May 2020
"Hard times don’t create heroes. It is during the hard times when the ‘hero’ within us is revealed." Bob Riley
The coronavirus pandemic has asked a lot of LeadingAge Georgia members. You’ve had to learn about a virus that is like none other we’ve experienced. You’ve had to work smart and hard to implement infection controls to keep older adults safe. You’ve had to work under conditions where you know you are at risk for getting COVID-19 because asymptomatic individuals can bring it into your community/organization and we don’t yet have rapid testing. In two communities, you’ve faced the loss of residents whom you care deeply about. We are with you in spirit.
Social isolation is a major concern of all members. Not only are assisted living and nursing homes prohibiting visitors due to the Governor’s Executive Orders, but independent living communities are being vigilant about visitors and adult day centers have closed for now.
As of yesterday’s estimates, 51% of all deaths in Georgia were in long-term care. As concerning as that is, the measures put in place that have caused social isolation have likely saved a lot of lives.
At this point, we need to buy some time. There is a lot of medical talent working on interventions, progress is being made on testing and companies across the world are working on vaccines.
So how do we buy time? We buy time by maintaining cultures of caring for the well-being of residents and clients during the coronavirus. We find ways of being the warmth that people miss out on when they’re in isolation. We find ways of connecting residents and clients to families and friends with the same dedication and innovation to overcoming isolation that researchers have for finding interventions and treatments for the virus. We find ways to forge community even when the furniture has been removed.
The hero within us is being revealed every day. LeadingAge Georgia members are working hard and smart to combat social isolation. Staff in most communities are calling residents daily, delivering packages, grocery shopping and delivering meals. Members are also fostering community wide communication through a resident channel, offering virtual activities and exercises as well as using technology for fostering connection with family and friends. LeadingAge Georgia members ARE maintaining cultures that reflect the well-being of older adults and those who serve them.
As you are caring for others, I hope you take time to feed your soul. It’s a form of PPE! I asked Robbye Jarrell, chaplain at Lenbrook to write an article for you to include in the newsletter. She did and it is lovely. It’s titled “Protecting the Treasure.” I hope you enjoy it.
We WILL work to get back to a new normal. We’ll share protocols and best practices for getting safely back to the sense of community you’ve built. We’ll also work with our state government and federal government on any issues you need to be addressed. We’ll continue to work with the media to help them understand the great cultures you have created and maintain.
As we move to the new normal, we’ll balance the safety and health of residents with their need for community. We encourage you to be innovative in arranging opportunities for resident engagement – particularly ways to foster connections with family and friends. We also encourage you to be thinking about how to foster small group activities with infection control measures in place and possibly setting up an area in your building for meeting with family members.
Take a look at the articles on resident engagement and please share your best practices for resident engagement and building community in the new normal. We’ll share them with your fellow LeadingAge Georgia members. Please also share stories of staff who are doing the things that show the hero within and we’ll share those stories too. Please email the best practices and stories of staff heroes to me at ghelms@LeadingAgeGa.org.
Thank you for all you do for older adults. We’ll get through this together.
Best,
Ginny
The deadline for organization/staff updates has been extended to May 22nd for the 2020 - 2021 LeadingAge Georgia Resource Guide and Member Directory. Verification forms were emailed to the main contact at each organization. Contact Susan Watkins, swatkins@leadingagega.org if you did not receive your form.
LeadingAge Georgia and ARC have chosen Campbell-Stone Buckhead and Cathedral Towers as the two communities to have a test pilot for behavioral health coaches. These two communities have pledged to share best practices from the pilot and to be champions for expanding the program to other communities in the future. LeadingAge Georgia pledges to seek funding to expand the program to other members.
We’re seeking to find five communities in need of funding for meals for residents in need. If your community has residents with food insecurities and you would like to have the funding to purchase food for your pantry, gift cards or meals for residents, please contact Scott Bassett at sbassett@LeadingAgeGa.org. We are grateful to Thanks Mom and Dad who provided $20,000 in funding for meals for residents of HUD communities.
The United States Department of Housing and Urban Development has created guidelines to address Tenant Concerns during COVID-19. These guidelines are available for print so you can post them throughout your community. They are currently written in 11 different languages and being updated with new languages each week. Please visit the LeadingAge National COVID-19 website under Affordable Housing. You will find the brochures listed under "Updates from Federal Agencies."
https://leadingage.org/coronavirus-information-affordable-housing
LeadingAge Georgia sponsor, BB&T Capital Markets, provided some additional insight to recent changes by HUD/FHA 232 mortgage insurance loans. Please see the attached article that was recently published in Seniors Housing Business.
https://seniorshousingbusiness.com/hud-makes-contingencies-for-borrowers-during-covid-19-outbreak/
Are you an Activity Director or related professional who is working (or has worked) in Assisted Living, Independently Living, or Skilled Nursing Community? If yes, SimpleC would like to invite you to complete this survey. We would like to learn more about your work and the technologies you use.
The survey will take about 10 minutes to complete. As a thank you, you will receive a $10 Amazon eGift card at the end of the survey. Please click here to start the survey.
In a call this week with adult day centers, GADSA president Ned Morgens led a conversation about the NADSA seminar on reopening of adult day centers. Ned stressed that center operators should be focusing on developing policies and protocols for all aspects of operating a center under the new normal. He indicated that effective infection control, purchase of PPE, plans for transportation and social distancing for every aspect of serving clients should be in the works. Several adult day centers indicated they will have a “soft opening” serving a small number of clients in order to have social distancing. They will serve those in most need initially and may limit services to clients to one or two days per week and stagger days for clients. The State will not be dictating whether or not centers may reopen. All centers are advised to base re-openings on when it is safe for older adults to attend and to be in contact with your local health departments, emergency management systems and hospital systems to determine when you can safely reopen.
Visiting Nurse Health System (VNHS) has developed a program specifically to care for older adults with early symptoms suggestive of COVID-19. The program called COVID-19 Patient Home Health Management Program allows patient care to be managed in the community by their physician and for skilled care to be provided by a registered nurse. Click here to learn more about the program.
The “unprecedented” nature of COVID-19 is changing our society and economy. We’ve only begun to bounce back and ultimately become stronger. That’s simply what we do. However, its impact on the way we interact and our actions around personal health are undeniable. Not only that, it’s changed our belief and perceptions about safety, thereby adjusting our behavior patterns as consumers. This in turn forces a unique response from each marketplace specifically through the lens of COVID-19.
Adjustments within the insurance marketplace are daily. Carriers are trying to find a balance between offering coverage and protecting themselves against the volume of claims. The response is segmented by industry. As a result of actual events and the media, the insurance marketplace’s response to the senior living industry has only just begun. The following are now becoming the “new normal” on just about every renewal: communicable disease exclusions on all liability policies, reduction in Excess/Umbrella Policy capacity, carriers pulling out of the Excess/Umbrella market altogether, inability to receive monoline policies (risks must now be pooled), and further rate increases on liability + excess/umbrella policies in an existing hard market. In the near future, I also anticipate carriers with a smaller share of the market to possibly pull out entirely. It’ll depend on their current and projected loss ratios within their senior living book of business.
At the very least, the immediate solution is to begin the renewal/negotiation process as early as possible (~120 days ahead) and be prepared for change since it’s a fluid situation. There are strategies and options available to reduce rate increases and gain excess limits, but it’s critical to have a plan. I encourage you to partner with your broker to attack the market with clear goals and expectations. This will allow you to prepare for the inherent impact and plan ahead for future.
David and Walter authored an article titled “Leadership Coaching is the Missing Link to Retain Staff” and it was published in the Society of Certified Senior Advisors Journal. The article makes the point that individual coaching is the missing link in professional development and retaining staff. With individual coaching, staff are able to work on issues that they are facing and are able to develop personalized development plans. LeadingAge Georgia’s Walter O Coffey Leadership Academy includes leadership coaching and we encourage members to take advantage of the Leadership Academy and to consider working with Walter and David for additional coaching. We thank Alliant Health Solutions for the grant that makes the Leadership Academy possible. Take a peek at the article.
As we entertain all of the options for ensuring well-being during the coronavirus, there is a lot of information floating around. One option in the arsenal for well-being is Vitamin D. We turned to the experts via PubMed, the resource that physicians often look to for information, in order to find the science behind claims that Vitamin D is beneficial.
According to William Grant who has a PhD in physics from University of California, Berkley, evidence suggests that Vitamin D supplementation could reduce risks of COVID-19 infections and deaths. According to Dr. Grant, Vitamin D reduces the risks of infections by lowering viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia. Read his article here.
Researchers tell us that sunshine is important for a healthy immune system. This article explains the way sunshine is turned into Vitamin D. Read this article,” Health Risks and Potential Remedies During Prolonged Lockdowns for Coronavirus Disease 2019” and it will show you why encouraging residents to get out in the sunshine can help ensure well-being. The lead author is an MD, professor of clinical biochemistry at the University of Verona. Click here for the article.
We’ve heard that sunshine played a role in healing of soldiers during the Spanish flu. The recap of the role of sunlight is pretty fascinating. Read a great article about it here.
This article gives the data behind the reporting that older adults have Vitamin D deficiency partially caused by inadequate exposure to sunlight. Note that adults over 80 are particularly deficient in Vitamin D. The article is written by Carlos Ocres, MD and others.
A quick read on the risks and benefits of exposure to sunlight for older adults indicates exposure to sunlight has been under appreciated.
So why aren’t older adults getting access to sunlight? This article says that it is because poor health, physical constraints and a sense of lack of ownership of outdoor spaces were barriers to sunlight exposure. The authors of the arti8cle, Seeta Durvasula and all say “improved physical access, more outdoor leisure activities and promotion of greater autonomy may improve safe and appropriate sunlight exposure in this population.” Read the article here.
The articles provide great support for the need to facilitate residents going outside for sunlight and talking to their physicians about Vitamin D supplements. Maybe a few meals high in Vitamin D might be beneficial too. Some of the foods high in Vitamin D include salmon, canned tuna, egg yolks and mushrooms. What if future visits with family and friends were in small settings with social distancing outside? What if happy hour was outside? What if exercise class like Tai Chi or Yoga were outside? What if strolls outdoors became the norm? What if photography contests involving the outdoors helped get residents outside? A simple phone with a camera could make being outdoors more fun! With some thought and creativity, we can foster well-being with better resident engagement with the outdoors!
Tools for Staff:Staff are a major life-line for residents/clients during the coronavirus outbreak, rising to what is asked in this unprecedented time. Being a caregiver in such an important time can be rewarding and it can be draining. Consider checking out these tools to help you recharge! In the article “Using DBT Skills in the Time of the Coronavirus,” psychologist Sandra Wartski gives great easy tips for coping and thriving. It is a quick read and well worth it. Check it out.
Marsha Linhan, founder of DBT says mindfulness is the foundation of DBT skills. It can bring peace and calm in the midst of chaos. Check out this quick video explaining how to be mindful. I also like her quick video on acceptance.
LeadingAge national has a live virtual session coming up on June 4th at 2 pm on Mental Well-being: Regaining Confidence and control. Click here to register.
The Science of Gratitude:Psychologist and author Karen Young says that research shows that gratitude can improve general well-being, increase resilience, strengthen social relationships and reduce stress and depression. She stresses that consistency is the key. Here’s a quick read on The Science of Gratitude- How it Changes People, Relationships and Brains and How to Make it work for You.
How about a gratitude challenge? Check out this gratitude dance and then get the dance going in your community through social media.
Everybody Loves Teepa:Teepa is truly one of the greatest teachers for helping staff learn to help individuals with dementia live their best lives. Now, Teepa has a short, 18 minute QuickCast on Care and Coping with Dementia and COVID-19. Thank you to LeadingAge National for making it free to members. Click here to register for the QuickCast.
Too much news can be hard on the psyche – particularly during a pandemic. Consider fostering some alternatives to the news for your residents/clients. During a McKnight presentation on overcoming social isolation, they said entertainment was the most common use of technology -- like tablets. Consider entertainment options that can foster well-being.
Here are some options to consider
The Met Opera has free nightly opera streamed. Click here.
The New York Philharmonic has a virtual tour of Europe, places they would have performed in May if not for the pandemic. Click here to enjoy their music.
Live nature cams can be found here.
Guidance on starting virtual book clubs can be found here.
Virtual symphonies and operas can be found here.
Virtual Museum Tours can be found here.
Not only does the Metropolitan Museum of Art, New York have great virtual tours, they also have a great virtual drawing class.
Your residents can observe the live Aurora Borealis Northern Lights in Churchill Manitoba Canada. The best time to see the northern lights is between 10 pm and 4 am Eastern Time.
National Geographic has great virtual tours including one on Machu Picchu.
We reached out to Governor Kemp’s office for help accessing PPE and his office shared the list that GEMA uses to purchase it. Click here for the list of suppliers.
Bobby Bernal, our Value 1st representative said that they have identified a supplier who is increasing supply and is moving to be able to deliver gowns in a couple of weeks. Click here for the order form.
Bobby asked that we remind LeadingAge members that it’s best to purchase N95 testkits from reliable sources like who you typically purchase medical supplies from. Supplier names to consider include 3M, Medline and Mckesson.
The CDC’s website has information for optimizing the supply of N95 masks.
Andrew Wonder, president of Sharper Edge Sales Group indicated he has Kn99 masks, 3 ply level 1 masks and will soon have N95 masks. You can reach him at Office: 678-239-4756 Cell:404-543-9454 or Andrew@sharperedgesales.com.
Linda Kluge, director of the QIO/QID for Alliant Health Solutions reached out and said she suspects our members are having a hard time getting through NHSN due to the CDC team being covered up with the reporting effort. She suggests that homes may want to track their attempts to reach the NHSN team….so they have a record of their effort on this. She also shared that there are upcoming trainings are listed on the NHSN website, https://www.cdc.gov/nhsn/ltc/covid19/index.html. She also offered assistance via Marilee Johnson if you need help. Linda said “she is our NHSN expert!“
MARILEE JOHNSON, MBA, MT (ASCP)
Technical Advisor, Infection Prevention
O 919-695-8331 | E marilee.johnson@allianthealth.org
Alliant Quality – Quality Improvement Group for Alliant Health Solutions
www.allianthealth.org
There’s never been a more important time for using technology to foster connectedness. Staff are working hard to ensure that residents can use social media can connect to family and friends.
Two platforms that allow for telehealth as well as connecting to family members are IN2L and SimpleC. Both platforms can also customize music for bath-time, which is a huge benefit because it can make bath-time much more enjoyable for residents with dementia. The “SimpleC One Touch Televisit & Care on Wheels” allows virtual visits with family members, customized music preferences and telehealth that is HIPPA compliant. Click here to learn more about the platform.
The IN2L has a “Digital Care Package for Residents” that includes a tablet with video chat and photo/video sharing, messaging and telehealth capability. Click here to learn more about the platform.
CMS has funding available for nursing homes to purchase technology for fostering connectedness during the pandemic. The amount is $3000 per community. Click here for the application.
Jack York will be offering a webinar for lessons on using technology for connections. We will announce the date as soon as it is set.
Remdesivir is now available in a limited supply in Georgia and is only available currently in hospitals. Today we sent a letter to Governor Kemp asking that he let us know which hospitals received the medication so that residents of our member communities may have access to the medication. We encourage you to send a similar letter to his office via Ryan Loke at ryan.loke@georgia.gov. Here is the letter.
Clinical trials of Remdesivir showed effectiveness in preventing the coronavirus from replicating. It has been approved by the FDA for emergency use. To date, it has been used only for individuals who were extremely ill from COVID-19 and the individuals responded to the medication.
Remdesivir is now available in a limited supply in Georgia and is only available currently in hospitals. Today we sent a letter to Governor Kemp asking that he let us know which hospitals received the medication so that residents of our member communities may have access to the medication. We encourage you to send a similar letter to his office via Ryan Loke at ryan.loke@georgia.gov. Here is the letter.
During the Coronavirus pandemic, we are trying to provide on-going updates for members and we are able to do this through your membership dues and the support of our sponsors. Please remember to do business with our sponsors and business members whenever you can! Here’s a list of our sponsors:
By Chaplain Robbye Jarrell, Lenbrook
When the winds of Covid encircled the globe, things forever changed. The tactile plates shifted. Historians may well refer to this time as BC (Before Covid) and AC (After Covid). Phrases like “social distancing” and “shelter in place” are now embedded in our vocabulary. And, when this storm subsides, we will see that, as Peggy Noon says: “The America we stepped away from isn’t the America into which we’ll re-emerge.”1
The world has changed. We have changed. But the real question is: “Have we changed for the better?” We have all heard of a refiner’s fire. Indeed, fire can burn, but it can also refine. As a Chaplain in a life plan community, I have quietly witnessed a brighter and more authentic world emerge. No doubt, the Covid birthing pains have been considerable, gut wrenching at times, however, the promise of a new beloved community beckons us forward.
Time and time again, I have seen staff throw life lines to those in this storm. The refiner’s fire has made it clear, that though “we are not all in the same boat……..we are most certainly in the same storm.”2 Storms have a way of forcing us to revisit our priorities. And what we, in our communities, have discovered anew is, the lives in our care are indeed treasures. The stories and relationships under our rooves are something no virus can touch. And through the storm, staff has also learned that their fellow colleagues, the ones they work shoulder to shoulder with, are treasures too. As this storm begins to lift, no doubt, there will be new challenges and needs. We will have a choice. Do we go back to our “before Covid” priorities or do we let our “after Covid” lessons serve as our new plumb line. May we not be afraid to take a long, measured look at the aftermath of this refiner’s fire. There are jewels shining through the ashes in this new day ……if we dare to stop and look.
[1] Peggy Noonan, Wall Street Journal; April 23, 2020 “What Comes After the Coronavirus Storm?
[2] Damian Barr, Ibid.
Pantries are being stocked to support residents -- like this one at Cathedral Towers. The bounty even includes 100 quarts of soup from Super Jenny!
Staff are showing their spirit – here the staff dressed up for a Mother’s Day celebration at St. John Towers.
Staff are keeping connections – like here where Hannah Brannan is using Zoom to stay connected to residents at Philips Tower.
The Thursday Pantry at Decatur Christian Tower has lowered that anxiety centered on the question, “What if I can’t get what I need to make it through.”
Members graciously welcomed the Georgia National Guard who came to member communities to help with infection prevention – like the team here at Lenbrook.
Members celebrated staff for incredible care and compassion during the outbreak – like Twyla Hill who was employee of the month at the Marshes of Skidaway.
Staff have adapted to changes with a “whatever is needed” attitude – like Tim Knight and colleague where their “new normal” includes delivering meals three times a day to residents at Park Springs.
RossWoods Adult Day Services in Dalton set up a drive-thru to safely distribute activity packets, crafts and resources to their participants. RossWoods is an adult day center that had to close on March 16 due to the COVID-19 pandemic, and many of their participants' caregivers are struggling to take care of their loved ones at home. These changes are very difficult for a person with Alzheimer's disease, Parkinson's disease or any cognitively impaired diagnosis. Since closure, RossWoods staff has been calling and assessing each families' needs and trying to help with whatever they may need.
On a bright, sunny Saturday two weeks ago, I had just returned from an unsuccessful shopping attempt at trying to find paper products for our seniors at Briarcliff Oaks. Kroger was out, Publix was out, Sprouts was out, even Walmart was out of toilet paper, Kleenex, and paper towels. As I sat in front of my computer, ready to scour the online purchasing options, my text beeped on my phone. It said, “Hey, I want to help, I want to do something to contribute to the welfare of your seniors. Is there anything I can do to help with your food pantry?”
My first thought was, no. Our Abundance Pantry at Briarcliff Oaks offers about 1500 lbs of food each month to residents in a shopping environment. The residents enter the pantry and select the items they would like from a large variety of healthy frozen, refrigerated, and shelf-stable foods. However, with COVID-19, we had to change our protocols to reduce exposure. Now the residents are given a menu of the pantry items delivered to their apartment door each week. They select the items they want and bring the menu with them at a designated time to the pantry. I bag their items, weigh the bag, and, with at least 6’ distance, place their bag on a table for them to take. There are no more than a few residents in our very large waiting room at any given time, and I am the only one in the pantry. My one incredibly valuable volunteer, Sandra, records the weight of each bag. Due to our rigorous protocols to protect the residents, there really is no place for another volunteer.
Instead of responding right away to my friend, I made a cup of tea and thought about how I might invite friends to help in other ways. I responded, “Thanks so much for your offer! What we need most now is paper products for the residents. Any chance you could pick up a pack of toilet paper and paper towels next time you find one at a grocery store? That would be a huge help.” She immediately responded with, “Perfect!!”
Thus began Operation Neighborhood TP. A few minutes later I sent an email to as many local friends and neighbors as I could think of. The invite was simple: “When you are at a grocery store or ordering online, if they have toilet paper, would you pick up a pack and donate it to me so that I can distribute it to a senior in need? If you do so, please text me and I will come pick it up.” Two days later, when I arrived home from work, there were two six-packs of toilet paper at my front door! In another couple of days, another two six-packs at my door, and three emails from neighbors I’ve not actually met yet in person saying they had TP and would drop it off.
To date, over the past two weeks we have received over 100 rolls of paper products! In addition, other friends have stepped up to volunteer in creative ways that will maintain the resident’s safety. Neighbors are writing cards, donating art supplies, and forming prayer circles. It’s a win-win situation - for the residents, and for those who are generously contributing their talents, kindness, and extra paper products!
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