One Community’s Response to COVID-19, One Year Later

 

The residents were fearful of COVID when it first happened, because nobody understood any of this. When we announced that we were going to literally move in, it was accepted very openly.

Deborah Hart

 

Stefanie Dziedzic: This was not an initiative that was done for show. It was really done from the heart, and I think that’s what made it successful. Residents couldn’t see their families. They couldn’t see their friends. They couldn’t do the things that made their life normal. We were what made their life normal. And so it really was an easy transition to make. Now, a full year later, it’s almost hard to remember how scary it was and how quickly things were changing.

Paul Zappoli: We moved into Montgomery Place because it was the right thing to do. We can’t help a resident or a staff member, if we’re not there. As we all know, emergencies don’t only happen when you’re there. They happen at the most inopportune times. So having someone in the building that is three minutes away from the problem is really important.

Hart: It wasn’t uncommon to get a call at 2:00 am. We were with our staff members, supporting them all through the night. We would do rounds at all hours just to make sure everybody was comfortable. It gave a calm to the overall organization and a comfort to residents and families that I don’t think we could have accomplished in any other fashion.

I was doing daily newsletters to residents and families. We also did a CCTV announcement three times a day, and staff were knocking on doors as many as seven times throughout the day, checking in on individuals, delivering meals, delivering library books, as well as doing wellbeing checks.
Deborah Hart

Communication was Key

Dziedzic: When I look back at the CCTV videos now, I’m like, What were we thinking? The graphics are terrible and the jokes are worse. But the residents appreciated it and they understood the intent and the spirit behind what we were trying to do.

Hart: Just like residents, staff were very scared. They didn’t understand this any more than anyone else. And the media and news reports became very confusing. So we did an Herculean effort in order to help educate, give comfort, and show and demonstrate everything from mask wearing to being able to put on all of the appropriate PPE—and making certain the PPE was present. They gained confidence. They also didn’t have a choice. [They] could not work from home.

Zappoli: It was very hard to actually get the staff’s comfort to a certain level where they’re able to execute their jobs. They came to work with a positive attitude, but the uncertainties created fear. And I saw that across all staff members. I saw this video by Dr. Matthew Bai, an emergency room physician at Mount Sinai Hospital in New York. He explained what he was dealing with on a day-to-day basis, and I sent it to the entire staff because I felt like it would be inspiring for them to watch it on their own.

I learned a lot from that video, and I talked to staff and I said maybe you shouldn’t be fearful of being around [COVID-19]. You maybe shouldn’t even be fearful of contracting it. What you should be more fearful of is spreading it.So knowing what you can do to stop the spread—wash your hands, don’t touch your face. You know, the simple things.

Hart: The most important lesson that I have pulled out of COVID, and the response here in senior living, is to understand and be empathic to staff, to residents, to understand their fears and develop a plan of action as a business that can respond, and not create more fear. Without communication fear sets in very fast. And communication is not just a one-time event. It is constantly repeating the same message. It’s consistency, and it’s demonstrating calmness as you go through the process, as well as letting people see your emotions. There were a lot of events that occurred and we had to let people see that we were human too. And that helped.

Creating Community

Dziedzic: The days were so long. I don’t recall ever feeling as mentally and physically tired as I did in those days—and yet invigorated at the same time. Some of my favorite memories from that time were dinner with my colleagues and getting to know each other. It really became a family environment. We were literally spending 18 hours a day together. And then as the days went on and we didn’t have any positive cases, we would get these alerts on our phones when somebody had a sore throat and we would panic. And then we would all be like, Okay, sore throats are still going to happen in the middle of a pandemic. Let’s not freak out. And we would talk each other off of our ledges. And I think the bond that came out of that experience is one of my absolute favorite things.

Barbara Dwyer, is a resident who tested positive for COVID-19 and ended up in the hospital for dehydration. After being released from the hospital, she says this of the care she received by staff at Montgomery Place:

“This was a good place to be because someone would bring me food, check my oxygen levels, take my temperature … whereas where I was living before, I don’t think I would have survived. Just having someone around me and watching over me was a good thing.”

Resident, Barbara Dwyer

 

Leading by Example

Hart: Leadership has to be very person oriented and you have to be able to pivot quickly—and in COVID we had to pivot very fast. You have to make rapid decisions. You have to have confidence in your decisions, even though underneath you’re wondering, Is this the right choice? We gained the confidence of our staff and our residents. We were doing the steps that we expected our staff to do (like delivering meals) so that they understood, we were part of this team that had to work together.

Zappoli: My motto is we need to be better everyday. Better tomorrow than you were today. Work hard and do the best you can.

Hart: I think the most surprising thing that came out of COVID for me is how quickly we were able to adapt. Any time you’re faced with a calamity, you’re always wondering, How am I ever going to make it through? As an organization that serves seniors, we have to go through emergency preparedness. All sorts of emergencies. It’s totally different when you’re living it, but we were able to do it and we were able to create a playbook. So should anything similar happen in the future, we can go back to it and say, this is how it works.

The Effects of Isolation

Zappoli: Every time we were able to see residents, we did our best to have a conversation and make them smile. And that helps all the way around. It was immensely beneficial to staff members because they became very close to all of the residents. So we relied on them to give us feedback so we could stay attuned to our residents.

Hart: When COVID struck, everything shut down, including, outpatient therapy for a period of time. We saw how devastating isolation can be. Our residents declined mentally and physically when we were asking them to isolate in their apartments. When we saw how many people had declined, we were very concerned about it.

Our need as human beings is to be with people. And we saw the decline that can be created by isolation, and I never want to see that again.
Deborah Hart

Dziedzic: Natalie Hackett, our director of rehab services was extremely concerned about physical decline in the residents and she was smart enough to think, You know, if they’re not going to come to me, I’m going to go to them. She took VSTBalance [which uses artificial intelligence to identify mobility deficits in older people] door-to-door so that people could get their assessment in their apartment, and she did inpatient therapy on an outpatient basis, and people started to improve. It really helped illustrate for the residents and their families, what an impact immobility had on people’s gait and balance and stability, and was really able to tell the future story of, Hey, if we don’t get ahead of this, this could really be a big problemWe could have falls, we can have injuries and we don’t want any of that. So by utilizing that technology and really showing people a mirror for where they were, it helped them overcome their fear and come out of their apartments and really start to re-emerge and re-engage and get stronger and healthier.

Coming out of this better than before

It has been the toughest year I’ve ever had to deal with in my career, but it also strengthened our mission and values as an organization. Our staff knows that we will support them at any moment and that will make us stronger.

Paul Zappoli

DziedzicI think where you work matters, and nobody wants to get up and go to work and spend a third of their life or more with people they wouldn’t want to normally hang out with. We are fortunate that we are a small enough team and a small enough organization that we can still maintain those personal connections. There’s no real barrier to anybody on our team coming up with a good idea and walking into our CEO’s office and saying, Hey, I really think we need to think about this, or we need to consider this. And it will always be considered. And I think having that shared experience of living through what we’ve lived through, has taken us to a different level as a team, as an organization, and as a community.