9/3/2020

Like much else in our economy right now, there is a push to re-open assisted living homes and nursing homes. Last week, I joined a group of nationally recognized professionals discussing just this topic.  Everyone on the 6-a.m. call wanted to advocate for the many struggling families and their elders. 

I came into this discussion because I got frustrated and angry. After spending several days obsessing over video lectures and Facebook posts that blamed facilities for mistreating elders and their families and venting to my Vista family and friends, I sent an email to the Positive Approach to Care (PAC) about their Community Care Circle Round Table Discussion. Positive Approach to Care, founded by Teepa Snow, has developed deeply meaningful approaches to Dementia Care for decades. This group has focused on showing elders facing dementia respect and compassion and is an amazing resource.  PAC has also been working with families to face the many painful issues that have arisen due to COVID and the isolation procedures that this virus has brought. My thought was that my email would either just get deleted or ignored. The opposite happened. Vista was invited to join this discussion about “Creating a Map for the Future During COVID” that respects elders and families. What Vista offers is a way to both protect elders and nurture families while allowing elders to have a vital, connected and joyful life.  

That same day, our governor, Michelle Lujan Grisham, announced re-opening with guidelines for counties that met criteria of decreasing cases. Part of the written guidelines for re-opening elder care facilities read as follows: “If you’re visiting your family member through an open window, notice the smell of the room, observe your loved one’s physical well-being and their hygiene, and if you notice anything amiss please contact our State Ombudsman at 1-866-451-2901.”   

The debate on re-opening elder care is painful to watch at times. Sometimes I feel like we are being pulled in a thousand different directions, without knowing how to balance everything we need to do with what we should do. What’s worse is that the re-opening discussion often pits families against caregivers and facilities, which quite simply does not work. Caregivers, nurses, managers, families, even owners are not the enemy. Everyone I know that deals with elders in any capacity loses sleep, cries, curses, and worries over COVID’s impacts. While I know there are facilities out there that stop communicating or don’t make the effort to maintain a happy or safe life for elders during COVID-19, my experience has been different. Yet the tendency to only focus on facilities that are failing eclipses contexts in which caregivers work hard, and where there is bravery in elder care. It’s true that eldercare, especially now, is categorized as toxic and negligent. But what about shedding light on other, more successful models where deeply loving, smart and focused care is ongoing? For for those of us who are trying to do the right thing, this debate and focus on negligence is exhausting. Institutions that refuse do the right thing can, at the same time, be excused by saying that subpar elder care is just the way it is. It is not. Every day I see staff at Vista Care in Santa Fe and Las Cruces, as well as people throughout Santa Fe, and our country, who are working very hard to shepherd connection, find joy, and give hope. Team member and family support takes many forms: Installation of water misters to make window visits comfortable in the southwest heat, making postcards, searching for proper PPE constantly, dropping off soup, desserts or vegetables from the garden, holding I Pads and telephones or just saying thank you. We all need to keep doing these things time and time again with no end in sight.

I looked at my notes from the last staff meeting and realized that, while we were talking about canopies, microphones, systems, food, masks, gloves, and practical day-to-day stuff, we were also exploring something very different. We were talking about sanctuary. We were talking about creating a place of refuge, and of safety. We were exploring how to be “shelter from the storm” for an extended family of elders, their sons, daughters, husbands, wives, our team, and our friends. COVID-19 has been a storm for all of us. This microscopic virus has changed our culture more than any hurricane. How we live our lives is fundamentally different, with  no choice but to talk to each other.  We need families to ask questions. We need to answer questions. We all need to be honest and listen to one another.  Individual actions have consequences for many others who we may or may not know.  One staff member Amanda put it beautifully by saying “I feel responsible for people I don’t even know.”  The consequences of all our choices can be the difference between life and death. All of us live with the weight of this each day.  

There is a more serious need for connection now than ever before. Kindness is not optional at this point. Connection is more than touch.  Connection is how we all create sanctuary. That connection is about being responsible for more than just the people we know and love. All of us live every day in the constant presence of absence. Missing people, touch and habit is a constant. Sorrow and unsettling quietude are always our companions. How are we responsible for one another in a very real physical way while also caring for all the other stuff that makes us human?  Maybe the only answer is we figure this out together.  Keep breathing.  Eat well.  Rest. Ask questions.  Find somebody to talk to.  Laugh.  Be patient.  Cry.  Pray. We struggle through this slowly, awkwardly, making small changes as we go. We try different ways of visiting. We say “I love you” more often. We ask someone “How are you?” and take the time to really listen for the answer.  We keep going. All of us have the job of creating shelter from the storm. There is no job description.

Thank you for the work you do every day.  Thank you very much.