Meeting the needs of your clients or residents in senior care on a day-to-day basis can be difficult. Meeting the needs of your facility during a pandemic can seem impossible. Assisted living, memory care, and residential care environments have a perpetual shortage of staff even without the threat of a pandemic.
Staff illness is only one aspect of the challenge. Day-to day issues are certainly escalated when an entire country is shut down. Issues such as daycare for children who are normally in school, changes in facility processes that eliminate communal gatherings, scaled back public transit, and governmental restrictions stress every system your facility operates within. Regardless of the ever-predictable daily changes and restrictions that surface, you are expected and required to care for your residents or clients in the same way and at the same level that you did prior to COVID-19. This pandemic calls for gritty innovation in a world that can feel oppressive.
Here are several tactics we have seen among our clients that may help your organization during this difficult time.
Staffing
Transforming Non-Essential Staff into Essential Staff: Facilities who have used volunteers for their food services can no longer do so because of the risk of transmission of COVID-19. Instead, non-essential staff are being mobilized to help with meal prep and delivery to residents in their individual apartments. Do you have non-essential staff that can assume duties that licensed or certified staff are currently responsible for that don’t require a license or certification to complete them?
Using Staff to Multi-task: Medication technicians and caregivers see every client/resident in a facility; they are the perfect conduit for providing and collecting menus from the people you care for. Menu options may need to be reduced because of the logistics of preparing and serving people individually. Some facilities are planning a couple of days to a week in advance to minimize disruptions to the day-to-day operations. They feel like it’s the least they can do to create predictability in an unpredictable world.
Creating and Promoting Flexibility. One client we work with is a residential care facility and a community outreach program operated out of the same building. For the protection of clinicians and clients, all face-to-face community-based services and visits were suspended. Without getting mired in the shock of the pandemic, this organization quickly adapted by implementing the use of technology to continue services to their clients in the community.
However, they found that the adaptation of technology was not going to compensate for all of the hours that were going to be lost by statewide lock down and clinicians were going to experience a decrease in pay because of their inability to meet with clients. Fortunately, the organizational leaders are forward thinkers and quickly redesigned their day-to-day operations, integrating the outreach clinicians into the daily operations of the residential care facility to make up a difference in their hours.
Childcare: With nationwide school closures, working parents are struggling to meet work and unexpected family needs. Childcare providers are apprehensive to remain open, let alone take on new children in the face of the pandemic. Many organizations are partnering with their employees and childcare providers in the community to meet the needs of staff and residents.
What does this partnership look like? Organizations are exclusively contracting with childcare providers for their staff, 24 hours a day. This can help decrease the number of sick calls or self-terminations. The childcare providers who agree to these contracts have cleaning regimens that strictly adhere to CDC guidelines. They have stringent rules for entering and exiting the childcare area and are restricting contact with adults other than the children’s parents. Some childcare providers are even limiting the number of children per room each day and grouping children into the same groups each stay to prevent the spread of illness.
Anticipating the Needs of Staff: In a recent article from The McKnight group, some organizations are having meals dropped off to their staff to help ease the increased demands at home so they can focus at work. Now that is impressive!
Care strategies
It has been proven that people need other people. Social distancing puts our innate human needs to the test, particularly amongst populations that are vulnerable to and easily impacted by isolation. The sense of community constructed each day in assisted living, memory care, and residential care is intended to mitigate isolation, but it feels nearly impossible to keep a sense of community during a time of necessary social distancing.
Here are a few ideas to help bolster your activities program and mitigate the sense of isolation amongst your residents.
Use technology like facetime, skype, or portal TV to keep residents connected.
Residents who own their own smartphones or computers can visit with their friends and family using the technology. Most of the technology available provides a method for visual interaction without direct contact. Residents can spend time with their friends and family without the risk of becoming ill.
Utilize conferencing technology to allow a group of residents to either visit or even watch a movie together. Technology that we often use for meetings can certainly be put to great use in preventing social isolation.
Nearly everyone has seen a social media post with family members visiting their grandparent through their window at their facility. While it is not ideal, is visiting through a clear barrier really that horrible? Maybe we reframe our perceptions and accept and optimize what we can do. Many people would rather see and talk to their friends and family, even if I can’t touch them.
If you have people who are self-isolating you will need to get creative in how you continue to provide care.
One organization provides med box refills for their clients. Nurses can be exposed to COVID-19 when this done in a client’s home. To improve this process clients place their pill bottles and the med box in a plastic bag. When the nurse arrives, they call the client and ask them to put the bag on their front porch. The nurse waits for the client to go back inside. They get out of their car, don gloves and get the bag of medications off of the porch.
The nurse removes each medication bottle and the med box from the bag. They then wipe it down with an appropriate disinfectant wipe, and place in a new plastic bag. The nurse then takes the medications to a designated area in their office building and fills the med box. The filled med box and medications are returned to the client’s porch, the nurse calls the client to notify them and waits for them to pick the bag up from the front porch. This is a creative, but necessary step to continue to provide care to our communities most vulnerable.
Leading during times of crisis demands that innovation and creativity rise to the top.
Exploring and considering all options will help your organization operate as smoothly as possible when normal operations are disrupted. Great leaders engage, encourage, and empower their employees to solve day-to-day issues. Before you change processes or operations make sure:
- It makes sense for your organization.
- Train staff who are assuming different roles.
- Continue to adhere to rules and regulations.
We are interested in hearing how your facility is navigating COVID-19. If you would like to share your facilities strategies email us at info@elderwiseinc.com
DUSTY AHRENS RN-BC
Kari McDaniel MSN RN CNE
