On bingo days at the Fauquier Health Rehabilitation & Nursing Center in Warrenton, nursing home residents sit in the doorways of their rooms facing into the hallway, four to a group, while a staff member calls out the numbers. “That way they can interact with other residents and still stay safe,” said Katy Reeves, FHRNC administrator. The residents use disposable paper bingo cards. “Bingo is very popular,” even while social distancing, said Reeves.
Residents used to have group activities and eat meals together, but since the COVID-19 pandemic hit, staff members take activities to them. In Virginia, 190 outbreaks have occurred in long-term care facilities, resulting in 4,451 cases and 691 deaths.
FHRNC is licensed for 113 beds, but currently has 80 residents – eight are temporary rehabilitation patients and 72 are permanent residents.
Reeves said, “It’s definitely not business as usual, but residents are not isolated in their rooms. When they do come out into the hallway, they must wear cloth masks … It can be a challenge,” admitted Reeves. “They don’t like wearing the masks, but staff are great about reminding them to put them back on.”
Meals are brought by staff members to each resident’s room. “It takes more time, but staff want to make sure everyone is eating and drinking and doing OK.”
Between 2 and 3 p.m. every day, residents have the option to “drive-thru” the dining room and pick up a snack – a meat roll up, some fruit or ice cream. “Residents know that they can come to the dining room, but for those who don’t want to, our staff will take them something. One resident loves Nutter Butter cookies. We make sure she gets them,” Reeves said.
The administrator is very much aware that her residents are vulnerable to the coronavirus. The average age of FHRNC residents is 89, and one resident is 102. Their health is compromised; many suffer from comorbidities like chronic obstructive pulmonary disease or diabetes. They are frailer and generally, more at risk.
“We took COVID very seriously from the beginning,” Reeves said. During the first week in March, visitors were limited to immediate family only, but that only lasted a couple of days before all visitors were banned. Since April 6, staff members have been wearing surgical masks when they are in the building.
It is common for caregivers to work at more than one facility, but Reeves said that staff members work only at FHRNC. “We asked everybody, 'Until this is over, where do you want to work?'”
On April 6, Hospice began using telehealth to check on their patients.
Volunteers – including pet therapy volunteers -- have been barred from FHRNC for two months now. Deliveries are left at the back door and wiped down before they are allowed into the building.
Families used to have the option of doing laundry for their loved ones, but employees are now taking care of washing residents’ clothing, as well as their masks.
FHRNC has its own portable X-ray machine, so if there is a need, a medical imaging specialist can come down from the hospital, so the patient does not have to leave the building.
Reeves said she has not had staffers out sick, and no one – staff or resident – has tested positive for COVID-19. “We are fortunate that we have such a committed staff. No one has said they are scared to come in. They come in and work, then go home to their families.”
Reeves said that the staff as a whole has not been tested, but no one has displayed symptoms. When residents meet certain criteria, they have been tested for the disease. Temperatures are taken, oxygen levels and heart rates are checked regularly, and lungs are screened for signs of illness.
New residents are being accepted still, but not if they have tested positive or are awaiting results.
In addition to caring for her residents’ physical needs, Reeves and her staff recognize that the no-visitor policy and the curtailing of group activities can be difficult on residents – and on their families. “We make sure they stay engaged, upbeat and don’t feel isolated or depressed. Going forward, keeping that level of engagement is going to be critical.”
FHRNC used to have gatherings to share the news of the day. Now, the Daily Chronicle is printed and passed out to every resident in their room. “A staff member brings it to each resident and reads it to them if they need help. It’s very popular,” Reeves said.
Every resident has a “buddy,” a staff member who makes sure to stop in and check on them several times a week. “Since they can’t have visits from family members, we make sure they have someone to talk to,” said Reeves.
FHRNC has several tablets set up with Skype, Google Duo and FaceTime, so families can keep in touch with their loved ones. “We set up times every week when families can reserve time for a video chat.” On Mother’s Day, for instance, staff was busy assisting with video calls. Between 60 and 65% of residents at FHRNC are women.
Reeves said, “We had one resident who celebrated her 100th birthday with us. She FaceTimed with her family and they sang ‘Happy Birthday.’ When she looked at the tablet and saw her daughter and granddaughter, her face just lit up.”
One service the residents miss, said Reeves, is the beautician coming in once a week. She said, “Several of our staff members got together … and once a week offer shampoos and styling. We don’t color or perm, but there’s nothing like a spa day to make you feel better!”
Reeves has no plans to lift restrictions any time soon. “We’ve received great messages back from families. It’s hard on them, but they understand.”
Reeves said, “Every Friday I communicate with families. I keep them abreast of what’s happening with COVID infections and Centers for Disease Control regulations. I explain what we’re doing. I include pictures of their loved ones and share milestones. This is stressful on everyone. Keeping the lines of communication open helps.”
She continued, “Our families have been unbelievably supportive, sending sandwiches and pizza or cookies. They’ve sent cards, emails and letters. They appreciate what we’re doing and want to say thank you.”
Reach Robin Earl at firstname.lastname@example.org