The Morning Journal (Lorain, OH)
Nursing homes respond to crisis
State closed doors March 11
March 11, 2020, was the day Ohio ordered nursing homes to shut their doors in an attempt to protect older adults from the spreading novel coronavirus.
Feb. 26, 2021, was the start of Beach Week at Independence Village, which has independent living, assisted living and memory care in Avon Lake.
After almost a year of pandemic questions, restrictions, isolation and loss, Beach Week was a chance for levity with margaritas and sand.
Literally, 28 bags of it in a first-floor alcove. The makeshift seaside celebration culminated in residents burying Executive Director Mark Sajna up to his neck.
“It was pretty comical,” Sajna said.
With health precautions and now vaccines beating back COVID-19, Sajna and other residential facility leaders said conditions are getting better.
But even after a year of coronavirus, the administrators, caregivers and residents still are learning, and some are grieving.
“There was no playbook for this,” Sajna said.
In the beginning
In January and February of 2020, the administrators said they heard about the novel coronavirus, but it was more a curiosity than a looming threat.
Sajna recalled talking about it in February at the parent company’s executive director meeting in Louisville.
“We had a big conference together, we weren’t masking, no one even thought about that,” Sajna said. “I think about how much that changed from that late February conference to midMarch.”
When early reports came out about deaths at the nursing home in Washington, local caregivers felt horrible for them, but were uncertain if it would make it to Ohio, said Jill D. Herron, administrator of Welcome Nursing Home, with 99 residents and 135 staff in the Oberlin facility.
“I felt like, oh, they’ll have it figured out by the time we have to deal with it,” Herron said.
Shutting down
On March 10, 2020, the last open day, Welcome Nursing Home notified families about the shutdown the next day, said Herron and Heidi J.W. Freas, its quality assurance director.
“We literally locked our doors and they haven’t been unlocked since,” Freas said.
They expected a twoweek lapse in visitation — and even that was a disruption.
Some residents had family members who visited daily for conversation, meals, walks in the halls.
“It’s still overwhelming to even think that we’ve endured a year of this when our focus so much is resident centered and family, homelike environment,” Herron said. “That’s what our culture is here.”
“These residents, this is their home, some of them have lived here over 10 years,” Freas said. “It has been a huge change.”
Wesleyan Village in Elyria has more than 400 residents and 350 workers.
“One of our biggest challenges, being the property we are, we have 25-, 30-plus entrances and exits in our building,” said executive director Stephen Wolf.
“We are very engaged with the community and our families, friends, loved ones,” Wolf said. “And to be able to come up with a plan to lock down our properties that we had, or controlling one way in and one way out, to be able to securely and properly check our staff, our families and residents was one of the biggest hurdles we had to accomplish.
“And I was very proud of our staff to be able to come up with a plan and a system to get that accomplished and then monitor it through this whole time.”
Daily living
After the initial scramble for masks, gloves, gowns and face shields, Sajna began daily meetings with the dozen managers at Independence Village.
“It’s all that old fashioned teamwork, which we have and I’m proud of,” he said.
Some tasks were not medical emergencies, but were necessary.
At Independence Village, bills went up for foam boxes for meals delivered to residents no longer gathering in the dining room.
That pushed up the trash bills to dispose of them, Sajna said.
Adults don’t stop living when they move in, he added, and acknowledged the facility also purchased more alcoholic beverages for residents who wanted to drink them.
Into the summer
The facility leaders described window visits and online communications. Independence Village had a number of events and later opened a ground-floor model suite for socially distanced visits between residents and families.
Freas described an occasion when her daughter brought her horse around Welcome Nursing Home.
Online communications were steady, if not as satisfying as real meetings.
Wolf said his father lives at Wesleyan Village and his mother did until her death in August. Her death was not COVID-related.
Wesleyan Village did whatever they could to set up online visits, Wolf said.
“I firsthand know how tough it is to have a parent living here,” Wolf said. “For others … it took an emotional toll for everyone, not only residents, families, but also staff in regard to feeling sorry.”
Before COVID-19 tests were widely available, everyone was watching out for symptoms.
Welcome Nursing Home staff had a daily regimen to check residents for fevers and changes to pulse-oxygen rates.
July 21 was the first time Ohio National Guard members could assist with a comprehensive test of all staff. All were negative for COVID-19, Herron said.
When employees began testing positive, they would go into isolation for two weeks away from work and residents would get tested every three to seven days.
COVID-19 arrives
Independence Village had its first resident positive case in October, Sajna said.
“Panic — holy cow, what do we do now?” he said. “And then after a few minutes of terror, what are we going to do?”
The facility sits less than three miles north of the Cleveland Clinic Avon Hospital, which had its own COVID wing, Sajna said.
Notifying family members was not easy, he said. No one was “super angry,” but were concerned about their loved ones, other residents and staff, Sajna said.
The worst outbreak came after the start of 2021 — just as Walgreens received vaccines to administer to residents starting Jan. 6. Now 99 percent of residents and at least 70 percent of staff have their shots, Sajna said, including himself.
Time to prepare
Dec. 2, 2020, was the first positive case among Welcome Nursing Home residents, Herron said. The resident was asymptomatic.
Happening late in 2020 gave staff time to convert a storage area to a six-bed isolation unit, Herron said.
“It was almost like we had a second nursing home that we had to schedule and staff, that was the COVID unit,” Herron said. “We were so hopeful it was going to be one and done. We knew that was probably not the case.”
Nursing Director Nikki Beck “garbed up” and volunteered to work there 24 hours a day, treating the resident and formulating the plan to staff the COVID-19 wing.
‘Overwhelming, exhausting’
Despite the best efforts of residents and staff, COVID-19 would spread.
From Dec. 2 to Jan. 11, 55 residents tested positive for COVID, with up to 32 people having it at one time.
Since Dec. 2, Welcome Nursing Home has lost 18 residents.
Many of them beat COVID-19, but suffered severe health declines in the following weeks, Herron said.
It was overwhelming and exhausting, Beck said. Residents looked ill and masks did not conceal grief on the faces of staff.
“It’s really lonely, I tell you. One night I told God I was ready to go. I told him, take me if it’s your will. He spared me. I thank God for that.” — Welcome Nursing Home resident David Smith, 72, a widower
Without belittling the experiences of military men and women, Beck used an analogy to describe what she called her worst experience in 22 years of nursing.
“It felt like we were at war,” Beck said. “But at the same time you could see the silver linings of how our staff shined and the love and the care, just dedication and self-sacrificing of so many of our staff that went into taking care of our residents.”
‘Lost my friends’
Welcome Nursing Home resident David Smith, 72, is a widower who was born in Cincinnati. He and his wife lived in Tennessee and Cleveland, where they worked making steel tubes.
The pandemic was difficult even before he tested positive, Smith said. As a Christian, he missed weekly worship at Kipton Community Church.
“I couldn’t go, that’s my number one thing,” he said. “And I lost my friends.”
Smith recalled another resident he would seek out for “friendly arguments” each day. “And I can’t believe she’s gone,” he said.
“When I go out in the hallway, I look for her,” Smith said. “She was a blessing to me.”
A three-year resident at
Welcome Nursing Home, Smith did not know exactly how he got COVID-19. He could not recall the exact day in January when he went into isolation.
“It’s really lonely, I tell you,” he said. “One night I told God I was ready to go. I told him, take me if it’s your will. He spared me. I thank God for that.
“I’m glad I was here when it happened,” Smith said. “They knew how to separate us and take care of us.”
Heidi J.W. Freas, Welcome Nursing Home quality assurance director, snapped a selfie while wearing a full complement of personal protective equipment at the Oberlin facility during the novel coronavirus pandemic. Welcome Nursing Home and residential facilities across the country locked the doors to visitors in 2020 to avoid spreading COVID-19.