Relatively few senior living communities across the United States are dealing with diagnosed cases of Covid-19 within their walls, but every community has been struck by one serious effect of the pandemic: fear.
“This is creating a lot of anxiety for our residents and our families and our team members,” Chris Guay, founder and CEO of Vitality Living, told Senior Housing News. “There’s a lot of fear.”
While fully alleviating that fear might be impossible, Guay believes that “overcommunicating” is a key step to easing anxieties as the company responds to the unprecedented coronavirus situation.
Brentwood, Tennessee-based Vitality operates 16 locations across Alabama, Florida, Tennessee and Texas. No coronavirus cases have been diagnosed in any Vitality communities, but like other senior living providers across the country, Vitality is adjusting each day to the evolving, escalating threat of Covid-19, and the virus is affecting every aspect of operations. Currently, Vitality is seeking creative ways to stay in communication with residents, family members and staff, while trying to keep the resident experience as rich as possible.
Looking ahead, Guay is concerned about increasing complications related to staffing and supply chains, and in laying out protocols for what happens if and when Covid-19 does strike a Vitality community.
Vitality’s corporate leadership issued its first communication about the coronavirus situation on February 28, and keeping communication constant has been a top priority since then, Guay said.
Key company leaders were holding daily meetings related to coronavirus, and it became clear that residents and their families had a tremendous number of questions related to the situation. Vitality COO Kelly Lindstrom had the idea of doing a live feed, in order to take and answer questions in real time, and one of the company’s ownership partners suggested taking that all the way down to the community level, Guay said. Facebook Live emerged as the best platform for doing so, because it is easy to access and sessions can be recorded so that people can watch them at their convenience.
The first Facebook Live webinar took place last Sunday, March 15. Guay began by sharing an update on Vitality’s coronavirus response and then took questions from attendees. Also starting on March 15, executive directors at each Vitality community began conducting daily Facebook Live sessions.
This form of communication has been a success, with Guay’s March 15 session now having been viewed more than 5,000 times.
“I think the feedback has been very positive and it gave our families an opportunity to also ask questions which are helpful to us, because there [are] things that they’re highlighting that we then know are important to them, and it helps us adjust our plan,” he said.
One example is a resident question about whether care packages can be delivered to residents. Guay wanted to say yes, knowing that packages could be a way for residents and loved ones to connect without in-person contact, given that Vitality communities are already limiting access only to essential visitors.
“But then, we started really thinking about it,” Guay said.
He and other leaders realized that staff are already giving every person who enters a building a Covid screening questionnaire and taking their temperature; workers did not have the bandwidth to also try to cleanse and disinfect packages, if doing so is even possible.
“So, we pulled back and said, as much as we know that you want to do these things for your loved ones, we’re asking that you only send essentials, such as a medication that they’re not getting already from our pharmacy,” Guay said.
In addition to the Facebook Live sessions, Vitality is communicating with residents in various other ways, including by email and letters slipped under their doors. The idea is to quell anxiety as much as possible by explaining how policies, procedures and best practices are changing in response to the fluid Covid-19 situation.
“I think it’s very important to our residents, our families, our team members that we don’t just react, but that we also explain why we’re reacting,” Guay said.
In addition to communicating regularly, Vitality is trying to ease residents’ fear by keeping life as normal as possible during this very stressful and unusual time.
“We’re encouraging our engagement directors to do virtual field trips and virtual tours; we’re working to connect [residents] with families via Skype and Facebook and other video avenues,” Guay said.
Although the situation was in many ways very different, Hurricane Harvey offered some lessons. Vitality evacuated one community in response to that crisis in 2017, which also was “incredibly stressful” for residents, Guay observed. Staff learned that the best way to combat that anxiety was through even simple activities like playing cards, and keeping the focus as much as possible on “fun.”
Of course, not all aspects of resident life can remain the same while the Covid-19 threat is so active. Coming and going from a building is more difficult, for example.
Anyone who leaves a Vitality building and then returns, including residents, must go through the screening process in order to re-enter. This has led to difficult decisions and recommendations, such as to avoid leaving the community to attend church — a large gathering that presents significant risk of exposure.
“We’re telling families that if they take mom out for 48 hours, for a weekend, before mom comes back into the building, we’re going to put her through the Covid screening — questionnaire and temperature — and that may affect her ability to come back in the building,” Guay said. “So, we’re just being open and telling people the actions we’re taking. We hope they make the right decisions … for themselves.”
In terms of other operational changes, dining rooms remain open, although some residents have opted to take meals in their room. Aggressive infection control procedures, based on practices developed to combat norovirus, are in place, and social distancing is being encouraged. Memory care accounts for a significant proportion of Vitality’s unit mix, Guay said, and it’s especially difficult to isolate memory care residents, at meals and any other time.
“The common areas of the building are their living space,” he said.
So, caregivers are focused on tracking memory care residents’ health, and focusing isolation efforts on anyone with signs of a cold or flu.
In-person community tours have been suspended, although virtual tours are being conducted. Many move-ins are precipitated by a health event or other emergent need, so new residents are still being accepted, but they are being carefully screened prior to moving in, Guay said. And, move-in procedures have been altered.
For example, Vitality typically conducts “Vital Connections” meetings for new residents and their family members, as a means of welcoming them to the community and creating positive early experiences. These meetings are now being conducted virtually rather than in person.
As recently as last week, the company was able to secure an assisted living license for a new community in Tennessee, and move-ins are happening at that site using the new protocols. Other efforts to expand Vitality’s footprint, including a few development projects in the works, are so far proceeding as planned, Guay said.
Concerns on the horizon
The spread of Covid-19 across the country has led to rapid and dramatic changes in day-to-day life, and senior living operations are being affected.
This week, school systems around the country began calling off classes, and this has led to staffing pressures for senior living communities where workers now have childcare responsibilities to worry about.
Vitality is feeling pressure in this situation and is seeking solutions, such as trying to partner with local daycare groups. But many other employers are also trying to forge these kinds of arrangements, and daycare providers lack the capacity to work with all of them.
“That’s proven to be difficult,” Guay said.
Now, he and other leaders are trying to get more creative in scheduling, such as by allowing employees to work longer shifts or flex shifts.
Looking to the future, supply chain pressure is next on the list of worries for Guay. Vitality has emergency stores of food and has taken stock of its inventory of critical items in order to strategically stock up, and Guay draws some confidence from the fact that the company works with major national supply companies such as Sysco. However, medical equipment is in short supply across the country. The situation may require outside intervention: Senior living industry associations have pushed the federal government to give providers priority access to emergency stockpiles of supplies.
Finally, Vitality is preparing for the possibility that one of its residents or workers will be diagnosed with Covid-19. This situation would be another test of open and proactive communication, and would demand coordination with local health departments and other authorities. But, as the spread of coronavirus is still in relatively early stages in the United States, there are huge looming questions about how the nation’s health care system will respond.
“That’s the next unknown we haven’t dealt with,” Guay said, of a positive Covid diagnosis in a Vitality community.
With all these looming challenges and anxiety-provoking uncertainties, he again emphasized that senior living providers must not only take all measures to safeguard the physical wellbeing of residents and staff — they must also maintain calm in the midst of a national emergency.
“We have to keep our fear in check, if we want to do right by our residents and help them keep their anxiety and fear in check,” he said.