By Paul Kaplan
On March 17th I was told that the development staff needed to join a training session to get certified to feed residents. The sense was that “social isolation” would mean we would soon stop using dining rooms on each floor and begin delivering meals room to room. There was also the possibility that staffing shortages would mean we’d be asked to feed certain individuals. I really didn’t give any of it much thought; it was a welcome distraction from calls to prospective donors in support of our annual campaign and would provide some interesting insight into what the frontline workers at the Jewish Home are doing day-to-day with the elders in our care.
It turned out that serving room to room was more than the already busy nursing staff could handle and I was recruited upstairs with my development coworkers to help out. We served the residents by pouring coffee/tea, stocking trays with yogurt, cereal and eggs and were off to deliver room service. I saw it as a great chance to see just what happens on the units and get to know the people I was helping raise money to assist. Stories are like lumber to a carpenter or clay to a potter, it’s the way we educate, build relationships and inspire donations and I was happy to get some more first hand.
I found that the level of detail the Certified Nursing Aids (CNAs), nurses and dietary staff knew about the preferences of each person to be amazing. They knew who wanted coffee and tea, who needed their eggs scrambled or poached and that Alan needed two sugars, three creams and hot water so he could mix in his own instant coffee packet. At the Jewish Home we call this type of concern for everyone’s preferences and needs “deep knowing” and I had spoken about it many times with donors, but never saw it as more than just a buzzword.
The days went by and everything was fine. My unit, as I had now started calling the Rubin Wing was the “safest” place in the building. Like so many other nursing homes, we took all the precautions we could, but COVID-19 snuck in and began creating quite a problem. Still in our safe oasis from the crisis I delivered meals, opened milk containers, mixed coffee and made cheerful banter to try and break up the boring isolation for the residents. As the worry began to grow and the virus spread I even dressed as an inflatable dinosaur to cut the tension among the staff and seniors. I made the rounds and asked, “How are you doing?” and “Much better now that you’re here” was the popular response. Then when leaving a room I’d say that today’s my birthday, “Oh yeah, really?” “Yeah! I’m two million years old today!” I’d respond. Anything to create a distraction. I had no clinical responsibilities so like a clueless Patch Adams I could easily act the clown.
Every night I would tell my four kids about everyone I met that day. Elaine and her dementia, always asking “Where am I supposed to be? Which is my room?” and Olga from Cuba who would answer my “Coma esta?” with more explanation than I could understand. Mrs. H. who was furious EVERY day of Passover that she couldn’t have toast. I sat with Barbara and listened to her complain and I would ask her questions about her life. The Polish lady who survived the Holocaust and had an aide help her eat every day. Mr G. who wanted two coffees and Mrs. P. whom I had met in one of our boxing classes months before. The second I got the gloves on her, she nearly knocked my head off trying to hit the bag! They loved to hear my stories.
Then just before Passover little pink signs started appearing on room doors that said, “Droplet Contact Precautions.” I would quickly begin to dread seeing these pop up. It meant that our unwelcome friend had also slipped into Rubin. Around this time, meal delivery was also getting busier and busier, as our staff was also getting hit with this virus. Beloved staff members would suddenly not be at work followed by word of hospital visits and requests for prayers. A few non-essential staff with preexisting conditions began working from home to keep themselves safe, but as a healthy 42 year old I was needed to continue my extracurriculars. In addition to soliciting for our COVID-19 Emergency calls, annual gifts, mailing out Passover cards and stuffing the mailing for our possibly doomed golf outing, I continued to dress up for work on my unit.
Each week the dress evolved. Nursing homes aren’t accustomed to this level of infection control. As the CDC released new guidelines, backed by the dollars we were raising, leadership would scramble tirelessly to quickly purchase personal protective equipment, gowns, N95 masks, face shields, etc. By now you couldn’t tell if I was off to operate on a ruptured appendix or serve an omelette to Carol in room 284. It was also about this time that, to my relief, I was forbidden from going into the COVID+ rooms. The worst of the spread seemed to happen hard and fast. Elaine suddenly was no longer wondering and refused to eat or get out of bed, our Holocaust survivor stopped eating right about the time her aide stopped coming in because she was afraid. Benni who was always singing to himself was quiet and despondent. I spoon fed a woman her soup so she could build up her calories rather than rely only on Ensure. I argued with Elaine to get up and eat breakfast. “No, Elaine, three more spoonfuls then you can lay down,” was our regular conversation. What else could be done? Things felt so out of control, could we keep them all safe? The nursing staff were amazing, so professional and caring. Their hard work and dedication would come to save many lives.
If my memory isn’t failing me, Tuesday Mr. G. was tested for Covid and Wednesday morning his door was closed with a pink sign. I skipped him for someone else to deliver his meal and when I got back to the kitchen area learned that he had died about an hour before.
I’ve worked for nonprofit nursing homes going on five years now, people grow old here and people die here, it’s natural. We provide them with dignity, care, socialization and love. But they don’t go like this. Something about this was just awful and unnatural, so many pink signs and now someone I had gotten to know and spoken to many times was gone. It was dizzying, the collapse of the economy, my wife out of work, fights with family to stop traveling, the worry, the stress, the hell of it all. I finished up and just sat and fell apart in my office.
This was April 8th, Erev Passover. My kids needed a fun and festive Seder in a few hours and our Seder is pretty damn awesome. We sing our way through the Haggadah and acted out Moses parting the red sea; with the three year old, Leora, as Moses holding a staff (broom), but I was emotionally shredded. I texted my friend who is an MSW, interrupting her Seder asking if she could talk me through all this in the morning.
The Seder is a bit blurry, we definitely did the four questions and I think the kids just fought when we tried to do the skit. In all the insanity of the world falling apart I had forgotten to buy wine, how I needed those four cups of wine.
The next morning my dear friend talked me down and reminded me that I’m not trained as a healthcare worker, I have no experience to pull from for all this and that what I’m feeling makes sense and is really, really intense.
At another point during Passover we lost our beloved resident, the boxer, for some reason I felt obligated to write her adult children a condolence note. I just wanted them to know that I saw their Mom when no one else was paying attention and I saw her get excellent care, that at the end she was not all alone, that she was loved.
We got through Passover and Mrs. H was very happy to get her toast and our isolation unit continued to grow and whispers of other deaths came, too. About a week or two later something I found unexpected started happening, I started hearing about people getting better. They were from the units that were the first to be hit and it sounded too good to be true. Then out came Mr. J. from the isolation unit and did the staff ever celebrate! Music and cheering, the poor man didn’t know what to think! That’s how things started to go. Our Marketing Director made up diplomas for each of our “COVID WARRIOR Graduates” and pink tags began popping up less and less until there were none at all. During this new positive “peak” we celebrated two or three times a day with someone coming out of isolation. I would tell my kids about it every night, that I witnessed a miracle – no different than Moses (Leora) splitting the red sea with his (her) staff (broom).
My unit is now COVID free. Sadly, one of my new friends was gone and of the last three remaining people in isolation, two have fully recovered. One moved to our last remaining isolation area in the facility, a bittersweet success. I said goodbye to everyone on “my unit” yesterday. I’ll be sure to visit regularly to keep up with all my new friends. This experience has certainly better equipped me to tell the stories, to bring to life challenges we are fighting and the successes we are having. In addition to the self-sacrifice and hard work of our staff, it was donor support that financially put us in the position to help so many, so quickly. That’s a great story to tell and that’s what my job is all about.
Paul Kaplan is Senior Development Associate at Jewish Home Family, Rockleigh, NJ. [email protected]