Overcoming the challenges of COVID-19 in long-term care

When COVID-19 restrictions meant rehabilitation therapists on the restorative care unit at the Edmonton General Continuing Care Centre couldn't bring large groups of residents together to do their daily exercises, they started “doorway rehab.” Now the therapists space themselves out down the hallway in the unit — where everyone can see them — and lead residents through their exercises standing in their doorways.

This is just one of many innovative ways that teams at long-term care centres across Covenant Health are overcoming the challenges of COVID-19.

“Our staff are can-do people. You give them a set of issues, and they will find ways to support the people they're caring for,” says Sheli Murphy, senior operating officer, rural services.

She and Lynn Klein, senior director of operations, Edmonton General, have seen staff in all areas — from environmental services to recreation therapy — find solutions and adapt to the realities of keeping residents safe. And they've met the challenges of the pandemic with warmth, compassion and humour. 

“I've seen tons of compassion for people and so many positive things happening daily,” says Lynn.

Often, finding solutions has required “huge collaboration” between different areas, and people at every staff level have contributed their ideas, says Lynn. “There are so many pieces to every puzzle. Everything is on the table, and everybody’s part of the conversation. And all of it keeps our residents in mind and how to honour what they need in this journey.”

All long-term care sites have been challenged by the loss of human connection for residents due to visitor restrictions and the continuous masking of staff. Before the pandemic, many residents were already isolated because of changes in their physical and cognitive abilities, says Sheli. Not being able to see their loved ones or the faces of staff has meant further isolation for them.

To address this challenge, staff have helped residents use technology such as iPads to virtually visit with family, friends and volunteers and set up window visits where people can come to outdoor spaces at Covenant sites to chat with residents by cellphone through the glass. At some sites, staff have also created name tags with photos of themselves so residents can see their faces and smiles.

Residents at the Edmonton General have adapted well to the virtual visits, says Lynn. “Some of them are well into their 90s, and they are easily adapting to that face on the video and having great conversations.” 

Maintaining normal routines for residents while observing physical distancing protocols, often in close quarters, has also been challenging. For instance, teams had to come up with safe ways to serve meals in their dining rooms, which at some sites are small. One solution was to have two sittings at mealtimes, a change that required “lots of coordination between residents, point of care staff and dietary staff,” says Sheli.  

Staff throughout Covenant are also embracing a new audit tool the organization has created to make sure its long-term care centres are following government regulations for enhanced cleaning, continuous masking and other measures needed to keep residents safe. Once a week, staff take turns going through their site and checking against the tool.

“Staff are empowered right at the point of care, so if they see something that needs to be done or that is not being done right, they recognize it and offer suggestions to make changes,” says Sheli.

From the start, a focus on gratitude and kindness has helped staff at the Edmonton General deal with the stresses and uncertainty of the pandemic. They have created gratitude boards and can often be heard offering support to each other, says Lynn, who also gets daily messages of appreciation from the families of residents, which she forwards to staff.

In turn, sites across Covenant are supporting residents’ family members through regular phone calls and emails. If a family seems to be struggling, spiritual care teams reach out to offer virtual support as well. “It has meant a lot to our families,” says Lynn.

Throughout the pandemic, staff and residents at long-term care centres across Covenant have been buoyed by support from their local communities. Musical and dance performances, car parades, animal visits, children’s art and more have lifted residents’ spirits, while countless donations of everything from flowers and gift cards to handmade scrub bags have encouraged staff.

“The rallying of the community is astounding,” says Sheli. “Staff have stepped up to do everything they can to help make the community support happen, and being uplifted will help them carry on doing what they need to do.

“They should be very proud. So many of them go to work every day with a positive attitude and the thought, What can I do for the residents to make today count, to make the day good for them? They are remarkable people.”