0006 HCH Caring For The Vulnerable

When the COVID-19 pandemic struck, few places were more at risk than long-term care facilities, which house the most vulnerable populations: the elderly and those with underlying health conditions.

Staff and leaders at long-term care organizations like St. Paul Elder Services quickly jumped into action, staying “laser-focused” on keeping the virus out of their facilities while still ensuring residents’ social needs were met.

“It’s completely dominated our operations for the last eleven months,” says Sondra Norder, president and CEO of St. Paul, which has about 315 residents at two campuses in Kaukauna and Green Bay. “This pandemic has disproportionately impacted long-term care residents and staff and has just completely turned our world upside down.”

Norder says since last March, St. Paul operations have been dedicated almost exclusively to COVID-19 management and related functions, such as keeping residents connected, with leadership often working 12 to 16 hours daily.

Across the board, long-term care facilities have adopted stringent infection control protocols that have included quarantines, limited visitation, masking and social distancing, additional health monitoring of residents, strict screening for staff, COVID-19 prevention compliance training, increased communication efforts and consolidation of care.

“It’s been a marathon and we’re finally starting to feel like we’re seeing an end in sight, but we’ve got a long way to go,” Norder says.

Vicky Wenzel, infection preventionist at Evergreen Retirement Community in Oshkosh, says the organization kept staff updated continually on the changing pandemic environment.

“Our role as staff here with COVID was like being on a high-speed highway with no directions in the beginning,” Wenzel says. “Our goal from the very beginning was to protect the residents and staff.”

When the surge of community illness hit in the fall, Evergreen adopted more frequent testing and adapted its operations around ill residents and staff.

“If there is a blessing in all of this, it is that Evergreen Retirement Community rose to the challenge,”  Wenzel says.

Rennes Group also had to adjust its operations to protect residents, including closing doors to all but essential staff. “That was really a dramatic change for us, when you think about the care we provide, which is about encompassing the resident and their family and loved ones,” says Rennes Group President Nicole Schingick.

Rennes has 12 facilities in Northeast Wisconsin with six skilled nursing facilities and six assisted living facilities. The organization has more than 1,500 workers and over 1,000 residents, so Schingick mobilized a command center with daily calls to facility leaders and produced a weekly newsletter to employees, residents and families.

“The changes came so rapidly early on — additional information would come out and we’d have to pivot and change what we were doing the next day,” Schingick says. “Our teams were just incredible.”

At its six skilled nursing facilities, the organization also added air purification equipment that can neutralize the COVID-19 virus and prevent it from traveling through HVAC systems, Schingick says.

Community actions count

Despite the stringent prevention efforts, the highly contagious coronavirus has impacted St. Paul, Rennes, Evergreen and hundreds of other facilities throughout Wisconsin. Outbreaks at nursing homes and other health facilities are subject to reporting and investigation by state and federal agencies.

St. Paul has had 101 residents test positive for COVID-19 since August, and of those, 30 have died. Norder wants community members to understand that their actions matter.

“Study after study has shown that nursing home and long-term care facility outbreaks happen because of the amount of community spread, and that held true for us,” she says. 

Vaccinations have begun throughout the three organizations, but that doesn’t mean the danger has passed, Norder says.

Staying social

One of the key challenges long-term care facilities have faced is keeping elderly residents socially engaged through virtual visits, carefully planned and limited onsite visits, or other activities. With staff tested for COVID-19 regularly, it’s also safe to offer hugs or hold a hand in place of a relative.

“We’re the only health care provider that is also a home to its patients,” Norder says. “We’re not only responsible for all of their medical needs and outcomes but for their entire being — their holistic and psychosocial needs.”

Among many changes, St. Paul created hallway bingo, mobile happy hours, Packers pizza parties and communication via iPads and Chromebooks donated by the Kaukauna Area School District and Facebook portals from Kaukauna Utilities.

Rennes Group also added iPads and is exploring the addition of TVs with a universal channel to broadcast activities from a central location. In warmer months, Rennes set up outdoor tents at all locations with safety measures in place for outdoor visits so residents could see loved ones.

“I’ve had a loved one in our buildings. It’s hard when you’re used to seeing your mom every day and now you can’t,” Schingick says.

Evergreen, which has more than 300 staff and 300 residents throughout its facilities, shifted gears to keep residents connected and safe, including creating a grocery shopping delivery service so they didn’t need to go out themselves.

Activities included socially distanced pontoon cruises, Wii Bowling tournaments (with shirts provided by 4-Imprint), and special events like delivered mimosas and party horns on New Year’s Eve, says Edie Norenberg, life enrichment specialist at Evergreen. She also created an “ice cream truck” from a cardboard playhouse and motorized scooter, delivering treats door to door, complete with music piped in from her phone.

Schingick says Rennes staff are optimistic but there have been difficult days. “We take care of the most vulnerable population. It’s emotional.”

She says community support has helped, from pen pals to businesses offering lunches, a high school student gifting blankets, and Mary Kay vendors providing gifts to both residents and staff.

“You hear the phrases ‘it takes a village, it takes a team,’” Schingick says. “It’s so true, and in this case, it extended so far beyond just the walls of our buildings.”