Nursing home families deal with pandemic restrictions
ALPENA — At 97 years old, his mother gets confused, Randy Neumann said.
“She likes cappuccino, though,” said Neumann, who waves to his mother, Florence, through a window several times a week.
A resident at MediLodge of Alpena since October, his mother doesn’t always understand why her children and grandchildren can’t come inside, or why the coffee drinks and flowers Neumann brings have to be delivered by an aide while he stands on the other side of a windowpane.
It’s frustrating, to say the least, Neumann said.
Closed to visitors since March to prevent the spread of the coronavirus, nursing homes and other long-term care facilities in Michigan house many of the older adults most susceptible to the life-threatening effects of the coronavirus pandemic.
Local facilities, for the most part, are doing the best they can to protect their residents, officials say. Still, families, facility staff, and the community are worried about the vulnerable adults kept separate from the world, often without understanding why.
Blocked from in-person visits, family members of seniors in residential facilities have to put their trust in institutions.
Those institutions don’t always live up to that trust. State regulators recently revealed violations of safety protocol at MediLodge of Alpena and Lincoln Haven Nursing and Rehabilitation Community. Those facilities promised the state shortcomings would be addressed.
While 11% of cases of coronavirus infection nationwide have occurred in long-term care facilities, at least 54,000 deaths — 43% — are linked to such facilities, according to a recent analysis by the New York Times.
In Michigan, at least 2,000 nursing home residents and workers infected with COVID-19 have died, and more than 10,700 people at 446 facilities have been infected, according to the state.
Eleven of the 12 Alpena County residents who have died while sick with COVID-19 have been 60 or older, and 80 of the 148 infected Northeast Michiganders have been older adults.
‘ALL YOU CAN DO IS TRUST’
Employees at MediLodge of Alpena are doing everything they can to keep his mother safe, Neumann thinks.
The facility has an iPad she can use to visit with family virtually, but the technology confuses her, Neumann said.
Communication from her caregivers has been good, he feels, and employees readily meet him and his brother at the front door to accept the large-print notes, church bulletins, and other items the sons wish they could deliver to their mother themselves.
Staffers even went out of their way to find a lost hearing aid, then personally took it to get fixed.
While staff have been as helpful as they can, it’s been tough keeping track of his mom’s health situation, Neumann said. Reports about her health sometimes got garbled as they circulated among family members. At one point, he thought she had the virus. Later, he wasn’t sure if she was being tested or not.
“All you can do is trust the medical profession that’s taking care of her,” Neumann said.
In recent days, visiting restrictions at Michigan nursing homes have been eased, allowing family members to come inside the building if their relative needs special care or in end-of-life situations. The Neumanns don’t fall under either of those categories.
When he glimpses her through her window, Neumann said, he can’t get close enough to see his mother’s expressions.
It’s hard to know if she’s worried, her son said.
Many people don’t know her job exists, said Sara Gusler, long-term care ombudsman for Northeast Michigan.
An ombudsman is the voice of nursing home residents, Gusler said — a go-between, advocating for residents who might not be able to speak up for their own safety and well-being. If needed, she helps the family file a formal complaint against a facility.
Normally, she can go into the 21 care facilities in her region to check on residents herself.
These days, her connections are mostly through the telephone, Gusler said, or through video chats, although those can be difficult with older adults not comfortable with the technology.
Some of the issues she helps with seem small — but, unaddressed, they become harmful, Gusler said.
The family of one resident was concerned because the resident couldn’t get her hair done while visitors were kept away.
Insignificant as curled hair may seem, the change of routine could have a significant impact on the well-being of the woman, for whom immaculate hair had been a point of pride for 70 years, Gusler said.
More now than ever before, the ombudsman said, she gets calls about the well-being of long term care residents.
Churches and local organizations have been calling, asking how to help residents with loneliness. Others just want to know if their community’s elderly population is safe.
She hears from long-term care facilities, too, Gusler said. Staff from local nursing homes have asked how they can advocate for visitors’ rights and help residents see their family members in person, not just through a screen or window.
Overall, “our nursing homes have done a fantastic job” caring for residents during the pandemic, Gusler said.
Turning Brook, an assisted living facility for seniors in Alpena, isn’t bound by the same reporting requirements as long-term care facilities, according to administrator Barb Werle.
Outdoor visits with families are allowed at the facility, with distancing and other precautions in place. Communal dining and activities among residents aren’t allowed.
The changes wrought by the pandemic put a mental strain on everyone, staff and residents alike, Werle said. To bolster spirits, residents are invited to hallway activities, seated in their doorways but able to participate in bingo, crafts, or a movie with their hallmates.
“It’s something we can do until we can get back to our routine,” Werle said.
‘IT IS WHAT IT IS’
Many nursing homes have had more difficulty than usual finding and retaining staff members during the COVID-19 crisis, according to State Long Term Care Ombudsman Salli Pung, who hears many concerns from residents, family, and staff statewide.
Some residents told her they have to wait a long time for help because of too-few workers, and staff have reported working double shifts to fill in gaps when other employees are unable to work, Pung said.
Some residents said they don’t understand why they are being locked away or compare being isolated in their rooms to being in prison.
Many families elect to leave their loved one in place, even if a facility has a history of COVID-19 cases, Pung said. Relocation and adjustment to a different environment and new caregivers for very personal services can be traumatic for a resident, and some families want to keep their loved one as close as possible.
Families should speak up if something isn’t right, Pung said. They should ask what corrective action and training the nursing home has put in place to contain the virus and prevent any further outbreak.
New federal regulations require the provider to notify residents and families of new cases of COVID-19 and continue to update them on the status at least weekly.
Residents at Orchard Manor, an adult foster care facility near Posen, keep asking owner Randy Kroll why he’s wearing a mask.
He tells them he’s getting a little cold, Kroll said.
His residents can greet visitors through a screen, their wheelchair parked inside the building while family stays on a back deck.
It’s hardest on the family outside, longing to grab their loved one for a hug, Kroll said.
Nobody — not families, not residents, not those working in the facilities — likes the disruptions and worries caused by the pandemic.
“It is what it is,” Kroll said. “I just have to do my best to keep it out of here.”
Julie Riddle can be reached at 989-358-5693, firstname.lastname@example.org or on Twitter @jriddleX.
To speak to Northeast Michigan ombudsman Sara Gusler, call 989-358-4630 or email email@example.com.
To hear weekly updates on COVID-19 in nursing homes and ask questions of an ombudsman, join a Zoom call from 6:30 to 7:30 p.m. Wednesdays To join by Zoom by phone, call 1-929-205-6099 and use Meeting ID 829 7146 7655, password 838159. Questions and answers from each week’s call are also available at mltcop.org.