Using Technology in a Senior Living Facility Under COVID-19 Lockdown

Background
Having written previously about the challenges of those in the Silent Generation using wifi-enabled technologies to connect with their loved ones, it was fascinating to have come across an article on using technology in senior living facilities.

Introduction to Relevant Article
Having previously mentioned that I recently purchased and began reading Flourishing in the Later Years: Jewish Pastoral Insights On Senior Residential Care, edited by Rabbi James R. Michaels and Rabbi Cary Kozberg, one article that jumped out to me was Rabbi James R. Michaels’ “Technology to Enhance Religious Life” (pp. 183-190). “In the world of Jewish aging services,” Rabbi Michaels writes, “technology is often employed to make the traditional davenen (praying) and more liberal services more accessible and enjoyable to residents” (p. 183). Specifically, he discusses “some of the techniques Jewish chaplains have employed to enhance Jewish religious and cultural experiences in long-term care settings” (p. 183).

In the article, Rabbi Michaels discusses customizing prayer books, PowerPoint prayers, televised services, televising services from synagogues, using smartphones and wifi, and others, although my mind went straight to the limitations under the current circumstances of operating amidst the COVID-19 lockdown.

Prayer Services?
While the facility where I work does not currently allow for prayer services at this time, hopefully, in the near future, it will begin opening up and allow for them (with social distancing, etc.); nevertheless, the idea of streaming services from within the building is not an option. However, showing services is, as our facility has a dedicated channel for residents, which has technology that permits YouTube videos to be shown, as well as YouTube Live, which can be a great boon for residents wishing to have some sort of prayer service as an entertainment option, even if getting together in a physical space with others to do such activities is not a possibility.

Teaching Classes
One aspect I find that I provide a lot of value with is in teaching/leading classes/discussions and the lockdown does not currently allow for such a possibility. While I hope to be able to teach/lead classes/discussions in the near future in-person with residents, in the meantime, I have begun to utilize Zoom to do so.

In using Zoom, I give the residents a heads-up about the online discussions (for instance, in my weekly Shabbat Newsletter issues, I include a front-page section about it for the following week) with log-in information for the following week’s session. I then record the sessions, edit out any residents who have not provided me with written consent to include them in the video sessions for use online, and then I publish the videos to YouTube, whence they are then able to be broadcast on Friday afternoons for residents to watch on the internal broadcasting channel in the facility.

While this is a great model, the severe challenge is that while numerous residents have spoken to me of their interest in such discussions (the idea actually sprang from a conversation with a couple of residents who were yearning for intellectual and Jewish stimulation amidst months of dulling in the lockdown), the few sessions I have held during this month of July have only had a resident or two participating in the sessions. The reason why is crystal clear: lack of technological know-how. When I mention that accessing the classes is by Zoom, they say they don’t know what that is. Sometimes, they are open to me helping them with it, and sometimes, not. Those in the Silent Generation are struggling to stay connected with the world in the same way that younger generations are able to connect with the world.

Looking Forward
One thing that Rabbi Michaels nails on the head is his assertion that, “As long-term care continues to evolve, technology will probably play an increased role in serving seniors’ religious needs” (p. 190). And, amidst the current global pandemic, this assertion is certainly true. However, there are a couple of challenges.

One challenge is the lack of technology available for seniors. “It seems that a relatively small investment of capital on the local, regional, or national level would allow technology to bring religious services to people in long-term care”, writes Rabbi Michaels, and that “The only limits to this would be the community’s collective will and imagination, providing Jewish religious services for people in long-term care when it might be more significant for them than ever before” (p. 190). A small number of the residents have either computers or tablets, let alone smartphones, although they may mostly not use the various technologies at their disposal for the second challenge.

That second challenge is part lack of know-how, as well as lack of interest. Those in the Silent Generation never needed such technologies in their lives, whether vocationally or even avocationally, and why should they need to learn them now? They also are not used to thinking about navigating apps and connecting with these methods, while telephone calls and television-watching are much more in their way of thinking and living.

Anyways, those are some of my reflections and thoughts with technologies in helping seniors under this lockdown.

A Surprise COVID-19 Case

A Resident’s Inspiration
While visiting with one of the residents at the senior living facility at which I work today, he asked me how my job has been, especially starting to work during the lockdown due to the current global pandemic. I said it’s been an interesting time and not without its challenges, but it’s been great to develop one-to-one relationships with the residents. He then responded to me, “You should write an article about this experience.”  Now, I don’t know if I will end up actually writing a full-blown article at some point about serving as a chaplain in a senior living facility during the current global pandemic, but, hopefully, this particular essay will certainly count as one part of the story.

A Ray of Hope
After many months of residents being cooped up inside with limited range of where they could go, they have been quite frustrated with the situation, as they feel like they are prisoners, which is more acutely felt by those living in the assisted living areas, although less so in the skilled nursing areas. A ray of bright hope shone the yesterday when residents received a memo informing them that certain opportunities would be opening up for them:

The Governor has written an order allowing us to start reopening some areas within Health Care and Assisted Living. I was concerned last week with the recent spike in cases and some “talk” in the industry that this order might be rescinded. I wanted to make sure before announcing these changes that they truly were going to go into effect. After 5 months of COVID and the mental and physical stress put on all of us, I did not want to get anyone excited about these changes until I knew they were in place.

The assisted living communal dining would be reopening for lunch and dinner starting on Tuesday, July 28th, although residents would need to be spaced appropriately. Not only would assisted living residents have family outdoor visitation, but, so, too, would those in the health care areas, along with certain small group activities for either health care or assisted living residents. And, finally, the beauty shop would be opening up, which would be extremely exciting!

The Gray, Grim Surprise
However, only hours after that memo was sent out to residents, residents’ families, and staff, another memo was then sent out to those people, which included the grim news that “We just learned that an Assisted Living Resident tested positive for COVID-19 while at the hospital. At this point, with just learning this information, we cannot determine where the exposure occurred. We will take an aggressive stance to protect all the residents and staff while we manage this situation.” The surprising and sneaky nature of this virus clearly came as a shock, especially considering that this resident was not a particularly social or a wanderer – this resident remained in the resident’s room almost all of the time during the lockdown, so this was a huge shock, to say the least.

That memo continued, “At this point, we will be requiring all Assisted Living residents to self-quarantine in their rooms until further notice. Unfortunately, the Assisted Living outdoor visitation will be suspended again.”

Adverse Effects on Staff and Residents
Between the resident life staff getting excited to have some small group programming (and possibly me getting to lead classes/discussions, as well), and other staff also getting excited about making progress opening up in the building to then having to go back to square one was deflating. And that was just the staff. The residents who lived on the hallway of the person who tested positive for the virus all needed to get tested, themselves, which was neither pleasant, nor fun. On top of that, nurses had to stay longer than the end of their shifts to get these important tests done, which clearly took a toll on them, as well.

In addition to the hallways no longer containing foot traffic of any sort in them and losing their liveliness, there was also an emotional energy that seemed to have been sucked out of them.

Worry and Concern
While there is concern and worry amongst the staff about contracting the virus, as well, the amount of concern that residents have for contracting the virus in the same manner that the resident in question caught it is high, not to mention, the increased protocols to maintain residents’ safety from the virus is also tough for them – it is highly frustrating for them.

Providing a Pastoral Presence
Of course, this is where I come in as the pastoral presence, both as someone who is literally there for them, but also someone there for them to whom they can speak. There is a lot of fear, concern, and more – both of what’s going on inside the building, as well as what is transpiring beyond the walls of the building, including riots and spiking levels of COVID-19. Perhaps in a later post, I will share some common themes that I am hearing from the residents.

Beginning Chaplaincy Amidst the Covid-19 Lockdown and Its Limitations

Having begun my chaplaincy position at a senior living facility two months ago as of yesterday, it is no small thing to have done so in the midst of the COVID-19 lockdown.

Senior Living Facilities as Vulnerable and, Therefore, in Greater Need of Protecting
As the world is currently in a very different place than prior to the outbreak of COVID-19, chaplaincy is, as well. Of course, senior living facilities are particularly vulnerable settings for the virus. For instance, right here in the state of Ohio, 70% of all deaths from the virus have occurred at senior living facilities, so there is a great amount of concern about opening up facilities to both the public and even having the residents mingle amongst themselves.

Pastoral Education
Whenever I have spoken with other chaplains and I mention I have begun in this current position, they often suggest I take CPE units. Now this is all well and good, yet, I don’t know of any place currently offering CPE units for me to get such training. However, I received fantastic pastoral education while in rabbinical school throughout my years there, so I’m not coming in without any pastoral education; moreover, I also had years of experience of developing my pastoral skills working with young adults and college students in southern California.

Beginning a Book
Curious to learn more about chaplaincy and, more specifically, Jewish chaplaincy in a senior living facility, I recently purchased Flourishing in the Later Years: Jewish Pastoral Insights On Senior Residential Care, edited by Rabbi James R. Michaels and Rabbi Cary Kozberg. Having read a few chapters of this book over the weekend, there is a lot of great material in here and, certainly, has stimulated a lot of my thinking concerning my job and the care that I provide in that role.

5 “P”s
In his opening chapter, Rabbi Kozberg lays out 5 “P”s of Jewish chaplaincy: The Priestly Role, The Pastoral Role, The Pedagogic Role, The Prophetic Role, and Presence (“You Shall Be Holy: The Roles of the Jewish Chaplain in Senior Residential Care Settings”, pp. 20-43).

The Priestly Role, as Rabbi Kozberg puts it, is “to help residents ‘celebrate’ and sanctify time. Like their non-Jewish colleagues, they facilitate regular daily or weekly worship, special holiday services and other religious ceremonies for the various Jewish holidays throughout the year (e.g. Passover Seders, Hanukah candle-lighting, etc.). Within this priestly role, they help Jewish residents continue to mark Jewish sacred times, both happy and sad, and, thus, help them to connect both with God and with the larger community of faith through its sacred liturgy” (p. 24).

The Pastoral Role is where “the chaplain focuses specifically on the individual – on his/her particular circumstances, on feelings of despair and abandonment, as well as on the concerns of family members” (p. 31) and the chaplain “works to restore a sense of hope among those who are struggling and hurting, inviting them to partake of Divine compassion and empathy, particularly when they are feeling despair and abandoned by people and by God” (p. 31).

The Pedagogic Role is helping the residents “to maintain their intellectual and spiritual connections to the best of their abilities. He/she works to steer them away from the ever-present possibility of mental stagnation and spiritual alienation by offering ongoing opportunities to continue (or even begin!) to have a meaningful interface with the teachings of Judaism, so that the end of their lives will still have opportunities for increasing wisdom and nurturing spiritual growth” (p. 36).

The Prophetic Role is serving as “the conscience of the care facilities in which they serve. They personify the mission and values statements of the institution. As such, their role in giving input to both the administration and board of directors is crucial” (p. 39).

Presence is simply that, even “the chaplain’s presence alone – and not any role or task he/she performs – that often inspires residents to continue to hold on to hope and purpose by bearing witness to the religious truth that God has not forsaken these places” (p. 42).

Limitations on Roles During the COVID-19 Lockdown
While I am fuzzy as to how much I may or may not employ the Prophetic Role in my current situation, the Pedagogic Role is an interesting one in the current COVID-19 lockdown and one that I yearn to discuss in a future essay, despite the noticeable limitations on gathering for a class or other such discussion.

The Priestly Role, however, is something that – while it is certainly the most public and most noticeable role that people notice of the chaplain – it is not taking place at this time. It is almost totally not-existent during this COVID-19 lockdown. That having been said, there are still opportunities to deploy it, such as creating videos or finding videos to share with the residents on the facility’s internal channel. However, there are limited opportunities for that particular role.

Pastoral Role is Key During the Lockdown
With so much isolation from both friends and family, not to mention the limitation on activities, both the Pastoral Role and Presence are extremely valuable in my work with the residents. Even just being present and providing a fresh face and new energy are good enough. Yet, also being a willing listener and conversating with them, as long as they need, whether an hour or so, has a noticeably positive effect on their mood and disposition.

More Reading
Even just this first chapter was greatly stimulating and I have more to share on the other chapters, so I plan on sharing more from this book, as well as reading it.

Empathy for Those Less Technologically Adept, Especially for the Silent Generation

During this strange time of Coronavirus before a vaccine is developed, we are expected to stay in place, at home as much as possible. For those who are older, especially for those in senior living facilities, this time can be especially trying, since much of what keeps the rest of us in-touch with each other, whether social media, Zoom calls, or more are something that various generations – whether Gen X, Millenials, Gen Z, or even Baby Boomers – are able to use, yet those in the Silent Generation are either less technologically adept and/or not in possession of such technologies.

It can certainly be tough for some of these people, as they are not able to be connected with their loved ones or the world around them through the use of these technologies, as younger generations are. I feel sympathy for those who are confined to their rooms and have only books or television to entertain them or otherwise provide a portal to the outside world. Although they may have phones, that may be it. Yes, some of them may have hobbies, including artistic endeavors, but not all of them.

The lack of in-person social activities is a serious challenge not only to the social and emotional health of those in such demographics, but also the intellectual and even physical health of them. It is certainly a trying time for everyone, but I feel great sympathy for those in the Silent Generation at this time.

Considering a Curious Question as a Chaplain

As I mentioned in my previous post, I began a new job last month and have a received a question that has been popping up from time to time for the past few weeks, yet it now occurs on a daily basis.

With this week being my first without my predecessor, I have received this question on a daily basis, if not multiple times a day: “Which rabbbinical school did you attend?” as well as a different iteration of it: “Which denomination are you?”

While I understand a certain level of interest in the latter question, as to perhaps serving in a certain capacity or having a familiarity with their level of practice, I get a sense that they only want to see if I am “one of them”, whether it’s in observance or some sort of loyalty.

A similar sense occurs to me when they inquire as to which rabbinical school I attended. While I understand there is a local rabbinical school and many of the rabbis in town attended that one, so they may have some familiarity with the school and/or other graduates of the local rabbinical school, when I tell them I attended one in New York, they may ask me which one, but I get the same sense from them as before: do you have local ties to a familiar local institution?

I am very tempted to deploy a different tactic when answering these questions: responding with a question. I am very tempted to ask them “Why are you interested?”

I think this may work, since I am getting the sense as a chaplain that they may be more interested in sharing about themselves, especially as it relates to their previous encounters/experiences with other rabbis. As such, it is not worth their time nor mine to talk about where I attended rabbinical school, since their question is not actually about me, but about them.

Wish me luck on using this new dialogic tactic.

Flying Solo in Chaplaincy

Having started a new job several weeks ago, I have had the fortunate situation of overlapping with my predecessor, who was able to share her knowledge of the position with me, which has been greatly helpful. However, her last day was on Friday, which means I’m it as the chaplain at the senior living facility where I work.

When I reach out to other chaplains for advice, whether Jew or Gentile, a common refrain I hear from them is, “Take CPE units.” CPE, which stands for Clinical Pastoral Education, has units of 400 hours apiece, involving clinical work, didactic, and more. While I am very glad to hear that they took CPE units and greatly benefited from that training, there are no opportunities at the moment due to safety concerns arising from Covid-19.

Fortunately, though, I’m not chaplaining blindly, as I received excellent pastoral counseling training while attending YCT, my rabbinical school. While the training there did not count for CPE units, I certainly learned a lot of useful skills there relevant for chaplaincy.

Beyond my education, I also received great experience while in California working college students and young adults. While a different demographic, the people skills and listening skills I honed during that time were invaluable and helped set me up for success in other arenas.

I look forward to continuing to develop my pastoral schools while chaplaining.