Nursing home residents, staff share experiences, challenges of pandemic

Mary Gant covers the last number called during Bingo at Primrose Retirement Community in Jefferson City.
Mary Gant covers the last number called during Bingo at Primrose Retirement Community in Jefferson City.

Residents and staff members at Mid-Missouri nursing homes said they are beginning to feel a return to normal, following the past 15 months of the COVID-19 pandemic.

Emotions ranged over the pandemic, beginning with some fear of the unknown, to frustration at being confined and having limited connection to family members outside facilities and elation at ease of pandemic-caused restrictions, said Dolores Knernschield, 92.

"It's a lot better. At least we can get out of our room - we can go out and eat," said Knernschield, a resident of StoneBridge at Oak Tree Senior Living in Jefferson City. "For a couple of weeks, we would have to eat in our room. We stayed in there a while. I kept telling people, when they let us out, we're going to go wild."

On second thought, she said, after restrictions eased, residents thought they "had better behave."

It has been a long, difficult stretch for residents and staff in nursing homes.

Mary Gant, 85, who resides in the independent living portion of Primrose Retirement Community of Jefferson City, said there was confusion at times. She said it seemed like independent residents couldn't go out for a year, but it was more like a couple of months.

"You really did need to be creative (when entertaining yourself)," Gant said. "I watched TV and read. Paid medical bills. And talked on the phone.

"We still got a little bored."

Residents who normally played pool together couldn't do that. Staff brought meals to residents in their rooms.

"When we were locked down, man, that was hard. Especially, if you don't have any family around," she said. She's originally from Kansas City, and her family is spread out.

Another resident at Primrose, 86-year-old Harold Lepper, said he's lucky he has family in the Jefferson City area.

Things looked grim for Lepper at the end of December, when he came down with COVID-19, Gant said.

"I was in the hospital New Year's. I had double pneumonia. I had food poisoning," Lepper said. "They thought I was going to die. The two nurses that saw me leave didn't expect me to come back."

He was in the hospital for 16 days.

Doctors told Lepper he may require six months to a year to fully recover. He still feels unsteady on his feet and walks with a walker.

"You have to live one day at a time," he said. "You have to have a good frame of mind to be here. Getting old is not fun, and you have some difficulties."

Residents of nursing facilities are very dependent on staff at the sites where they live, said Rose Marie Bogdan, an 84-year-old resident of Jefferson City Manor, a JMS Senior Living site.

"Being in here, I didn't have to worry too much. (Jefferson City Manor Administrator Brandon McIntire) and everyone else in the staff was very much up on everything," Bogdan said. "The masks, the restrictions. We had to stay in our rooms at times. We couldn't have any visitors, which made a lot of the more elderly people very sad."

Despite the challenges, residents felt they were well cared for, she continued. Staff had to be creative when finding ways to keep residents active. Before the pandemic, activities were oftentimes held in one large room, where residents could gather and play trivia games, hangman and bingo.

Bingo was always a favorite. It still is, Bogdan said.

"We did things from our rooms, like play bingo," she said. "We had to sit in our doorway. (The activity director) would come with the cards. Everybody would sit in the doorway, and that's how we'd play bingo."

Residents couldn't sit with friends, but that was OK. There were other unusual activities, she continued.

"I remember one time they said we were going to bowl," Bogdan said. "I said, 'Where are we going to bowl?' They said right along here (and she pointed to the hallway).

"It was so much fun. We had a good time anyway."

It was frustrating to be stuck in the same building for more than a year, said Stewart Strong, a 36-year-old resident of Jefferson City Manor.

Strong requires care because he has spina bifida, a defect that occurs along the spine (typically a birth defect) when the neural tube does not close all the way and the backbone doesn't form and close as it should.

Because of his condition, Strong has no feeling and is paralyzed from the waist down. He uses an electric wheelchair to get around.

The past year-plus has been challenging for him, Strong said, because he couldn't spend time with his brother and family. His brother has two children, ages 3 and 4, and he missed teasing them. They have visited with each other via the internet, but it's not the same as seeing each other in person.

Strong said he also misses hunting and fishing on the family farm in Macon County. The family has a specially equipped six-wheeled (Max brand) all- terrain vehicle that he uses to get out into the woods.

"I hope, this year, I can go deer hunting," Strong said. "Shooting a water gun (at staff) is not the same."

But overnight outings aren't open yet, he said.

"We've come miles since the beginning of the year. I'm hoping, by the time hunting starts this year, we've opened back up again," he said.

On the bright side, Strong has returned to work. He works afternoons at the front desk for the Missouri Department of Transportation offices on Capitol Avenue.

"I (returned) a week before everybody else," he said. "Which was a good deal. We got all my computer's kinks worked out."

The desk isn't as busy as it was pre-pandemic, but things are picking up, he added.

"The further we go, it will pick up again," he said.

Nursing homes learned lessons

Vaccines have eased some of the burdens weighing on nursing home staff, said Rick Doerhoff, administrator at StoneBridge at Oak Tree.

Early in 2020, as the pandemic began to spread into Missouri, staff at his facility felt like they had it under control and there wouldn't be any problems.

Then in October, despite following all the state and Centers for Disease Control and Prevention guidelines, the facility had its first outbreak. It was traced back to an employee who went out of town to a funeral.

Dozens of residents and staff came down with COVID-19, despite efforts to isolate anyone infected, Doerhoff said.

"There were just a lot of wheels in motion," he said.

However, hospitals were filling at the same time.

"You try to treat the residents while they are here, before they need to go to the hospital," he said. "We were really stressed in October."

And multiple employees had to stay home.

"That was hard to get through - a number of people sick and gone at the same time," he said. "You still have all the cares in the world to provide here. Help was available; but, honestly, we didn't ask for help. Residents wouldn't have known them."

Doerhoff said he felt "like an ogre" for having to tell people they couldn't visit with their mothers and fathers or that they couldn't leave the building to attend family celebrations.

It was sometimes hard to justify letting staff in, but preventing family members from visiting, he added.

"We had an opportunity later in the pandemic, in which we could offer an 'Essential Caregiver' category, which meant the family member would look at four videos - we had a mini- education, if you would," he said. "They were immunized, wore masks. But they could still come in and have one-on-one with their family member."

The facility bought a "tent," which it used to keep people separated from residents when they were visiting. The tent, which has clear walls, at first stood outside and now stands within the building, allowing people to visit without having physical contact.

"We did a lot of FaceTime phone calls," Doerhoff said. "We did a lot of Zoom. Our activities people didn't have a lot of time to help people with anything but helping people with visits."

Fourteen residents went to heaven, he said. Some hadn't been in the facility long enough to get to know. Most who died had lived in the skilled nursing portion, had pre-existing conditions and were already compromised with other illnesses. Some within the assisted living portion had been there five years.

McIntire, the administrator at Jefferson City Manor, and Katie Finley, head nurse at the facility, both came from emergency room backgrounds.

There aren't many emergencies one or the other hasn't experienced, McIntire said.

Each had left emergency room settings for the slower pace that comes at a nursing facility.

"The beauty of long-term care is you connect with these people and they become like your family," Finley said. "ER can get heavy on your soul. It can cause a lot of spiritual you know. It's a different pace."

Patients come through the ER and are gone, McIntire said. You don't ever hear the patients' stories after they're gone.

At the nursing home, especially during the pandemic, staff became the patients' surrogate families, Finley said.

"They didn't have any face-to-face outside communication. It was a privilege to be there with them through that," she said.

Jefferson City Manor was the first nursing home in the city to have an outbreak, McIntire said. August will mark a year since the event.

"You just roll up your sleeves and do what needs to be done," he said.

Staff members were learning what to do about the same time that society was, Finley said.

And parent company, JMS, was also learning at the same time as everybody else. The company brought in specialized equipment to scrub air. Two scrubbers remain in the building. The company determined which cleaners worked best. And it connected with disaster-relief teams, McIntire said.

JMS never discussed the costs with McIntire. Its outlook was to get done what needed to be done and worry about costs later, he said.

"That was a huge thing for them to say to us - we care about the people in the nursing home, not the numbers in the nursing home," he said. "That's the sort of institution I want to work for. I want to work for somebody that cares about people."

Despite her experience in emergency rooms, Finley said the beginning of the pandemic was a "scary situation."

And staff lost friends - residents at the home.

It was just their time, she said. And she was grateful she was able to comfort them and their families.

"It hurts you. It hurts your soul," McIntire said. "You'll never get those people back, no matter how hard you tried."

The facility never prevented anyone from being with a loved one during their last moments, he said.

And if families could not be beside their loved ones when they passed, staff from the nursing facility was there.

"We were able to hold their hands and made sure they were comfortable," he said.

All nursing facilities' staffs have lost a number of people who meant a great deal to them, he said. But they have to suck it up and keep doing what they do, he said.

Any health care worker, whether a nurse or aide, or housekeeper or dining room staff member, has lost someone they care about, he said. All are hurting.

"The beauty of our facility here is we were able to lean on each other and help each other through it," Finley said. "It's our shared experience that did a lot of that emotional debriefing."