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Monterey Herald: Longterm Care During COVID-19

Monterey Herald
By: Allison Gasparini
Full article can be found here.

When Jean Menke’s grandchildren would visit her at the Eden Valley Care Center in Soledad, they loved to get popcorn from the 1950’s themed snack shop inside.

Now, Happy Days Soda Shop is shut down and there are tight visitor restrictions at the center to combat the transmission of COVID-19. It’s something that has happened at long-term care facilities across the country and it’s left many residents missing their loved ones.

“It’s been a challenge over the past year to keep up with the ever-changing regulations and best practices,” says Daniel Cummings, the administrator at Eden Valley.

Now, as residents of care facilities finish getting vaccinated and their loved ones start to receive the vaccine as well, a road back to normal is becoming clear.

“We’re very excited as a group, as a team, as a facility, as a community, to see a bit of light at the end of the tunnel and to get back to a bit of normalcy,” says Cummings.

Since the start of the pandemic, conversations have been sparked on how shutdowns and visitation restrictions are weighing on elderly patients in long-term care facilities. Senior citizens were already facing an epidemic of loneliness when COVID-19 further cut off their contact with the outside world. But now COVID cases and deaths have dropped significantly among nursing home residents.

Since vaccinations began, deaths have dropped by 66% and cases by 83%, according to the Kaiser Family Foundation, a nonprofit organization focusing on national health issues.

The California Department of Public Health released updated guidance for visitation in long-term care facilities recently. Visitors may now visit residents indoors, with certain restrictions still applied. Though facial coverings and a 6-foot distance between the resident and visitors will still be enforced, the updated guidelines do allow for brief physical contact from visitors who have received complete doses of the COVID-19 vaccine.

Among the acceptable physical contact listed by the CDPH are brief hugs, hand-holding, and assisting with feeding or grooming.

At Del Monte Assisted Living & Memory Care in Pacific Grove, the staff is working to make the updated guidelines a reality as safely as possible for residents.

“We’re waiting for the go-ahead from the (Department of Social Services) and from licensing to essentially be able to allow indoor visitation with loved ones,” says Gabriella Schlesinger-James, the Community Outreach Director at Del Monte. “And that’s absolutely just mind-blowing.”

She says Del Monte is working to juggle the “really open guidelines” with what they feel comfortable with. For example, all staff will continue to wear masks despite being vaccinated and the facility will continue to encourage visitors to wear masks. “It’s such an easy way to stay safe,” she says.

“Of course, there’s going to be the COVID screening questions and temperature taking for the foreseeable future,” says Schlesinger-James. “But it’s looking really, really positive and it’s really, really exciting.”

Further, she says she’s excited to see how the change impacts the “well-being” of residents.

“I think the folks that have been hit the hardest are the ones whose family members have been making regular visits before the outbreak,” says Meggie Pina, the Ombudsman Program Manager for the Alliance on Aging.

“Those residents have probably felt the impact the greatest, along with your folks that have dementia.”

A recently published article in the American Journal of Geriatric Psychiatry found that social isolation and loneliness in adults older than 50 is associated with a 50% increase in risk for developing dementia.

The Ombudsman Program is federally mandated and exists in every state and county. Ombudsmen work with nursing homes and other care facilities to advocate for residents’ rights. Pina says throughout the course of the pandemic, the program has been receiving calls from family members who are facing barriers and challenges to visiting residents.

“I think the families are eager to see the state of their loved ones,” says Pina. “And there are things that you should be looking out for as a family member when you do your visit.”

Pina urges family members to assess not only physical signs of wellbeing, such as whether the resident has lost weight or is well-groomed but also mental and emotional indicators, like alertness and energy level.

At the Eden Valley Care Center, where Menke, 93, resides, the staff has made ensuring their residents can safely visit with family members under the CDPH guidelines a top priority. Menke has spent most of her life living in Salinas. Previously, she was a state surveyor. She is an active resident at Eden Valley, participating in group activities. Her daughters continue to visit her under the socially-distant guidelines.

Cummings attributes the care center’s ability to accommodate many socially-distant in-person visits to a “combination of luck and creativity.”

The facility’s ample outdoor space has allowed for appropriately socially distanced visits. From the beginning, the staff ordered iPads and subscribed to Zoom to ensure their residents could at least use technology to keep in touch with family.

Still, despite all how residents can see their loved ones in a socially distanced way, Cummings recognizes the significance of even just a simple hug shared between a resident and their loved one.

“I think it’s a very important piece of being human, is that physical contact and the comfort that it brings to people,” he says.

Menke, who has been at the facility since 2018, says she and the other patients at Eden Valley are understanding of the restrictions. They know regulations are in place to keep them safe from COVID transmission. Further, she feels the staff have provided a good support system for her and other residents over the course of the pandemic.

“We have lots of people we can trust,” says Menke. She says the staff is very responsive to patients’ needs, “Even if we seem to be depressed or anything.”

Menke is excited to be able to see her grandchildren again. She says on the last visit, her daughter brought popcorn and other treats Menke can hand off to the little ones when they come to visit to make up for the closed-up soda shop.

While Menke is looking forward to less restricted visits as vaccines continue to be distributed, she says it’s “rewarding” to know the staff is checking in regularly.

“Of course, it’s [been] more isolated. But, as far as the facility is concerned, they have been wonderful right from the very beginning.”

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