Opening Up Slightly Provides Noticeable Improvement in Mood [Chaplaincy Chronicles]

Having mentioned previously about the surprise COVID-19 case we had at the senior living facility where I work, I have some follow-up to the story, which is that there’s good news and there’s bad news. The good news was that the case was confined to just one particular resident, and the bad news is that this particular resident passed away, as a public letter on August 4th from the building’s administrator that was sent out to all residents, staff, and families said, “the resident who tested positive for COVID-19 has passed away at a location outside of” the facility. According to this letter, the administrator continues

What I can tell you is that this resident was sent to the hospital for an unrelated COVID-19 illness. They were not showing any signs or symptoms of COVID-19 at the time of their hospitalization. They were then tested at a later date during their hospital stay. Our contract trace testing that was conducted amongst our other residents and employees came back negative for COVID-19.

Following the discovery about that resident testing positive for COVID-19, all of the residents in that resident’s hallway were tested for COVID-19 and had to stay in their rooms for several days until the results came back. It was really unfortunate to see these residents having to stay in their rooms (or, as one resident called them, “their jail cells”), and they certainly weren’t even permitted to leave their residential wing. Morale had dropped precipitously – not only that there had been a COVID-19 case on their wing, but also that they had been told that visitations, the dining hall, and even the salon would be opening up the following week, but, instead, they had to be shut in their rooms for an unknown number of days and have those openings-up cancelled.

Fortunately, all of the remaining residents tested negative for the virus and in-person happenings were rescheduled.

Finally, last week, the facility was able to open up its assisted living dining room, was able to resume assisted living outdoor visitation with family, as well as for the first time in 5 months opening up healthcare family visitation outdoors, and even including some activities here, albeit with social distancing. This was some welcome good news for the residents.

The other week, I was beginning to feel optimistic, as I knew all these things were about to open up, even though no letters had been sent out to families, staff, nor residents, because the last time a letter was sent out, someone got COVID-19 and hopes for staff, residents, and their families had all been dashed, so no letter was sent out in advance of everything reopening. But, the other week, I was getting quite optimistic for the residents, even though there was still quite a down mood across the building amongst the residents. In conversations with residents, I was trying to impart optimism about things opening up, them getting to see a friends, and, after having 5 months of having meals served in Styrofoam containers alone in their rooms, they would be able to be served in a dining hall and getting to see their friends. Yes, I realize that they would be at least six feet apart, it would be hard to hear, be hard to talk, but at the very least they’re not cooped up in their own rooms.

A week and a half ago, I remember speaking with a resident before everything opened back up and she was quite concerned that we would have another COVID-19 case and have to close everything down again, so she didn’t want to get her hopes up about opening up again. Well, thank God, things went ahead – the dining room opened up last week and it was really exciting to see residents coming out and talking to their fellow residents. After these first two-and-a-half months of working at this facility and seeing the residents mostly in their rooms, it was really great for me to see the mood lighten up, as residents got to see their friends and talk to them, no longer needing to be confined to their rooms any longer. Sure, they need to maintain social distancing and face masks are required, but there is a sense of optimism in the air and a noticeable improvement in mood since I began.

I am looking forward to see how the mood continues to improve.

[The First] Tisha b’Av During Coronavirus Season

I don’t know what Tisha b’Av is typically like at the senior living facility where I am presently working, but I suspect that this year’s Tisha b’Av was certainly markedly different than any that had preceded it.

In my email to the department heads at the senior living facility at which I work, I mentioned that it was the saddest day on the Jewish calendar and a day in which we are not supposed to be involved in joyous activities. I then made the comment that it’s actually oddly and gloomily easier this year than typical, not only on account of social distancing, but due to our facility not having opened up to small group [and socially-distanced] activities (although the facility was to have opened up already, a surprise Coronavirus case happened at our facility). So, there were no activities at all, which was oddly appropriate for the somberness of the day.

Of course, as programs begin to take place and with social distancing, I’m quite confident that the mood will change amongst the residents, but, for now, it’s been it’s been still quite emotionally gloomy, especially as there had been a resident who recently contracted the virus, so there’s still a great deal of uncertainty moving forward – not only about residents’ physical health, but also their own mental and emotional health going forward.

To make Tisha b’Av even gloomier (on top of the literal gloom, as there was a gray and rainy day (that had broken through the many consecutive sunny days we had been experiencing)), there was even a death of a Holocaust Survivor in the building, which felt sadly appropriate for the day.

In future Tisha b’Avs, there will certainly be much more to deal with, including programming, but, for this year – the first Tisha b’Av in the Coronavirus era – it was gloomily quiet, and that felt uncomfortably appropriate.

Lacking Historical Context: Covid-19 Lockdown as the Baseline for Knowing Residents

Generally, Lacking Historical Context Coming Into a New Situation
One of the interesting limitations of starting at a senior living facility is meeting residents where they are, without any historical context of their mental health, emotional health, or physical health. True, one could talk to people and gain a familiarity with how healthy they were prior to starting in that position, but it is not part the chaplain’s experience with the person at that time.

COVID-19 Lockdown Serving as My Baseline for Understanding and Knowing the Residents
The lack of historical context is something that is all the more curious having begun this chaplaincy amidst the COVID-19 lockdown. One thing I hear about certain residents is how much the lockdown and isolation have exacerbated their dementia. It’s a really tough thing to hear, as they may be able to leave their rooms and perambulate around the grounds of the senior living facility’s campus, but otherwise remain socially isolated (unless they write notes or call friends (or, for the minority of residents, FaceTime or Zoom with family)), mostly either staying in bed all day and/or watching television. Of course, there is widespread depression, which is acutely felt in the assisted living side, less so on the independent living side, and the least felt on the healthcare units, but still noticeable on certain units moreso than other units.

Catalyzing Concerns
Another thing that I had heard was that the rate of death was higher than pre-pandemic – not because any residents had died of COVID-19, but because of the lockdown, stoppage of programming, and the social isolation causing them to worsen. Furthermore, when there is a COVID-19 case on the floor and residents are really not permitted to leave their rooms, much less their unit/floor, then, as one resident put it to me, their rooms are “their cages” or “cells”. I can’t imagine that it helps their situation.

Looking Forward to Post-Lockdown
For me as a chaplain, I don’t have that kind I don’t have the prior context to know how the residents functioned pre-lockdown, as I have only known them in this era, which is my baseline for knowing who they are and how they function. It would be really fascinating for to see when the lockdown is lifted and the Coronavirus is no longer a problem on the horizon to see residents’ mentally, emotionally, and/or physically improve, which would be a really fascinating phenomenon. Until then, of course, there will still be limitations on what takes place in this facility. How much longer the safeguards will be in place and how much further decline in the mental, emotional, and physical health of the residents remain to be seen.