COVID Pandemic Challenges Catholics Regarding How to Provide Better Care for Our Elders
Experts tell the Register that the tragedy of the death and suffering the health crisis has inflicted on U.S. seniors spotlights the need to implement new models that can better protect their health and dignity.
Mary Beth Bonacci thought she and her siblings had done everything possible to find a safe place for their 88-year-old mother to live, but all went horribly wrong when they learned she had been found dead outside her care facility.
For Bonacci, her mother’s death, after prolonged exposure to sub-freezing temperatures, opened a window into a broken elder-care system in need of significant retooling.
“I am discovering the enormous problems we face in senior care, particularly in the era of COVID,” Bonacci wrote in a heart-rending column.
Even before her mother died in January, Bonacci had taken her 97-year-old father out of an independent-living facility and moved him into her own home after a COVID outbreak had caused him to be even more isolated.
“He was by himself all the time,” she told the Register, adding that, now, “I can’t imagine leaving my father in a facility.”
COVID restrictions also had kept her mother from receiving the sacraments inside her memory-care facility, Bonacci said.
“The only exception in those six months was the one time I took her to the doctor and made a stop at a local parish, where she received the Eucharist, as well as reconciliation and last rites,” Bonacci said. “I was told that there was no way to bring Communion to the facility that would conform with Colorado health-department regulations for COVID quarantine. But, of course, it could have been done safely. The risk would have been so minimal in comparison with the benefit, especially for a devout Catholic woman we now know was in the last months of her life.”
Indeed, the COVID crisis has shed new light on the question of how better to care for elderly people both in their homes and in facilities.
New York Gov. Andrew Cuomo’s decision to move COVID-infected patients into nursing homes is one blatant negative example. But other governors’ restrictions have come under fire, as well, for the way they have isolated seniors and kept out family members who normally check on them.
In an open letter to Sen. Joe Manchin, D-W.Va., Charles Camosy, associate professor of theological and social ethics at Fordham University, said the pandemic has revealed decay in the infrastructure supporting the elderly. He called for a shoring up that will give families the resources they need to care for the elderly at home and rebuild the nursing-home system.
Besides an overhaul of the physical structures of nursing homes, Camosy said he would like to see families reimbursed for taking care of the elderly in their homes. Additionally, he suggested offering grants that would help pay for remodeling family homes to provide space for seniors.
Vatican: New Models Are Needed
In “Old Age: Our Future,” a recent document on lessons to be learned from the pandemic and their consequences, the Pontifical Academy for Life has observed that during the first COVID wave, death struck the elderly who were in institutions disproportionately more frequently than it did those in family homes. The document goes on to say that institutionalization of the elderly should not be seen as the only possible solution and that it would be better to use available means and financing to guarantee the best possible care in more familiar environments.
The academy proposes a new paradigm that helps society as a whole to care for the elderly and a continuum in which an elderly person’s care can be supported by new models providing home assistance, neighborhood health personnel and family homes.
Julie Trocchio of the Catholic Health Association of the United States told the Register that some such models already in place include the Village Movement, in which seniors who want to stay in their neighborhoods pay dues into an organization that uses volunteers and paid staff to provide various kinds of support and connections to services such as transportation. Similarly, Trocchio said, Programs of All-Inclusive Care for the Elderly (PACE) allows elderly people who might otherwise be in skilled-care facilities to remain in their homes by providing them with medical and social services coordinated by an interdisciplinary team of health professionals.
Lindsay Mullins, a family nurse practitioner who has done research on community-level healthy aging, said the concept of aging in place safely has been successful around the country and is helping more seniors stay in their homes.
Mullins, who holds the Sister Agnes Marie Fitzsimons Endowed Chair of Gerontology at Franciscan Missionaries of Our Lady University in Baton Rouge, Louisiana, said features of this model include the availability of public transportation, accessibility of outdoor activity, the presence of a social center and close proximity to food, clothing and medical services.
“That concept is one we’re seeing really help people to stay in their homes, stay connected socially and not have to go to institutional care,” she said.
The Catholic Difference
Whether care for the elderly occurs in someone’s home or in an institution, however, it should look different when informed by the Church’s values and principles.
“When the mission is to continue the Catholic tradition of service and the belief that you see the face of God in every person you’re treating, that makes a difference,” Trocchio said. “Tied to that would be the concept of dignity and respect for the life of every person … no matter how disabled, no matter what condition they’re in.”
She said Catholic values in care of the elderly can also include concern for the common good and the poor, hospitality and a sense of excellence that calls for providing the highest quality of service possible.
Mullins said respect for human life has the most impact on treatment of older adults.
“In American culture, we are drawn to ‘new’ and ‘shiny’ and ‘independence’ — all things that can be lessened as we age,” she said. “When working with students and community groups, one message we try to make clear is that every stage and age is a gift from God. And, actually, the more ‘seasoned’ a person is, the more valuable they are in sharing life lessons and in what they have contributed to their families and communities.”
That principle is especially evident in homes operated by the Little Sisters of the Poor, a community founded by St. Jeanne Jugan, who began her mission by giving her bed to another woman who was destitute and blind.
“We recognize the dignity of every human person as a child of God, an individual created by and loved by God, and we’re here to love them and give them attention and gratitude in their time of need,” said Mother Francis Gabriel, superior of the St. Augustine Home in Indianapolis. “These people have gifted our world with their presence, and it’s our time to return that gift and recognize God in them and treat them with the dignity and respect they deserve.”
Even though they care for the elderly in an institutional setting, Mother Francis said, the Little Sisters attempt to foster a family spirit in keeping with the principles of their foundress.
“This is something near and dear to us — that we have that same vision of creating a family versus an institution or medical facility,” she said. “It’s a home where family are loved and cared for, where they’re able to express themselves and be loved as they are.”
Coping With COVID
Much of that was challenged by the COVID restrictions, Mother Francis said, because gatherings within the facility, including the chapel, had to be limited. But she said residents seemed to understand and accept the restrictions. “What was beautiful about it was the concern one had for another during the time of lockdown, and that was totally enriching, as well. They cared for one another, bore one another’s burdens. Prayer was stronger than ever.”
When Gabby Garcia started working as activities director at the Little Sisters’ home in Kansas City, Missouri, and began learning about St. Jeanne Jugan’s vision, she said, “I thought, ‘Well, it is a very nice idea, but can that be done?’” What she has seen since between the sisters and the residents has convinced her that it can.
Sister Gonzague de St. Chantal, administrator of the Kansas City home, known as the Jeanne Jugan Center, said employees like Garcia receive training in how the Little Sisters care for the elderly, but benefit as well from the example of the sisters’ themselves. “Gabby has the spirit of the Little Sisters not because we preach to her, but because of what we’ve done and the way we do it and how she has picked that up.”
Garcia said she also has been struck by how the spirit the homes attempt to engender is often caught by family members so that they become attached to all the residents and want to do things for them, especially during holidays.
As homelike as their care facilities are, however, the Little Sisters firmly believe the elderly should be kept at home if at all possible. “A nursing home is not an ideal situation,” Sister Gonzague said. “It has to be a second choice because the place for an elderly person is with the family, not with strangers.”
Although much of the discussion about care for the elderly tends to focus on families, services and facilities, Mullins said parishes have a role to play, as well.
“Encouraging ‘healthy aging’ groups at church parishes rather than focusing only on help for the sick is another way of changing the paradigm of aging from one of negative to positive,” she said.
Mullins said she has collaborated with the Diocese of Baton Rouge on this by talking about ways to help older adult parishioners stay connected to the resources they require to live and adult children who may be caring for their aged parents. She also identified a need to help aging priests prepare for their retirement.
“What I saw was that, in a lot of parishes, programs for anointing the sick and visiting ill people were in place.” But, she said, “What about when people are not sick and dying? What about staying connected, informed, linked and sharing their knowledge and wisdom? How do we have more of that?”