the residents can do from their doorways is play with remote controlled cars. The nursing home also purchased an inflatable T-Rex costume that one of the employees has been wearing to entertain the residents, showing up outside their windows.

One point to keep in mind is that, just because the residents are under quarantine doesn't mean they're confined to their rooms. In fact, Marshall said they have really taken a liking to regular walks throughout the building.

'In the beginning, we were having them to range of motion exercises because we want to keep people mobile,” Marshall said. 'But we could see the range of motion exercises weren't cutting it.”

Marshall said the company has a 'no visitors” policy but it does allow for 'essential” visitors and workers to enter. An example of an 'essential” visitor is someone visiting a loved one in hospice who is near the end of their life.

Life inside McCreedy Home

McCreedy Home in Washington has been one of the hardest hit by the coronavirus with 25 confirmed cases as of April 16 according to the state's coronavirus website. Jacob Green, the home's long-term care administrator, said he has implemented all precautionary and mitigation strategies as recommended by agencies such as the Centers for Disease Control and Prevention, Iowa Department of Public Health, and Centers for Medicare and Medicaid Services.

In particular, the home is conducting daily monitoring of all residents and staff by checking their vital signs and assessing them for symptoms of the virus. All health care staff are properly adorned with personal protective equipment such as a mask, face shield and a gown to prevent the spread of germs. Residents are isolated in private rooms with only essential staff entering the room for care.

'McCreedy Home staff are engaging residents with activities that can be completed within their rooms to ensure social distancing,” Green said. 'Residents are provided with craft-like activity packets that can be completed safely including word searches, different types of puzzles, and coloring pages.”

Community support

Green said the community has been helpful in raising the residents' spirits during this trying time. One friendly community member posted notes to residents' windows wishing them well and providing happy thoughts. Washington County Hospital and Clinics staff have decorated the windows with hearts to let the residents know they are not alone.

McCreedy Home Activities Coordinator Jan Flieg dressed up as the Easter bunny and went from window to window around the outside of the home wishing residents a Happy Easter. A band from Marion Avenue Baptist Church set up outside the nursing home to play some uplifting music, too.

The Washington County Hospital Foundation and Brinton Trust granted McCreedy the funds to purchase the IN2L (It's Never 2 Late) program and tablets that give residents access to music, spiritual enrichment, trivia, games, exercise programs and more. The IN2L tablets also let the residents talk to their families over Skype.

'Residents' outlooks remain positive as they receive phone calls, letters, cards, Skype/FaceTime from family and friends,” Green said. 'One family even brought their lawn chairs and sat outside of their loved one's window and sang songs. Staff continues to offer support through conversation and humor. Maintaining connection with others has kept residents' moods uplifted and positive.”