One story, but unfortunately one that is all too familiar.
My friend has had the responsibility of assisting with the care for a gentleman for the past 30 year. He has seen this gentleman, Mr. T., through many stages and physical ailments, until most recently the gentleman’s condition deteriorated requiring admission to a hospital. In a matter of days, without any notice or opportunity to make any inquiries, Mr. T was transferred to a short-term rehabilitation center. My friend conveyed his frustration with his friend’s lack of progress: recounting that his friend didn’t appear to be motivated, was unwilling to participate in therapy, wasn’t eating and was getting weaker. My friend received information on Mr. T’s lack of progress from speaking with the nurses on the unit where his friend was a patient. He was trying to figure out how to connect with Mr. T to offer encouragement and motivation because by this time his friend had been in the short-term rehabilitation center for almost two weeks and there was talk of him being discharged due to lack of participation or progress. Mr. T.’s house was in the process of being sold because he could no longer live at home. Panic started to set in. I asked him if they had any virtual visits. The reply, NO. I couldn’t believe it!!! In the wake of nursing home visits banned from nursing homes, CMS issued guidelines indicating that nursing homes facilitate virtual visits between residents, their families/friends, and loved ones.
Older adults and families isolated from one another due to the Coronavirus has presented challenges. For residents of Nursing Homes, and assisted living facilities, already away from their familiar home environment, it is particularly devastating. They residents are isolated, lonely and frightened. Families are worried knowing
that oftentimes their very presence impacts the level of care their loved one receives.
The hallmark of the nursing home resident prior to the ban on visitation during the coronavirus has been loneliness, isolation and lack of engagement. Connections with others, especially those we love and care about, is a source of light in our lives. This lack of light only compounds the actual lack of sunshine and access to the outdoors that many nursing home residents experience a large part of the year due to changing weather patterns in different geographic areas of our country.
Nursing home residents are isolated, lonely and frightened. The stress from prolonged isolation is documented and can be considered equivalent to smoking 15 cigarettes/day. It impacts anxiety, sleep disorders, falls, cognitive decline and symptoms of depression.
Thus, the COVID-19 crisis played out for our nursing home residents in ways that were detrimental and harmful on many levels.
The challenges faced by persons with dementia, their families and facility care workers are unique and difficult at times. Staff members who are task driven oftentimes don’t have time to engage the person with dementia on a variety of levels. Residents confined to their limited-spaced rooms for weeks-on-end during the virus experienced decline in function due to lack mobility and exercise which is sorely needed to maintain function. The lack of mobility which contributes to weakness, can also increase the risk of falls, contributes to sadness and loneliness and hastens cognitive decline. In addition, routine is important for residents with dementia. Disruption to the routine is more likely to result in persons with dementia becoming more agitated, confused and scared, ultimately resulting in presentation of more challenging behaviors. This can be more traumatic for roommates, staff and the environment in general.
Virtual visits help ease the anxieties and fears of our elder citizens and their families. These are our grandmothers and grandfathers, mothers and fathers, husbands and wives, sisters and brothers, uncles and aunts, and friends.
Through donations on the GoFundMe campaign, Senior Connections Matter, I purchased an iPad populated with person-centered technology which not only facilitates virtual visits, but also provides a wide array of engagement technology that can be accessed so his friend can stay connected with the activities and interests he enjoyed while he was at home. This has made a difference for my friend and Mr. T in the short-term rehabilitation center. Making difference in the life of one nursing home resident and his friend is an amazing feeling.
Yesterday’s conversation with a professional colleague in an entirely different area of the country had echoes of my friend’s situation.
Grandma’s condition seemed to be deteriorating. Her family felt they had no choice but to move her into a long-term care facility. Though the family tried doing their homework, Grandma’s first stop was in a facility that was an entirely unacceptable living environment. The process for transfer during these times presented an enormous challenge but they knew it needed to be done. After about two weeks, they were able to make the transfer. According to the nursing home staff at the new facility, Grandma didn’t understand why no one was visiting her, did her family no longer care about her?
Hearing those words, the family felt like they were being gut punched, those words were so far from the truth.
There was no window access at this facility. It had already been almost two weeks since they had spoken to, or seen, Grandma. They tried bringing an iPad from home but were told it wasn’t allowed. It had to be brand spanking new in original, unopened packing and they couldn’t enter the facility to drop it off. It had to be sent directly to the facility. They followed the mandates, purchased an iPad that was mailed to the building. As the story unfolds, it took several days until someone was able to open the box, turn on and charge the device, and load it with the appropriate information. During that time, they were thankful that a caring certified nurse aide, was understanding grandma’s anguish and feelings of abandonment. She used her personal cell phone to facilitate a face time call between family and grandma.
Grandma’s family discovered there were many residents of the facility that had not had virtual visits with their family or loved ones. The family pooled their resources and purchased