NEW YORK — As the COVID pandemic enters its 22nd month, elderly men and women continue to bear the brunt of sickness, death and isolation. They are weary but holding steady, whether at home or in nursing homes. Meanwhile, caregivers are burning out due to a situation where many in the nursing-home industry have quit their jobs, leaving fewer people to care for this most vulnerable segment of society.

The onset of the pandemic hit the Little Sisters of the Poor in New York very hard. 

“In March 2020, many people on staff started getting sick. It was hard for people to obtain a test at the beginning, so we had to furlough staff based on symptoms,” said Sister Raymond Marie of the Little Sisters of the Poor Jeanne Jugan Residence in the Bronx. “It was very difficult.”

Staffing issues took place immediately. 

“Some nurses and nursing assistants, petrified with this unfamiliar, unseen and lethal enemy, quit with no notice. Fortunately, Mother Provincial sent us help in the form of several extra Little Sisters to help us meet the staffing crisis,” she said.

By order of the state of New York, the Little Sisters had to close their residence to family visits for five months. Communal dining was also suspended for many months. During this time, family members would come to the residence and speak to their relatives through windows and/or a phone by the window. On Aug. 24, 2020, visitor areas were set up where family members could come and sit six feet apart.

“Rules have changed so many times. It has been challenging keeping up with the innumerable changes,” said Sister Raymond Marie.

Today anyone can visit, but they must show a negative COVID test from the previous 24 hours. Visitors are not required to be vaccinated but must wear masks. The Little Sisters worry about COVID infections from these visits, while also realizing how good it is for residents to see their loved ones.

Only three residents have tested positive since the onset of the pandemic, and all recovered fully, according to the Little Sisters. Part of the reason residents have been safe from COVID is that each has his or her own room.

“We had also been working on infection control months before the pandemic. So we were constantly having spot checks on hand hygiene,” said Sister Raymond Marie. “I know that God protected us.”

Right now, the sisters are getting calls every day from staff members who have been infected by the Omicron variant, so they have staffing challenges again. Many people have quit working in nursing homes altogether because they don’t want the vaccine or don’t want to work in such a regulated environment. The Little Sisters lost staff to Calvary and Montefiore Hospital in the Bronx because of their better benefits.

“The residents who have advanced dementia do not really know the difference between a world with COVID and one without it. For residents who are well, cognitively speaking, much depends on their attitudes,” Sister Raymond Marie said. “If they are other-oriented, have various interests, then the restrictions imposed by COVID have not been quite so devastating.”

Sister Raymond Marie noticed one elderly person with an underlying mental-health issue experience a radical change in personality with the initiation of the quarantine. For some of the residents, seeing staff with masks on means not recognizing them. For those inclined to depression, COVID has made things worse. So the staff invented creative ways to keep the residents engaged.

“The activities took a very individual twist during times of quarantine. Door-to-door activities included karaoke, internet games, bowling, horse races, word games, adapted fishing, basketball hoops, and many others. These activities united staff and residents while alleviating some of the difficulties resulting from the isolation caused by the virus,” said Mother Gertrude, mother superior and administrator of the Jeanne Jugan Residence.

Today, the Jeanne Jugan Residence comprises eight sisters who are physically able to care for the elderly. Their facility has capacity for 30 residents, but they have decided to put a hold on admissions because of staffing difficulties.

“We have not admitted anyone in the last two years because we want to be sure we are able to care well for the residents we have,” she said.

 

Down in the Heart of Texas

Chris Martin founded Cross Healthcare Management company in 2019 with his cousin-in-law. It is a company that owns and manages nursing and rehabilitation facilities in Texas. On any given day, they take care of 275 elderly men and women. Martin is also known in Catholic circles as one of the Rome Boys, a Catholic podcast and YouTube show that focuses on evangelization.

“When COVID hit, we were just buying our first nursing home on March 1, 2020. That nursing home was locked down, with no church services and no family visits for six months,” said Martin.

The rules for operating nursing homes seemed to change every day during the last year and a half — with seemingly often contradictory regulations coming from the Centers for Disease Control and state and federal government.

“It was terrible,” said Martin. “We — nursing homes — have the highest regulations of any other industry. Even nuclear facilities have less regulations than nursing homes.”

Today the facilities are still operating under regulations whereby all visitors need to wear masks. In the past, negative COVID tests were needed. Texas has never required that visitors be asked about their vaccine status.

Nursing-home residents have had to eat in their own rooms — instead of the dining rooms — for a year and a half. Religious services resumed at the end of 2020, according to Martin.

“In 2020, they opened up ECGs — essential caregivers. This could be anyone caring for an elderly person,” he said.

The ECG rules were from Texas’ Health and Human Services Department, but other states have similar rules. Every resident in a nursing home could designate two ECGs, but they could never visit at the same time. If one died, they could not be replaced.

In terms of how the elderly have fared during the pandemic, Martin has noticed an increase in bedsores directly related to decreased care. This occurs when patients are not turned over enough in their beds and injuries occur in a body’s pressure points. 

“The CDC and HHS made a rule that said that the caregivers should limit their interaction with the residents and go into the resident rooms as little as possible in 2020,” said Martin. 

Because of this, nurses and aides were scared to see patients at the height of the pandemic because they could possibly infect the elderly or catch COVID from them and bring it home.

“When COVID hit, there seemed to be a lack of concern from regulators for the quality of life of the elderly. Everything went out the window that was important for their mental health. It devastated our residents and health care workers, and it burned them out,” said Martin.

Because so many people quit working in nursing homes across the nation, people have had to work in shifts, often twice as hard because there are less people working. There are half a million jobs available in nursing homes, and more than one million in all direct care: nurses, nurse aides, medication aides, etc., in hospitals, home health and nursing homes, according to Martin.

“In 2021, we had over 100 cases of COVID in our facilities; 99% of those cases were people who were vaccinated. Only one was unvaccinated,” he said.

The general consensus among those working in the nursing-home field is that the elderly come from the toughest generation.

“The generations before us are very resilient and have gone through things we never have,” Martin said. “One woman in one of our facilities lost eight siblings to the Spanish Flu. She said, ‘This won’t take me down. God will take me when he wants to.’”

Besides irrepressible nursing-home residents, Martin said he takes comfort in his nursing homes’ staff.

“Our staff has been amazing. They are an example of the human spirit. They show how people should behave towards the outcast and forgotten,” he said.

 

Working in Westchester County, NY

Mary Stein has been working as a nurse for 40 years in Westchester County, New York. She has worked as the head of nursing at the Osborn, one of the county’s premier senior-living communities, and has worked at Burke Rehabilitation Center. She is now teaching nursing at Iona College in New Rochelle.

“COVID has affected every single layer of society. It is a four-pronged problem: It is a medical crisis, it is a health system crisis, it is a public-health crisis, and it is a mental-health crisis,” said Stein.

Steain said, in the beginning, things were very bad in the facilities where she worked because no one understood the disease. The only people allowed to come into the facility were the staff — many of whom lived in intergenerational families and who took different forms of transportation to get to work.

“So there was a constant threat from the outside that COVID would come in,” she said, and many residents did contract COVID and die.

“The problem with COVID is that many of the elderly already have underlying health conditions. So COVID was like a peg being pulled out of a building block,” she said.

Another major problem Stein pointed out during the height of the pandemic was that the elderly could not get into hospitals to treat other issues, like strokes and heart conditions, because hospitals were full of COVID patients. 

“People died trying to get into the hospitals,” she said.

 

Isolation

One of the biggest issues, according to Stein, has been the feeling of isolation for elderly who are not able to see their families.

“There is a sense, for families, when things are going well with an elderly parent. But it is important not to lose that connection. When visitors were not allowed, families had to rely on Zoom or video chats. But if the elderly got depressed, and the situation worsened, you could lose your pulse on the problem. And this is very disturbing for families,” said Stein.

One sad anecdote is that when visiting resumed at one of the facilities where Stein worked, families were allowed to visit with their elderly parents outside. However, they were not allowed to kiss or hug their relatives but had to maintain six-feet distance.

“If you are cognitively intact, there is a level of depression and feeling of isolation,” Stein said. “If you aren’t cognitively intact, you miss the stimulation.”

She added, “It is a terrible situation that is going on, but we have to remember that this generation has been through worse. We have to remember who we are dealing with. They built this country.”

 

Bright Light Amid COVID Darkness

Mary Brown Wynne is a 98-year-old resident of the Jeanne Jugan Residence in the Bronx, New York. According to Little Sister Raymond Marie, Wynne has been one of the bright lights in their facility during COVID. Every night she comes to the dinner table with an article or a book to discuss with others what she has learned.

When asked how she felt about COVID, Wynne responds in a slow and steady voice: 

“I think that COVID has turned the whole world upside down and inside out, from children in elementary school, middle school and high school, and all adults,” she told the Register. “I wouldn’t want to be a parent right now. I am glad that I raised my three kids and did the best I could. I think COVID has made life difficult for work and travel. It has been hard on families. I worry about my grandkids, who live in New York state, all the time.”

Wynne said she does not feel depressed, however.

“I am pretty strong. I love being in this residence,” she said. “It has made my life so much easier. I am studying so many things now that I didn’t have time to before. I am learning the Gettysburg Address. I almost have it memorized. I am also reading a book of poems called America for Me. I enjoy learning new things every day. I love listening to radio talk shows. I love my new life.”

When asked about her faith, Wynne is steadfast.

“I am 98, and it’s not easy. But I follow the rules of life,” she said. “There is a right way and a wrong way. I have my faith, too. I believe in God and the Church. I follow the rules there, too. That helps me cope.”

— Sabrina Arena Ferrisi