Imagine Newsletter Volume XXIII

My Piece of the COVID Puzzle: A Poem for the Times
Composed by Jacqui Lynn Fidlar, Mezzo-Soprano and Actor, IMAGINE Citizens Member

Where do I fit into this COVID puzzle?
Where do you?
Are we scared; are we blue?
Time creeps and reels inexorably
Towards a distant horizon,
Recognizing neither passion nor
Responsibility amid the erosion
Of Life_ As_ We_ Know_ It…
But Come! We can Do a Thing here,
Cause a Spark there;
And if the Act of Wringing your Hands
In Wrath, Worry or Despair
Has caused new muscles to emerge-
Engage Them! But Beware:
Hands Washed in Error or hurry
May cause those Bugs to scurry!
Their methods are cagey and slick:
They’ll burst on the Scene, Savage and Quick! Rushing from hand to eye to mouth
To doorknob to hand….
To mouth…to eye… (pausa)
So! Whenever you Step Up to the Sink
To rid yourself of microscopic Foes,
Please Remember your Healthy Marching Orders:
Using soap and water aplenty
Scrub those hands for a count of Twenty
Singing that Birthday Song can be an Aid
Or listing the Artists who sang in ‘BandAid’;
Or sing your favourite Nursery Rhymes
Or count it backwards in German “…drei, zwei, eins!
However you time it, it’s lovely to linger
And work up a lather ’twixt each and every finger…
And now to the Rinse! It’s JUST as essential
To Banish ALL motes; Destroy their Potential to
Hurt, or to sicken your Family, friends, neighbours…
So double your efforts; there’s LIFE in your Labours!
And then when you dry off your beautiful hands
Remember it’s YOU and Yours Saving our Lands!
We hope you’ll consider the message you’ve learned,
And always remember:

#SpreadtheJoy_NOTtheGerms!

COVID-19 and Me – A Grandmother’s Story
Alex, IMAGINE Citizens Member


My daughter-in-law made the 12-hour (+ stops) road trip from Seattle to Calgary with a 4-month-old baby and a 2-year-old. The self-isolation location was set up, but the young mother arrived at 10 p.m. alone in the dark with her babies. I met her decked out in my PPE costume – long sleeves, long pants (which went straight to the laundry) gloves, mask, and shower cap! I helped her unload and set up beds; held, fed and comforted my grandbabies as we got them to bed. I left them at midnight for my own self-isolation.

I am a senior with an underlying chronic health condition. I know people like me have suffered disastrous consequence when infected with COVID-19. I did my personal risk assessment; I know the household was healthy when my daughter-in-law left Seattle, I know she traveled with food and water and is fastidious with hand hygiene and not touching potentially contaminated services.

Others are experiencing this inter-generational tension when grandparents cannot respect the “stay two meters apart” recommendation. Parents who are challenged   by working  at home with young children   sometimes need to ask grandparents to step in to fill the child care void. Yet, the older grandparents are at greater risk for a severe COVID-19 outcome.
 
A happy ending – after 14 days of self-isolation our family is healthy, but figuring out how to reconnect with these beautiful grandbabies, and at what potential cost, weighs heavily on my heart.

Logic Missing for Care during COVID-19
Anonymous

My father-in-law has Parkinson’s Disease. As a result of a fall, he was admitted to hospital in Calgary a few weeks prior to COVID-19 being declared a global pandemic. In addition to my mother-in-law, there were two adult children and other family that visited and actively participated in his care while in hospital. This was necessary given the busy nature of the ward. 

As the COVID-19 crisis progressed, visitors were limited to one person. My mother-in-law was that person. She too has existing health conditions and is at risk. Her visits were regulated by hospital staff and just prior to hospital shut down, they screened all visitors by taking temperatures. No guidance was given to her to protect herself while in hospital, or after leaving the hospital.
 
Family was initially told that my father-in-law would be staying in the hospital and there was no intention of sending him home or to long-term care. Being at home without full time help was no longer an option. His care needs had progressed to this point. We had been told by a friend, who is a doctor with geriatric experience, that we should be ready as he will most definitely be required to leave the hospital to “make room” for potential COVID-19 patients despite what we had been told. We did not want to believe that this was the case and so had not made any arrangements for his move. A few weeks passed and that is indeed how it played out. Our friend with all of her experience was correct.
 
The family was told he would be sent to long-term care. The long-term care crisis had not yet begun here in Alberta, but was clearly happening in British Columbia and Ontario. It was explained that in light of COVID-19, the usual long-term care deployment protocol would not be followed. My father in law would be placed in the first bed that came available within a huge geographical radius. He would not have any choice on where he would go.  They would circle back to him on relocating, if it was required, when the crisis subsided.   At that point the facilities had been closed to outside visitors.
 
By now the COVID-19 crisis had progressed in Alberta. Hospital staff were preparing and as a result staff seemed overwhelmed with the additional responsibilities. Getting information from staff was challenging. We were worried for the safety of my father in law.  Was the real risk leaving him in hospital?
 
There was a big decision to be made and the family decided that he would not be safe in a long- term care facility and in fact, this was the highest risk option when looked at with the knowledge of what was occurring in other provinces. Why would Alberta be any different? The difficult choice was made to bring him home.  Over and over the family was told by the hospital staff that they needed to be aware of the significant risks of having him go home. At no point was the risk of being in a long-term care facility during COVID-19 addressed. The risk of staying in hospital was also not addressed. No tools, support or guidance were provided to reduce the perceived risk of being at home. No care support could be offered up.
 
Very little was done to support the transition from hospital to home. No home support was offered. COVID-19 was cited as the reason for their inability to mobilize any care other than potentially once per week.  At that time there was a very long waiting list for any in-home care. It was left to the family to figure out all logistics and the continuum of care was only addressed when we asked about it. 
 
While we all fully understood the reasons for limiting hospital visitors and then banning them, the risk to patient safety should have been acknowledged and dealt with in conjunction with the realization that family is a critical part of the care team when people are in hospital. This care is not limited to emotional support.  It was our experience that family is charged with ensuring consistency of care is provided across nursing shifts as information does not always seem to get shared easily, especially with the added work of COVID-19 preparations.
 
Family members accessing the hospital before the visitation ban were given no direction on how to minimize their risk to COVID-19 exposure. Hand sanitizers were on site but that was all the protection provided. There was a lack of consistent information on how to protect ourselves and our loved ones from COVID-19, other than social distancing and washing our hands. There was so much additional information on actions that should be taken for protection floating around from various sources. This caused anxiety and confusion.
 
Long-term care has historically had many challenges being underfunded and understaffed. The logic behind removing a patient from the hospital because of the COVID-19 pandemic, and placing them in a facility where the risk of getting COVID-19 is clearly very high, was beyond any understanding. It was clear that no risk assessment with this policy and protocol was carried out. The risk assessment done by the family directed their actions.  The resulting stress and health risk transferring to other family members is undeniable.  What happens post COVID-19? The family was told he would have to go back into hospital so that he could more quickly transfer to long-term care. What on earth is the logic here? Simply following a process because it is the process screams inefficiency and puts people at increased risk.
 
The COVID-19 situation has required us all to adapt to new ways of functioning and carrying out our lives.  The binary response of the health care system, and the professionals working within it, during this pandemic is disappointing. One could argue the response has put many more at risk than those at risk of getting COVID-19. 
 
Discharge procedures from the hospital should have been ramped up to provide more than the bare minimum normally provided by transitional services. How can we be “safe” at home? It was left to family members to figure that out. The existing process was already lacking. Re-admission data, especially when seniors are involved, would validate this point. Providing extra resources to ensure that support is in place for patients that should otherwise be remaining in hospital would contribute to the likelihood of success.  It was disappointing, but not surprising, that the system could not pivot that quickly. I would have hoped that the professionals charged with carrying out the important function could have been informed and empowered enough to take these extra steps themselves. This was not the case. Long-term care should never have been an option. It is horrifying that it was given as an option seeing what has unfolded a mere three weeks later.

The Guilt is Eating Me
K. Kitchen

My mother is 81 years old and lives in a care home in Calgary, Alberta. I have been unable to visit her since the middle of March or speak to her since April 14th via FaceTime because of the restrictions around COVID-19. This particular home, Millrise Seniors Village, has not allowed any visitors since the virus first started. Millrise had its first case confirmed, with an email sent to families, on April 15th.

A kitchen staff member had the virus, which in turn led to the kitchen being shut down. Meals were being provided from another care home initially and, we were later told, from a restaurant. Reports from other families were that the meals were often cold and did not meet specific diets. From that first reported case on April 15th to April 18th, three residents and four staff were infected. In a facility such as this, with so many vulnerable people, the spread moved rapidly. Every night, I wait for the email to come in to tell me how many more are infected, praying that my mom isn’t one of them. As of the day I write this, those numbers are 25 residents testing positive, 13 staff testing positive and five residents dead. Mom has been swabbed twice within the last week for displaying some COVID-19 symptoms; luckily both have come back negative. She has dementia and is in a locked unit and likely is not aware of what is happening in the world around her. This may seem like a blessing, but the sadness and guilt that I feel on a daily basis knowing that she has been by herself in her room for weeks on end are almost too much to handle. Mom has also suffered a stroke in the past so has lost mobility and most language. I am able to communicate with her pretty well in my own way, but have not had to opportunity to do so. She is likely aware enough that none of her kids has been to visit but does not understand why.

I believe my mom was receiving the care she needed; the staff I have contact with are lovely and caring. However, the recent events have made it apparent the facility management was not prepared for a crisis situation – especially considering what they had seen happen in other care homes in the area and the high risk of spread of infection. This mismanagement can be seen by a number of staff having taken a leave of absence, a large number becoming sick themselves and others being too scared to work. I don’t blame the staff for not coming in as it would be a terrifying environment to work in, putting yourself and your family at risk each day. I am unaware of how the management company has operated, but with the number of staff that have left, it really makes me wonder how they were treated. So many of the health-care aids work at more than one facility; I believe just to have enough hours to live off of. The ratio of staff to residents should be looked at, especially in light of COVID-19 in continuing care homes so people like my mom are not left for hours on their own with no way of helping themselves.
While I understand the restrictions that have been put in place, I feel they came a little too late. As a family we watched the devastation that hit the McKenzie Towne facility and hoped it would not enter my mom’s home in the same tragic way. Too many seniors were unnecessarily put at risk through this pandemic and I feel it could have in part been avoided.

I hope the lessons learned from COVID-19 are taken very seriously in long-term care homes. Different protocols need to be in place to ensure our aging population is given the care and respect they so deserve during a time of crisis.

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