Since the beginning of the pandemic, facilities that care for the elderly have been hot spots for the spread of COVID-19. And a new report says nationwide new cases in nursing homes have reached record numbers this month. Locally, some have been able to stop the virus from entering their facilities, but others have not.
This story aired as a two-part series:
The Current Situation
KAZU's Michelle Loxton connected with Jannie Fritchle, 75, over Zoom. She’s one of the 45 residents who call Del Monte Assisted Living in Pacific Grove home.
"My daughter lives in Santa Cruz, so when my husband died and I had a stroke, she moved me down here,” Fritchle said.
Fritchle has been living in this assisted living facility for over three years. When the pandemic arrived, the facility went into a short period of lockdown and then got strict with visitor policies.
“It's not terribly different other than the insiders stay in and the outsiders stay out,” Fritchle said.
But the insiders still found ways to have fun.
"But we are still having our celebrations and we had a party for Halloween,” said Fritchle.
Julia Galaeano is the administrator at this assisted living facility.
"We knew it was going to take a toll on them not to see their loved ones, and we were worried about that,” she said.
“We got extra creative by getting a lot of laptops and iPads to do Zoom calls and FaceTime,” added Galaeano.
They also brought in a physical therapist and activity director. Jannie Fritchle enjoys bingo, scrabble and trivia, which are all played in small groups.
When family members became desperate to have a face-to-face visit with their loved ones, a plexiglass outdoor visiting station was set up. Masks and hand washing compulsory.
Del Monte Assisted Living is one of the facilities that care for the elderly that’s been able to keep the coronavirus out. Others haven’t been as lucky.
“Absolutely heartbreaking for all of us who worked on it,” said Dr. Gail Newel, the health officer for Santa Cruz County.
She’s referring here to the recent and first significant outbreak in her county at a skilled nursing facility called Watsonville Post Acute. Sixteen residents died of COVID-19.
Newel is, though, quick to point out that no negligence has been identified in this case.
"Everyone who worked there who’s very committed and dedicated to their work and they did the very best that they could to respond to this situation. And it could have happened in any one of our seven nursing homes,” Newel said.
According to Newel, the outbreak has been brought under control at this facility and there have been no cases for more than a month. But the county is monitoring two new outbreaks -- one at an assisted living facility called Maple House II and another at a skilled nursing facility called Santa Cruz Post Acute, both in Live Oak.
At time of publishing, Maple House II had a total of 25 cases among residents and staff, and one resident death. Santa Cruz Post Acute had a total of 95 cases (28 staff and 67 residents) and one resident death.
“We know that in almost all cases it's the staff who are bringing it to the facilities,” said Newel.
They know it’s a staff member that’s often "patient zero" because most of the residents never leave the facility. Newel said one of the staff members at Santa Cruz Post Acute likely caught the virus attending a Halloween event.
“I kind of perceive what's happening to be a trauma for the staff and for the residents,” said Meggie Pina. She’s the long-term care ombudsman program manager with the Alliance on Aging, a non-profit that provides advocacy services in Monterey County.
“So how do we get the resources and support into the facilities that they need as opposed to, like, finding fault or judgment?” said Pina.
Throughout the pandemic Pina has conducted unannounced visits to facilities and is hosting a weekly meeting, or a safe space as she calls it, for directors of nursing to get clarity and talk about their challenges.
And the challenges are immense.
“When there are positive cases where staff are afraid or if they have a large number of staff that test positive, what do you do when you have 10 people out,” said Pina.
The size of some of these facilities also creates challenges.
“So, some of them have 150 staff members, whether it's housekeeping, the actual caregivers. So, it's a lot of exposure, right?” Pina said.
Pina says at least 90 percent of skilled nursing facilities in Monterey County have had registered COVID-19 cases at some point. She expects with time all might see cases.
Systemic Issues And Solutions
Despite the heartbreaking circumstances, Dr. Gail Newel, health officer for Santa Cruz County, is armed with suggestions for these facilities that could help prevent or slow the spread of the coronavirus.
“Working actively with the staff to continue to educate them about appropriately donning and doffing, which is the fancy way of saying putting on and taking off their PPE,” said Newel. “Good ventilation is a really big factor,” she added. “It helps if the facilities are able to offer full time jobs so the employees don't need to shop around for a second part-time job. But I know that's not always economically feasible.”
Employment challenges are a systemic problem, as Meggie Pina, with the Alliance on Aging in Monterey County, explained.
“Something we've seen across the state of California is just some of these caregivers... they don't even have health insurance,” she said.
Pina said healthcare workers are under a huge amount of pressure right now.
“They're making less than $20 an hour, sometimes less than $15 an hour. Now they're essentially maybe putting their life at risk by working in a positive facility or maybe they have family members they’re caring for at home,” Pina said.
As an advocate, Pina makes unannounced visits to nursing homes to speak to residents to see what can be improved upon.
“We asked them, ‘what would make you feel better?’ You know, it's like ‘this pandemic being over. George Clooney coming to visit me in my room.’ You know, we collected arts and crafts, supplies like crossword puzzles... many of them don't use social media or the Internet,” said Pina.
And the isolation that’s been put in place to protect residents is actually causing its own problems.
"We are all having our own kind of emotional challenges from the isolation, right? But can you imagine that the only people you see are masked?” Pina said.
They've also noticed a pretty rapid decline in those with dementia because of the isolation, Pina said. In this case, they actually recommend a compassionate care visit utilizing COVID-19 safety protocols.
For Pina, talking about these challenges really does reveal the solutions. And as we head into the holiday season, these two local healthcare experts have messages about the future of caring for our elderly.
Dr. Gail Newel is thinking about the short-term.
“It's never been more true than at this time and this time of year, when we're all craving time and physical touch with our loved ones. And yet it's never been more important to follow these social distancing requirements because of the current surge,” said Newel.
For Meggie Pina, it's about thinking about the long term too.
“I guess my question is like, you know, how do we redesign safer, more compassionate and more joyful environments for aging?” said Pina.
A question that’s not only on the minds of these healthcare experts, but also the residents, their loved ones and the staff inside these long term care facilities.
Del Monte Assisted Living is one of KAZU’s many current business supporters.