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Nursing Homes Work To Protect Vulnerable Residents During COVID-19

Lindsey Reed
Oaknoll Retirement Residence
Oaknoll Retirement Residence resident Hope Solomons speaks with University of Iowa student Molly Anderson. Anderson used to work with Solomons in person, but since the COVID-19 outbreak, they have communicated through FaceTime.

Iowa has more than 400 assisted living facilities. And right now they’re under tight restrictions to try to keep COVID-19 away from their vulnerable residents. But this has left many facing a lot of pressure to keep residents safe -- and occupied. 

When COVID-19 cases were first reported in Johnson County last month, Oaknoll Retirement Residence in Iowa City immediately made changes to protect its 380 residents.

"We limited our access to the building to three different entrances. And we've been staffing those entrances for about 12, 16 hours a day," said Oaknoll administrator Kim Bergen-Jackson.

Bergen-Jackson said for the past month, the facility has been extremely careful. But she still worries constantly about a COVID-19 outbreak.

"You’re terrified. Essentially, you're holding your breath waiting until -- if it comes to your place, you know, you're doing everything you can to fight something that you can't see," she said.

Because nursing homes are particularly vulnerable to viral outbreaks, state and federal agencies directed them last monthto take strict measures. This means no visitors and all staff must be screened for symptoms daily.

But even the strictest precautions aren’t guaranteed to work. A long term care facility in Cedar Rapids had an outbreak at the end of last month. It currently has more than two dozen cases among both residents and staff.

"You know, it's very stressful," said Sylvia Barlow who manages Manilla Manor with 32 residents in rural Crawford County. "It's a lot of sleep that gets lost, praying that nothing comes into our building."

Barlow said in addition to the government restrictions, her facility is making sure residents practice social distancing. This means limiting the number of people who can sit together at meal times, but that’s been hard on residents.

"It's a lot of sleep that gets lost, praying that nothing comes into our building." -Sylvia Barlow, Manilla Manor

"When we pulled different ones away from the table and put them to a different table, then they're upset because they're not with the regular table partners," she said.

Barlow said Manilla Manor has started doing activities to try to put residents at ease, like taking them for van rides and posting more photos of them on Facebook for family to see.

"We're trying to keep things as normal as we can. Obviously, it's not normal, but trying to keep them engaged and things of that nature," she said.

But the restrictions that are necessary for seniors can be really hard on them. 

"People...might have cognitive difficulties or really not have a whole lot of physical function, and then just basically confining them to their rooms and not really be able to walk around and have social activity," said Michael Barnett, a professor of health policy and management at Harvard University.

Barnett said it’s important for nursing homes to make sure residents can regularly contact family.

"That's going to be really one of the only things that's going to help ground them in this really scary new reality," he said.

Ryan Stuck, the executive director of Kennybrook Village in Grimes, said they made adjustments right away to keep their 110 residents connected.

"We went out and purchased new iPads for the purpose of doing FaceTime as much as we can, and Skype with family members," he said.

Stuck said the facility also has increased activities. They now do socially distant bingo with just one resident at each table, small group movie screenings and root beer float delivery services.

"It's a bad situation. But I think it's really, really encouraged a lot of the staff and these long term care facilities to really step things up," he said.

But the changes have been hard on residents that have been cut off from their families. Betsy Boyd’s 93-year-old father, Sandy, is at Oaknoll Retirement Residence in Iowa City.

"My father and mother would have dinner every night at Oaknoll in his room. And so obviously, that's been a change, that they can no longer do that," Boyd said.

But Boyd said staff members have helped her father use FaceTime and she regularly drops off books.

"He is just a voracious reader, and that's how he's coping," she said.

For her father’s 93rd birthday this week, Boyd said they threw a virtual family party using the video conferencing program Zoom. Twenty-four people showed up, which she said doesn’t even happen in real life."

"One of the members of the family is a Marine and he's stationed in Okinawa, and so it was, you know, like four in the morning for him," Boyd said.

And she said even though it is tough, the family prefers her father is locked inside, away from the virus as much as possible.

Natalie Krebs is IPR's Health Reporter