“We’re hanging in there,” Pat Klouda says.
“That’s what we do best,” Reenie Reichel adds.
Both residents of Heritage Place, Klouda, 91, and Reichel, 59, spoke to the Clarion last week using Facetime — now one of the only ways they can have a face-to-face conversation with somebody outside the building — about adjusting to life during the new coronavirus pandemic.
Since the early days of the pandemic, the 60-bed skilled nursing facility in Soldotna has been closed to visitors.
The pandemic has been especially dangerous for nursing homes or long-term care facilities of any type. These facilities feature elderly, often with health conditions, living in shared settings.
As of July 30, according to data from the Kaiser Family Foundation, the 43 states reporting had 62,925 deaths related to COVID-19 in long-term care facilities. Long-term care facilities had 9% of the total cases in those 43 states, but 44% of the deaths.
On March 11, Heritage Place got a directive from the Centers for Medicare and Medicaid Services to completely shut down the building to visitors.
“We’ve been in that mode since March,” Sandi Crawford, administrator and director of nursing at Heritage Place, said.
Crawford said residents have not been able to touch family members since then. The only visits possible are when the visitor is in a small room in the entryway to the nursing home and the resident sits inside the building, separated by a pane of glass.
“It’s absolutely like a prison visit,” Crawford said.
The motto at Heritage Place is, “Dignity to all holds the power to heal.” Before the pandemic, that motto took the form of residents getting out into the community, and the community coming to residents.
“It’s like night and day,” Crawford said. “Prior to this, we had a huge community involvement and a huge volunteer program.”
Impressed with community
Despite the abrupt change in their lives, Klouda and Reichel are making do with what’s available.
Klouda, the treasurer of the resident council, has been in Alaska since she was 16.
“I lived in Anchorage when it was a small town,” she said. “When we had 5,000 people, we thought it was getting pretty crowded.”
Klouda moved to the peninsula with her husband, Fred, in 1985. Fred died in 2015 and Pat has been at Heritage Place for six years.
“I’ve been impressed with the good job they’re doing,” Klouda said of the staff at Heritage Place. “I can’t think of anything I’d do differently.”
In the wake of the shutdown, Heritage Place started a Love Thy Neighbor program in order to encourage the community to reach out to Heritage Place residents.
Klouda said reading materials, ice cream and flowers from the community have been very welcome.
With three children in Alaska, Klouda said visits also have been helpful.
Reichel, as she puts it, “grew up all over creation.” She was born in Pennsylvania and has had stops in Colorado, Wyoming, Minnesota and the state of Washington. She has been at Heritage Place for almost six years and is president of the resident council.
“For me, I am no longer able to go volunteer at the River Tower, which is an extension of the hospital,” Reichel said. “I miss that dearly. I miss going to see my people over there.”
At the River Tower, Reichel would greet patients, give them assistance on the elevator and call a cab if it was needed.
She volunteered three times a week. Two years ago, she received a pin for 1,000 volunteer hours. In April, Reichel was on track to get a pin for another 500 volunteer hours before the coronavirus intervened.
Reichel said she texts a lot with her sister, Kathy Brincefield. Brincefield’s daughter was in town last week and visited Reichel.
“Things are going as well as can be expected,” Reichel said. “Everyone is trying to make things as normal as possible.”
Procedures hold up
Heritage Place residents can’t be physically present with community members anymore. Aud Walaszek, the activities coordinator at Heritage Place, said the community still impacts Heritage Place in big ways.
“Members of the community may or may not be involved, but what they do has a great impact on us, directly or indirectly,” Walaszek said.
Direct impact is the Love Thy Neighbor program, where the community reaches out to residents.
Indirect impact is the actions the community takes to either slow or facilitate the transmission of the coronavirus. The number of cases in the community affects the quality of life for Heritage Place residents. The cases also either increase of decrease the odds of the coronavirus making it inside Heritage Place.
Heritage Place has 110 employees, though not all are full time. These employees live in the community, so they have the potential to bring the virus to work with them.
At the end of June, Crawford said all the employees and residents were tested for COVID-19. All came back negative. Employees continue to be tested every two weeks, as mandated by the state.
Employees also have a strict screening process before they are allowed in the building. They are asked about symptoms and take a temperature check. A normal temperature is 98.7 degrees. At a temperature of 99 or above, employees can’t enter the building.
Crawford said on July 4, an employee had a temperature of 99. The employee was sent for further screening and tested positive for COVID-19.
Even though the employee who tested positive had worked the previous two days, no other employees or residents tested positive. The event forced residents to quarantine in their rooms for the next two weeks.
“I can’t stress how committed our employees are to stay safe, especially the direct-care staff and CNAs,” Crawford said of the certified nursing assistants. “A lot of them have changed their lives outside of here to protect the elders they work with.”
Crawford also said the Fourth of July incident shows how careful employees are being inside the building as well. All employees wear masks all the time. Many residents aren’t able to wear masks, but residents stay 6 feet apart at all times. Hand-washing and sanitizing is frequent.
There is low staff turnover at Heritage Place. Crawford said that means employees treat the residents like family. That is more evident than ever during the pandemic.
“It’s a pretty miraculous testament to how careful we are being here,” Crawford said of the Fourth of July incident. “Masks work. Social distancing works. It’s all working.”
Go Be Kind
Case numbers do more than increase or decrease the chance of COVID-19 getting into Heritage Place.
“What degree and what phase we are in as far as opening and getting back to normal depends on the number of COVID cases,” Walaszek said.
Walaszek said she takes inspiration from Leon Logothetis, author of “Go Be Kind” and host of “The Kindness Diaries” on Netflix. Walaszek said in the Netflix series, Logothetis travels around relying on the kindness of strangers.
“Wearing masks, staying 6 feet apart and hand sanitizing is a method of going and being kind, not rights being infringed upon,” Walaszek said. “It’s thinking of other people and how it affects the residents in here.”
The toughest was the two-week quarantine. Crawford said the staff had to immediately adjust mealtime so residents could be served in their rooms.
“We have two girlfriends, two buddies, who always eat meals together and hang out together,” Walaszek said. “They couldn’t see each other. We had to set up iPads even though their rooms are back to back so they could converse and see each other’s faces.”
Until late June, Walaszek said Heritage Place’s Desination Dignity Bus — which can hold eight residents and two staff — was able to take residents to see the mountains, Cook Inlet and the beach.
“Right now, we’re not able to do that,” Walaszek said. “Residents are allowed on the patio and can walk and roll around the block.”
Crawford said Heritage Place is currently in Phase 1 of three reopening phases. Phase 2 would allow more visitation options and salon services to return.
When it comes to giving families more visitation options, Crawford said every day counts.
“With illness and what it is doing, some people probably don’t have that long with us,” Crawford said. “We’ve have five months of not being able to touch a loved one.”
Walaszek said it has been almost five months since the residents have had salon services.
“It was a morale boost,” Klouda said of seeing a stylist. “You get your hair done and you walk out feeling like you’re looking better. It gives you more confidence.”
Added Reichel: “Everybody needs a boost. Getting your mustache colored or your hair colored makes you feel better. You feel better if your hair is cut, especially the men.”
Abilities, not challenges
In addition to affecting residents indirectly by the number of COVID cases, Walaszek also said the community can still find ways to directly connect with residents.
Walaszek said this is beneficial not only to the residents, but also to the community member reaching out.
“It does something for yourself during this time when you’re at home with your kids,” she said. “It gives everybody a purpose. A family at home can’t do what they used to do, maybe they can’t play contact sports, but they can make homemade cards.”
Leah Eskelin, visitor services park ranger with the Kenai National Wildlife Refuge, said continuing to interact with Heritage Place residents during the pandemic has definitely helped her.
Eskelin has been doing a monthly program at Heritage Place for about three years. She would bring virtual reality goggles to share a place in the refuge. She’d also bring things like moose racks and berries so residents could touch, hold and smell a little piece of the outdoors.
When so much changed in March, Eskelin made sure her mission didn’t change.
“Everyone here at Kenai National Wildlife Refuge works with a mission in mind,” Eskelin said. “We’ve developed this community partnership between Heritage Place and the refuge to provide residents access to this public land.
“This is a unique community and we didn’t want them left behind or left out of anything.”
Eskelin was teleworking from home in March but she found a way, through technology, to up her presence at Heritage Place to once a week. She’s now using Zoom to go to different areas of the refuge once every two weeks and present to the residents of Heritage Place.
In addition to making her learn technology, Eskelin has learned valuable lessons as well.
“What I found in the unfortunate situation we find ourselves in is those who have risen to the top are flexible and resilient,” she said. “The creative nursing staff, especially the activities staff, they are inherently resilient, creative and adaptable.”
Eskelin said that’s because the staff focuses on the abilities of the residents — what they can do — rather than challenges — or what residents can’t do. She added that mind-set is important for everybody during the pandemic.
“It’s something that had to be learned and something a lot of people are not used to,” she said.
Missing the personal connection
Even with that said, Eskelin said it’s tough not to see the residents face to face.
Frank Alioto, director of spiritual care at Central Peninsula Hospital for six years, agrees.
“I definitely miss the personal connection, even with the great technology,” Alioto said.
In his role as director of spiritual care, Alioto also would also regularly go inside Heritage Place for a weekly church service on Sunday, one-on-one spiritual counseling, a spiritual book club and a sharing or memory circle once a resident passes away.
Alioto has not been able to get inside to do any of those things since March. Technology has filled the gap as much as possible.
“We’ve had a few Zoom memorials and sharing circles up on the big screen,” Alioto said. “I’ve led residents, family and staff through a funeral-type thing.
“It was pretty rusty in the beginning, but it worked out well. We had a family that liked seeing each other. They hadn’t seen each other in a while.”
Alioto also gives residents a look at the outside world. Thursday, he brought some residents into his home to celebrate his daughter’s 14th birthday. Residents also got to see sheep, chickens and baby rabbits on Alioto’s farm.
The youth group at Alioto’s church, Roots Family Church in Soldotna, has sent residents letters and greetings. Alioto also has still gotten one-on-one time with residents through iPads.
“It’s been harder to interact,” he said. “They pass me around on the iPad to different rooms and I would talk to residents just to check in. For many that aren’t that verbal, it’s hard to read their faces and hard to communicate back.”
He said he hasn’t seen some of the residents with the most medical and care needs for months.
“Even if they are low-functioning and may not understand what’s missing, they may know something is regularly missing,” he said.
As director of spiritual care at CPH, Alioto has seen the burden the isolation caused by coronavirus is placing on families.
“I have talked to other family members, even not so much at Heritage Place but at another local facility, who are in tears,” Alioto said. “They haven’t been able to see their mom in three or four months.
“It’s been really hard, especially with parents and people with dementia. They go four months and can’t see that person.”
Alioto said the staff at Heritage Place does a great job helping the residents, who are pillars of the community. He encouraged the community not to forget the residents by sending a letter, video message or praying for them.
Love Thy Neighbor
At one point during a Thursday phone interview, Walaszek was asked if anything is the same during this pandemic.
She dropped the phone and said to staff in the room, “Ha! He wants to know if anything is the same.”
She continued: “I don’t know if anything is the same. We try to continue the things that are important.”
For instance, bingo. (Reichel proudly notes she still gets to volunteer to call bingo, by the way.) With 6 feet of distance required between residents, some are forced to use iPads to play in a different room.
Also, if a resident has to make a hospital visit, that resident must be quarantined. One resident being quarantined was always in a prayer group, so she had to join via the iPad in her room.
Since March, gone are the days when residents could take the Destination Dignity Bus to Fred Meyer and have volunteers assist with shopping. When classrooms could drop by for a visit. The 4-H club could bring animals. A child pianist could give the residents a recital.
When a community connection lunch could get seniors around community leaders and hatch ideas like paving the paths at Soldotna Creek Park so Heritage Place residents could use them.
When residents could make items for silent auctions happening around the community.
“It was a great life, all things considered,” Walaszek said.
With that life gone for now, Walaszek said the mission remains to connect everybody inside Heritage Place and make sure they are not invisible in the outside community.
Walaszek is proud the residents recently showed their commitment to remaining a part of the community by raising $2,400 for Alzheimer’s awareness in an online auction.
The activities coordinator also said Heritage Place has taken advantage of the new existence by upping its gardening game.
The Love Thy Neighbor program also has been facilitating connection, with flower donations, homemade cards, shared magazines and ice cream events where residents get to choose their own toppings.
“We’ve gotten beautiful flower donations,” Walaszek said. “You can’t imagine, just taking a flower into somebody’s room, how it lights them up.”
Walaszek said anybody with a talent to share is welcome to do it over Facetime, whether it’s a piano recital, science experiment or a collection of art.
There are restrictions on what Heritage Place can accept. For instance, homemade food is not accepted. Walaszek said those wanting to participate in Love Thy Neighbor should contact her at 907-714-5039 or firstname.lastname@example.org.
Walaszek said as people are learning what is possible, special moments are happening.
Reichel had a friend at the nursing home who died in late February. Every morning, Reichel and the friend would have coffee together. The friend’s family also would bring dinner from time to time and invite Reichel to join them.
Walaszek said the family recently learned they were allowed to bring coffee to Heritage Place.
“They just dropped off this big package of coffee,” Reichel said. “They said they wanted me to keep up with the coffee every morning.