May is National Older Americans month and May 21 began National Nursing Home Staff Appreciation week. Fourteen months into living with COVID-19, I think these individuals are particularly deserving of our attention and appreciation.
The individuals who care for our elders are under—under paid, under-appreciated, and even misunderstood. I know this because I regularly visited my grandparents who lived in a retirement community for the final eight years of their life. I know this because I worked as a nurse aid during college breaks. My perspective includes 25 years visiting parishioners in all sorts of nursing homes. And now my perspective includes almost eight years on staff with United Church Homes.
Called to this work
Nursing home staff are amazing people. When you ask them why they work in senior living, you will get a variety of answers. For some, they just need steady work with benefits. But for many, you will most likely hear about a grandparent who was very important to them in their childhood. Or you might just get the response that they have always had an affinity for older people. I believe for most they are “called” to this work—whether they use that language or not.
And then there are others who have more personal reasons. I recently met an aid who, about a year ago, started work at the local nursing community where her grandmother lived there. This was a way for her to be able to see her grandma during the pandemic.
Unlike other medical care workers, because people live in our communities over a longer period of time, the staff really know and love their residents. Many staff marvel at the history that the residents have witnessed in their 8 or 9 decades of life. And many make their mark in our hearts when they share of their own experience and give to us the gift of their presence. The residents remind us of parents and grandparents long gone and can provide inspiration as they share of their own life stories.
Many staff will refer to “their” residents as family, particularly in this past year. When you ask people why they continued to show up during a pandemic which was threatening and at times ravishing the health of residents and staff alike, they say, “I did it for the residents”. They knew that they had to be surrogate family when the residents own children and grandchildren were prevented from entering the community. And when the staff returned home to their own families, they at times restricted their interactions there to reduce the possibility of exposure and bringing the virus back into the community.
Similar, yet Different
You have undoubtedly seen the images and heard the testimony of hospital staff in the past year talking about their experiences working in the ICU and emergency departments of hospitals around the world. The challenge with preventing infections involves everything from personal protection equipment (gowns, masks, gloves) to assessing the building ventilation systems in every room to new cleaning protocols and re-inventing just about every other system and program that helped to make life worth living. These challenges were also faced by every nursing home.
And yet nursing homes have their own unique trials. Nursing communities had to close dining rooms and suddenly deliver three meals a day to every resident with a staff model that was designed to serve people in dining rooms. All leadership, from the administrators to the chaplains to the department heads and activity staff helped during each meal to deliver the food that it would still be hot.
Reconciling Conflicting Regulations
In nursing communities, the staff had to negotiate the conflicting orders under which they operate. There were many times when the directives from the Centers for Medicare and Medicaid (CMS) differed from the directives from the state health department and from the department of aging. And these may also differ from the mandates from the local health departments. Staff had to decipher, decide and track and record every update to be able to later justify why very specific actions and policies were taken on any given day. And when any of these agencies could announce changes—which could happen at any time, it felt like a moving sidewalk of regulations. I was recently shown eight full notebooks with copies of each new regulation at one community.
Meanwhile, their family were hearing another set of recommendations from the CDC which were usually about two to three steps “ahead” of the regulations under which staff had to work. This undoubtedly added to the stress of family and their sometimes-angry responses to the nursing home staff. One staff member told me recently that she has never been yelled and screamed at by so many family members in her more than ten years working in the field.
Documenting our Pandemic Story
But I cannot do justice to telling the full story of the challenges of the past year, nor can I fully describe the dedication of the staff or the impact on their own personal, emotional and physical bodies. I invite you to hear their own words. United Church Homes recently documented our journey through the pandemic by producing a video of the story from staff members. I invite you to watch We Are Warriors –as our staff share how they experienced the COVID-19 pandemic.
So, in the next day or two while we are still in Nursing Home Appreciation Week, I invite you to share your appreciation of those staff who work in our nursing communities. For in so doing, we acknowledge that we see them and know that what they do matters.
And in these last days of May, Older American Month, may you also express your support and respect for those older adults who pave the way for each of us as we look to the years which stretch before us. It is their lives that we respect and honor as they bless us with the wisdom of their years.