COVID-19 has had a huge impact on senior living and care operators around the world, and every country is at a different stage of reopening. But commonalities have surfaced in the experience, no matter the population served, as evidenced by speakers at a McKnight’s Senior Living webinar on Wednesday.
The importance of communication with residents, families and staff members; trust in employees; and maintaining relationships were the top three takeaways.
Alexandra Robert, group chief marketing officer for France-based Aegide Domitys, a leader in independent living in Europe, said the biggest challenge in independent living during the pandemic is finding the right balance between allowing freedom of movement and keeping residents safe.
Independent living residents, she said, are autonomous and agile, and they want to maintain their daily activities.
“We tried to take great care of letting them have their life while still easing their life under these constraints,” Robert said, adding that the challenge for her organization was bringing all of its services to residents’ apartments, including activities and meals. “Those people are very much about entertainment and having a rich life,” she said.
Robert said she heard from residents during the lockdown that they felt safe, which led the company to realize that it was a mistake to close residences to new move-ins during the pandemic.
“We realized we were offering a service to those people who could not stay alone in their home,” she said, adding that, contrary to what company executives thought, welcoming new residents for even a short span of time was the best option for some individuals. “It’s a really great serve to offer them at that time. Never think you should just work with your current customers. It’s important to open up to the rest of the community,” Robert said
Marc Saillon, managing director of the France-based Almage Group, which operates memory care and skilled nursing facilities in France and China, said his group operates on the belief that families are essential and part of the therapeutic approach to its residents. Visitation restrictions, he said, were “very detrimental” to residents.
“We will comply with the regulations that may evolve in the future, but we don’t see ourselves using stronger visiting controls, because it would be detrimental to what we’re trying to achieve in our homes,” Saillon said. “It’s always about finding the balance between the risks and benefits — how great is the benefit and how hard is the risk.”
Delivering meals and magazines to doorsteps, providing activities via an internet television channel, and organizing music residents could enjoy from their balconies were among the ways Aegide Domitys maintained the lives of its residents during the lockdown.
“What is extremely important is, you have to stay very agile and reactive,” Robert said, adding that staff members took on a variety of new tasks throughout the lockdown. Volunteers from the company headquarters also were recruited to fill in staffing gaps and maintain the relationships the company had built with residents before the pandemic.
With the recent reauthorization to reopen in areas where Domitys operates, Robert said it’s all about returning the “spice of life” for residents who chose independent living for the opportunities to socialize and have daily rituals.
“It’s not that much about what you have on your plate,” she said, adding that it’s more about the people you meet, the coffee you have after lunch and the people you want to play cards with. “We know the spice of life is the congeniality they had — they miss that a lot, even with all of our efforts. Creating these moments is the key element for us now,” Robert said.
The key to maintaining that balance in the future, she said, is maintaining close relationships with residents — daily visits and special attention to individuals, and helping them accept the constraints of the situation will go a long way.
Communication, especially with families, is one of the keys to maintaining relationships, Saillon said. Members of his group did not communicate well with families and staff members at the beginning of the pandemic, but they adapted and learned that you can never communicate too much, he added.
“The total lockdown was very long and, honestly, families went crazy. They suffered so much from not being able to come and visit their relatives,” Saillon said.
One lesson learned, he said, is that people prefer the truth, no matter how hard it is to hear, to uncertainties. Communicating the number of cases, deaths and recoveries is important in maintaining that trust and reassuring everyone about the true state of affairs.
Communication with employees also is critical, he said. Almage listened to its employees, who were working with residents daily, and allowed them to implement creative solutions to issues within facilities, Saillon added.
“Having the freedom of allowing them to try things was important,” he said. “It helped us as well as a company to cope with whatever we were facing.”
One major change Robert said her company had to make was in meal delivery. When communal dining closed, packaged meals that could be reheated were provided — but that change turned out to be difficult for some residents. The company ended up having two meal services — one with cold meals to be reheated, and another with meals already warmed.
Because Almage has residents who have dementia, Saillon said the lockdown was especially difficult, because they could not understand what was happening, why they had to stay in their rooms, and why they could not closely interact with others or their families.
With communal dining halted, meal times were a challenge because they typically were social events, he added. Almage got creative by moving tables into hallways, allowing residents to eat in their rooms but still share their mealtime with their neighbors dining right down the hall.
Part of the profile of residents with dementia, he said, is their desire to wander. Residents could not be locked in their rooms to ensure their safety, however, so facilities had to organize spaces to allow residents to wander as safely as possible. That involved changing door knobs on staircases and programming elevators to prevent residents from traveling to certain floors.
“We were watching out for them, because they were not aware of the dangers to themselves,” Saillon said. “You have to protect people from themselves sometimes.”
And although the lockdown was difficult, reopening is even trickier, Scallion said.
“You’re really at risk at that time,” he said. “People are starting to come into the home again, residents starting being near one another. This period is trickier than the one we’ve just gone through.”
Reopening after the lockdown also was traumatizing for residents, Scallion said. Homes had to prepare residents for visits restarting, monitor visits to ensure that residents could handle the interactions, and hold sessions with residents afterward to make sure they could cope with the emotions generated by those visits.
Ming Fen Yee, operations director of Sodexo Seniors Singapore, shared the COVID-19 situation in Singapore in an interview that was pre-recorded due to the time difference.
Singapore entered into lockdown — or what the country calls “circuit breaker” — on April 7. June 2, the country entered Phase One of reopening, but senior living communities and nursing homes remain closed, with no visitation.
Singapore approached the pandemic proactively, with the Ministry of Health mandating testing and swabbing of all 30,000 senior home residents and caregivers in late April and early May, Yee said. The proactive testing was important in ensuring that a vulnerable, at-risk community was not exposed to risk, she added.
Singapore’s government is paying all costs associated with testing to encourage active testing, Yee added.
“When you make testing available to all, you can ensure the status of your community and your elderly population. They are most at risk,” she said. “The mortality rate is very high in this vulnerable group, and we need to take car of them. It’s a good practice approach that should be adopted anywhere.”
Singapore also adopted community surveillance through the use of two mandatory apps. Anyone traveling in the community — whether to the office, a shopping center or a mall — must scan a QR code when entering or exiting the location. The Trace Together app allows the contact tracing team to know where someone has been, using Bluetooth technology to track individuals someone was in close proximity to if they test positive for COVID-19.
Sodexo was the sponsor of the webinar, which was part of the McKnight’s Online Forum COVID-19 Update IV and will be available to listen to on demand for those who register at https://www.mcknights.com/062420onlineforum.