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Even for nursing homes without COVID-19 cases, it's a time of change

Tribune-Democrat - 11/21/2020

Nov. 21--EBENSBURG -- Inside Cambridge Ebensburg Senior Living, a $1 million remodeling project repurposed one common area into a stylish 20-seat movie theater, Sales and Marketing Director Rebekah Stratton said.

A patio was enclosed into a "Hideaway," allowing family members outside the facility to reconnect with loved ones from the opposite side of an over-sized picture window while chatting via two-way baby monitor microphones.

But in these times, it's something the Ebensburg personal care home hasn't added that might make it even more distinctive.

It hasn't had a single COVID-19 case all year.

That's become a challenging feat.

Over the past month, the number of resident cases in Cambria County's nursing and personal care homes has more than quadrupled. Thirteen facilities across the area have a combined 254 cases.

In Somerset County, eight more have reported one or more cases, state Department of Health data show.

The death toll is on a sharp rise across the region, too, with one Johnstown facility losing five residents this month, according to the Cambria County Coroner's Office.

"We're proud of the proactive steps we've taken ... and the collective effort of our staff to keep the virus out of our facility," Stratton said of Cambridge's "zero cases" feat.

"But these are scary times. It's almost a matter of 'when.' It's basically inevitable."

'Most vulnerable people'

Across the region -- and the nation -- personal care homes, nursing homes and assisted-living facilities have been on the front lines of a deadly battle against the coronavirus, which has been shown to spread like an infectious net through indoor spaces where people gather -- schools, prisons and offices.

For those tasked with caring for a generation of older people -- many with health conditions -- it's even more dangerous, Pennsylvania Health Care Association President Zach Shamberg said.

"This virus is putting the nation's most vulnerable people at risk -- people who already have underlying conditions. And those are the folks we care for," said Shamberg, whose association represents long-term care, personal care and assisted living facilities across Pennsylvania.

"When we're starting to see 6,300 cases a day in Pennsylvania ... that's very concerning."

Cambridge Administrator April Adams said care-home officials understand that well.

They also have the dual role of making sure the residents they care for aren't the ones worrying -- and that they are still "at home" in their living spaces.

That's not always simple for residents who suddenly realize they cannot go on van trips or join their adult children for Thanksgiving dinner, she said.

That's when Carol Deetscreek goes to work.

Deetscreek, Cambridge's activity director, said she gets creative to ease residents' minds -- sometimes one wish at a time.

Safe at 'home'

Deetscreek made virtual vacations a weekly event, using the movie theater and its 85-inch screen to transport residents to special destinations.

On Wednesday, they toured San Antonio's vibrant River Walk.

A week earlier, it was Niagara Falls -- leading several residents to reminisce about family trips or honeymoons spent there decades earlier, Deetscreek said.

A tour of Hawaii ended with residents being treated to a luau at dinner, she added.

A resident-decorated "ticket stand" doubles as a photo booth.

"Whatever it takes to bring a smile to their faces, that's what I'm going to do," said Deetscreek, recalling times when she surprised a new resident with a favorite snack or cherished book.

Other times, it's about dialing up a family member for a quick Zoom call or booking a resident an appointment at the in-house salon, she said.

'Virtual environment'

After the personal care home introduced its "hideaway" to residents and families in the spring, residents decorated the space with her.

On Wednesday, it was dressed in earthy, fall shades of orange, brown and gold.

The enclosed visitors' side was brightened up, too, with a potted floral arrangement as the guest table's centerpiece.

"This place saved Mother's Day," Stratton said, crediting Deetscreek's creativity.

Shamberg praised those efforts in an interview with The Tribune-Democrat.

He said nursing homes have found ways to adjust to a "new normal" and thrive by developing new ways to connect residents and those who care for them through a "virtual environment."

Whether its a Zoom call between loved ones or a safe telemedicine visit with a physician, "these facilities are taking it upon themselves to adapt."

'A numbers game'

Cambridge, a network of personal care homes that first established roots in Warren, acquired the former Rebekah Manor in Ebensburg late last year and kicked off an interior and exterior renovation project it hoped to share with the community this year.

COVID-19 changed that.

Rather than welcoming local leaders for a ribbon cutting or open house, staff had to navigate an ever-evolving set of guidelines aimed at restricting who can enter the facility -- and above all, keeping residents healthy, Stratton said, during an interview inside a vacant, renovated personal care room that was decorated in a blend of blues and beiges.

Just as facilities across Pennsylvania, masks, temperature checks and wellness question "screenings" have become routine protocol at Cambridge Ebensburg's front entrance.

But to Adams, it's also been a mix of facility-level decisions and her 16-employee staff's willingness to fully embrace the culture change that has kept her facility COVID-19 free.

"One thing of pride for me is how our staff has responded to this," she said.

"We're all cognizant that what we do outside the facility can impact the people who depend on them here. Because this is their second home. They are thinking about residents first before they make an unnecessary trip."

"It's about the people we care for," Deetscreek said of her adapted lifestyle.

A colleague made the tough decision to miss a family funeral in Ohio because she worried about the consequences.

"It's a numbers game," Stratton said.

"The more exposure to other people, the higher the risk."

Family ties

That's even more true in areas where some people still dismiss the seriousness of the virus.

Adams said she noticed more frustration from families earlier in the year, noting it's natural that people want to see loved ones, particularly during these isolating times.

At their facility, they said they've placed an emphasis on making sure family members outside their walls know how to connect -- by phone, video conference or a scheduled "Hideaway" visit. And every update they put into place is shared with them through email, social media and phone calls, Stratton said.

That has helped alleviate fears, Adams said.

And it has helped family members adjust.

Until Monday, one-on-one, in-person visits were permitted at a designated room within Cambridge Ebensburg, although masks and no-contact guidelines were required.

On Monday, after recognizing the swift rise in cases in the area, the sudden decision was made to halt in-person visits -- a move the state has not yet mandated for homes without cases.

Adams said the response from family members was all positive -- gratitude even -- something that probably wouldn't have happened earlier in the year.

"This is a difficult situation," she said. "But we're all adjusting."

Help for the helpers

Shamberg said communication is vital at every level. He often hears from nursing home administrators or employees statewide that they also feel "isolated" when an outbreak occurs.

They shouldn't, he said.

He's trying to remind area care homes and assisted living facilities that help is there for them even on the most dire of days.

"If you're a facility struggling with cases -- if you're going through this the first time -- know that there are others who have gotten through it," he said.

"This is happening all across Pennsylvania and there are groups like ours out there to help you get through it."

In northeastern Pennsylvania, when an early wave of infections caused masks and other supplies to run dry, community leaders formed a group called the SOS Program and ended up delivering hundreds of thousands of dollars in personal protective equipment.

"Sometimes help comes from places you'd least expect it," he said. "But help is always there."


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