Hope behind closed doors

On March 13, as the threat of COVID-19 began spreading across the United States, Kris Erickson got news he never expected: he had to ban everyone but staff members from the long-term care and assisted living facilities of Bethany Village, a retirement community in Lindsborg, Kan., where he is CEO.

“This is my 19th year in the industry, and in all my years, I’ve never had to ban all visitors from a building,” he said.

Prior to early March, things at the ELCA-affiliated care facility were running normally—volunteers and visitors frequented the buildings to provide services and spend time with loved ones.

When Bethany Village received the directive, Erickson said, he expected it to last three to six weeks and then things would be fine, but the restriction was still in place months later.

Erickson said keeping up with the information about which preventative measures work has been exhausting. Early on the search for supplies proved challenging. Staff was able to procure a small batch of medical masks but has also made do with cloth masks donated by people in town and, in place of protective gowns, plastic rain ponchos purchased online for $1.35 apiece.

Before entering the village’s buildings, staff must now go through a series of screenings. A new screening kiosk takes employees’ temperatures and reminds them to put on a mask if they aren’t wearing one.

While the new protocols come with challenges, the vigilance gives cause for celebration. At press time, Bethany Village has yet to report a single case of the virus, impressive given that more than 40% of all COVID-19 deaths have been in long-term care facilities.

Part of that success can be attributed to Bethany Village’s new resident care assistant (RCA) program—something Erickson said has been a “lifeline” since the start of the pandemic.

“You don’t have to be certified to care for others.”

The idea for the program came last year after Bethany Village, responding to a shortage of health care workers, looked for ways to stretch its staff. It decided to hire unlicensed employees to help with essential tasks such as making beds, delivering meal trays and escorting residents.

“You don’t have to be certified to care for others,” Erickson said. “We hired five or six [RCAs] in January, and when COVID hit, we put an ad on Facebook and got 30 people almost instantly.”

RCAs help with disinfection rounds on high-touch surfaces and spend time talking with residents who might be lonely. Because some RCAs have expressed interest in becoming certified nursing assistants, management found a class to certify one of the facility’s registered nurses as a teacher so those employees can be trained.

“They were able to do their clinical rounds here, and we trained eight certified staff when the schools were all shut down,” Erickson said.

A new normal

As the pandemic progressed, Bethany Village had to restrict in-building activities. Residents couldn’t share dining tables, and group activities became problematic. The activities department moved bingo to the hallways so residents could play from their doorways and used pool noodles for balloon soccer games to ensure people stayed 6 feet apart.

The residents were also encouraged to wear face masks. “It became normal after a couple of weeks,” Erickson said. “We didn’t like it, but we knew we could live with it.”

As news of the pandemic continued, residents began to worry less about their own health and more about their loved ones, Erickson said. The facility ordered computers and mobile pedestals so residents could enjoy video calls with friends and family, and “window visits” enabled them to meet with loved ones, separated by glass but talking on phones.

Bethany Village has also organized a couple of parades in which residents saw family and friends drive by in decorated cars while holding signs, waving and sending their love from a safe distance.

While employees have tried to find as many ways as possible to adapt, meeting the social and emotional needs of residents has been difficult, Erickson said, adding, “Human touch is still an obstacle we have yet to overcome. They miss hugs from family.”

Susan Lundstrom is grateful for the precautions Bethany Village has put into place but said the steps have also come with a downside for her mother, Verlla, who has dementia. “I see so much decline in my mother’s mental capacity and mental health,” she said. “Some of that may well have happened anyway, but certainly the situation has contributed greatly. It really is a no-win situation. I’m grateful for Bethany and sad all at the same time.”

Lundstrom has stayed in touch with her mom through video calls coordinated by staff. She has also paid window visits, participated in both parades and scheduled patio visits, conducted through a plexiglass barrier, once that became an option in June.

These encounters are better than nothing, she said, but communicating with her mom through such means is still difficult. Lundstrom is waiting for the day she can hug her mom and have a real conversation with her.

Eternal hope

As time goes on, Phillip Hett, the chaplain at Bethany Village, said it’s increasingly important to care for residents’ emotional and spiritual well-being, in addition to their physical health.

A worshiping community, Bethany typically has daily devotionals, semiweekly services and weekly Bible studies. People from the community also come for worship. “We’d usually have 50 to 60 people per service, but since we’ve had to close our doors, our worship has changed,” Hett said.

Services moved from the chapel to the dining room, where there is more space to spread out. Some residents choose to stay in their rooms, watching the services on Facebook Live or listening through the home’s public address system.

“When someone smiles, even when they wear a mask, you can still see it in their eyes, and I think God is at work in the hope we have for what’s to come.”

Hett has been investing a lot of his energy in pastoral care and individual visits. “In my ministry, I believe very much that it’s important to preach the gospel, to preach God’s love for you, but it’s just as important—or more important—to show it,” he said.

“And I try to do that by being there as much as I can for the residents. When that other support system of people they get to see regularly is gone, it’s more important than ever.”

Hett said he’s been inspired by residents’ faith and that he’s been relating this time to the exile in the Old Testament. “We haven’t been in exile as far as having to move, but the world around our residents has shifted and they’re separated from families,” he said. “But in that narrative in Lamentations, in the exile period, there is still hope—hope that God is with them. And God is with us.

“I get encouraged when I hear [residents] talking about finding God in their friendships and the people they do see. When someone smiles, even when they wear a mask, you can still see it in their eyes, and I think God is at work in the hope we have for what’s to come.”

Part of what’s to come for Bethany Village is an expansion to its assisted living facility, which broke ground during the pandemic. “It’s another part of this emotional roller coaster we’re experiencing in COVID-19,” Erickson said. Staff had spent years planning and conducting assessments for the expansion, knowing there is a large generation of people reaching an age in which they might benefit from services Bethany offers.

“We were in the midst of the final yards and COVID hit,” he said. “But we thought, the virus won’t stop progress. People will still need this care. And the community has been excited to see this happening when everything has seemed frozen in place.”

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