Guide to this FAQ
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Planning our New Normal
How are things changing with MA easing into a Phased Re-Opening?
As we enter into a cautious phased re-opening of MA businesses, we are all looking forward to feeling like things might finally be getting to some kind of new normal that feels less restrictive.
With hair salons, barber shops and places of worship opening in Phase 1 (starting 5/25) SLR communities have been getting questions about whether your loved ones can go out for hair appointments and to attend religious services. We are also fielding questions regarding physicians appointments.
Unfortunately, state-issued guidelines have not changed yet regarding Assisted Living communities:
- The governor said his new “Safer at Home” advisory does not apply to those over the age of 65 or with underlying health conditions. He stressed that seniors should continue to only leave their homes for essential needs
- His advisory urges everyone to hold off visiting nursing homes and residential care facilities (which include Assisted Living communities)
- The Executive Office of Elder Affairs has not lifted any of the mandated restrictions regarding family visits inside the community, communal dining or group activities
We are hopeful we will get detailed guidance in the coming weeks. In the meantime, we must do everything we can to comply with the Governor’s order, while preparing for restrictions to be lifted:
- We are urging families NOT to bring your loved ones out of the building into the larger community at this time. If a resident leaves our building, we have to adhere to our “safer in your apartment” quarantine protocol for 14 days. This protective measure is in place currently for any returning or new residents because individuals can be positive for Covid without exhibiting any symptoms
- We are getting in touch with our hair stylists to establish protocols, so that we can reopen our salons the minute we get the green light
- We are planning on starting up in-house podiatrist services as soon as we can; in the meantime, our Resident Care Directors are coordinating services now for any resident with an urgent need
- We are facilitating physician telehealth appointments for residents (Phase 1 continues to limit in-person appointments to high risk patients)
- We are installing plexiglass at Reception Desks and will have a new digital sign-in process for visitors to avoid the use of paper and pens
- We are working on plans to safely open up dining rooms and community spaces, including installing additional signage to promote face masks, hand washing and social distancing
- We continue to encourage safe family outdoor visits!
We can’t let our guard down. Please be patient and work with us to remain focused on the health and well-being of our residents as our number one priority. Governor Baker said it best: “I know we’d all prefer to believe that the virus is less serious now and that it’s behind us. But if we don’t keep up the fight and don’t do the things that we all know we have to do, and know we can do, we run the risk of creating a second spike in the fall. People need to be vigilant, they need to be careful, and they need to understand the role that they can play themselves as we continue to bring this fight to the virus. It’s how we move forward together.”
What are your plans for communal dining?
When we get the green light and can get back to communal dining, we anticipate there will be state-mandated guidelines on limiting the number of people allowed in the dining room to allow for proper social distancing. We are developing workable plans now that include staggered dining times to accommodate smaller groups.
Right now, we are still prohibited from communal dining (except in very limited situations for residents who need assistance). We will continue to deliver meals to resident’s apartments. Since the crisis started, we have served hot nutritious meals, and we will continue to feature favorite recipes from our Brain Healthy Cooking menu including fresh vegetables and fruits, whole grains, lean meats and seafood. The foods we serve have potent antioxidants and nutrients with anti-inflammatory properties that boost immunity and reduce inflammation. It’s heart healthy, great for seniors managing diabetes, and proven to boost overall cognitive health.
Experts say during times of stress, eating well is one of the things that helps us stay healthy and boosts our immune system. Residents very much look forward to mealtime especially now having to stay in their apartments for a majority of their day. Familiar foods, warm nourishment, and sense of normalcy around mealtime is bringing comfort to them. They also enjoy seeing our servers three times a day, which has become an important social touchpoint for them.
Kudos to our dining team for continuing to serve excellent meals with excellent service under these trying times.
What about physical activity?
As soon as we are able, we will add a full schedule of small-group fitness classes to augment our escorted outdoor walk schedule now in effect. We are looking forward to when residents won’t be confined to their apartments so we can amp up their level of activity and increase their access to and enjoyment of all types of movement from walking to gardening, to exercise classes and dancing.
Throughout our state-mandated “Stay at Home” orders we have been working with residents to keep them active and engaged through one-on-one walks inside the building during inclement weather and now outside on warm days. We have also organized chair/hallway exercise programs, and have promoted creative ways to encourage movement with dancing dining servers and music in the halls aimed at getting residents moving.
Even with all our efforts, with mandated quarantine measures that have been in place for months, residents have been less physically active. To address this concern, starting in early April, our communities have been coordinating medicare-qualified Physical Therapy (PT) and Occupational Therapy (OT) services for residents. PT sessions take place in residents’ apartments and are focused on building up and/or maintaining physical strength and balance. The therapists are able to coordinate Telehealth conferences between the resident and resident’s Primary Care Physician to share updates. We anticipate that this will continue throughout this year.
Are you allowing new residents to move in?
Yes, during these unprecedented times, we continue to work with families and our Professional Referral Partners to accommodate seniors who have a need for a more supportive living arrangement. We are committed to ensuring a smooth transition into one of our communities while safeguarding everyone’s health. Learn about our cautious move-in protocols, and protocols that protect the health and safety of of our entire community.
Are new residents "quarantined"?
We have a “Safer in your Apartment” 14-day protocol to protect everyone’s safety, including our new residents, our current residents, and our staff. Here is a full description of our Move-in Guidelines.
We want to reassure new residents and their families that you won’t be isolated. For the first three days you will be able to have a family visit. For the next 11 days you will have, at a minimum, these daily touch points:
- All the managers at our community will drop by to say hello and introduce themselves. You’ll meet the heads of our Resident Care, Programming, Building & Grounds and Business Office departments
- Our friendly servers will deliver meals to your door three times daily
- Our Programming staff will be encouraging you to participate in hallway sing-alongs and bringing you activities to do on your own
- You will receive your personal care services from a team of dedicated and compassionate caregivers (we call them Resident Care Associates)
- If you need help with medications you’ll get additional visits from our caregivers
- Your mail will be delivered, along with care packages from your family
- You’ll have a pendant or pull cord in your apartment so you can call for assistance at any time, even if you just want to see a familiar friendly face or have someone to talk to
- We will set up virtual calls with your family (maybe you’ll see their smiling faces even more than before because we’ll be here to help with the technology!)
When can I visit Mom inside the community?
We don’t know yet. The state-mandated restrictions are still in place.
However, we are happy to accommodate an outdoor visit for you. Please check with your individual community to schedule this. We have creatively pursued all opportunities to facilitate people getting together following appropriate social distancing and wearing masks, and staying protected from the elements with porch, balcony, gazebo and tent visits. The granddaughter of one of our residents hosted part of her wedding reception outside!
Taking walks outside together is still problematic. We want to keep footpaths open to residents who want to enjoy the sunshine and nice weather without being exposed to visitors who may be carrying the virus. Because we now know that so many people are carriers even without showing symptoms, we need to continue to be overly cautious.
In the meantime, we encourage friends and family members to post a sign outside a loved one’s apartment to pass along positive wishes, and we continue to connect families and loved ones with virtual visits. Enthusiastic families have also participated in car and foot parades around our buildings.
What are you doing to prepare for a second wave of Covid-19 in the fall, if it comes?
We have been hearing expert predictions about a potential surge in Covid-19 cases coming in the fall or early winter. We will be prepared for that if and when it hits. The best way to identify and minimize the chance of an outbreak is through testing. We are, and will remain, in constant touch with our local public health agencies regarding available testing for our residents and staff, and we are hopeful that even more testing will be available in the fall.
During this pandemic a huge problem has been the availability of PPE (personal protective equipment). Even as the current cases in our communities slow down we will continue to source PPE so that we have back-up inventory on hand if the pandemic surges in the future.
We have spent the last several months, since the end of February, practicing and improving upon our virus and infection control protocols to mitigate community-wide infection, identifying and containing the virus when someone does test positive, and establishing quarantine measures for residents who are symptomatic as well as those who are not. We will continue employing and reviewing these practices, making modifications where warranted to enhance and sustain our protocols. We will also conduct ongoing, in depth associate training so that we are all prepared as a team – from the dishwasher to the Executive Director, veteran employee to new associate – to handle any new outbreaks.
Throughout our entire Senior Living Residences’ family of communities, none of us ever imagined we would be working on the front lines of a pandemic. But, we have weathered this storm together. We have collectively gained very meaningful and extensive experience. We have implemented processes that will become a part of the fabric of our company. We are preparing for our new normal with sustainable practices and programs that we expect to be with us for a very long time. While we are all certainly hoping a major surge does not hit us, we will be ready if it does.
What are you doing to keep residents engaged and active?
We have always made resident “Quality of Life” our top priority. Quality of Life goes beyond physical safety and health, it speaks to the importance of social interaction, personal dignity and just plain feeling engaged in life. Obviously, social distancing has impacted all of our lives. In this difficult environment our team members are making every effort to keep residents engaged through exercise, entertainment, outdoor walks, and personal interaction. We have not forgotten the importance of caring for our residents as social beings, and we continue to do our very best to boost their spirits. Family support and participation has been key to creating most of the best moments of these last few months as our “good news page” highlights!
How is your staff handling this?
Our team is working diligently, providing the very best care and services for our residents that we can under difficult circumstances. We are so proud of our staff who are living our Right Values every single day, every hour. They are showing determination, compassion and courage as they come to work to fight this pandemic knowing they might be putting themselves and their own families at risk. Many families have been sending along words of support and love – thank you! We are sharing these beautiful messages with our whole team – they are so much appreciated during this challenging time. The understanding, patience and support of our residents and families means more than we can adequately express.
How do you ensure food prep is safe?
As with the rest of our buildings, kitchens are cleaned, disinfected and sanitized constantly. Food prep is done with the utmost care following universal precautions. We are using a special wash for fresh fruits and vegetables that offers additional protection from the coronavirus. We are also very careful unloading deliveries. Everything is dropped off outside to minimize contact with delivery personnel. Also, all of our chefs and cooks are Serv Safe certified.
What is your cleaning regimen?
Our universal infection control practices have always included proper hand washing, physical distancing and infection control training for all employees; frequently disinfecting high-touch areas like doorknobs, elevator buttons, faucets and handrails with CDC approved antibacterial/germicidal cleaning materials; and increased cleaning of high-traffic common areas such as dining rooms and activity spaces. Additionally, as we enter the third month of state-mandated quarantines we are conducting a deep cleaning of resident apartments. We also thoroughly deep-clean and sanitize apartments prior to a new resident moving in, as well as apartments of current residents moving back home to the community following a hospitalization.
Should I take Mom home to live with me?
In this unprecedented time there are no right or wrong answers. This is a family decision, and if you have the resources and the ability to care for your loved one at home we will help with a smooth transition. This fact sheet published by the MA Department of Public Health offers guidance on this topic. Considerations for Moving out of AL – April 9th 2020
Handling Coronavirus Cases
How do you handle suspected or positive cases?
Click here to review a complete description of our protocols for how we handle suspected and confirmed cases of Covid-19 for residents and associates.
Who do you report to?
We report all suspected and confirmed cases of Covid-19 to our local Boards of Health, as well as appropriate Public Health state agencies, including:
- MA – Executive Office of Elder Affairs, Department of Public Health
- NH – NH Department of Health and Human Services
- CT – CT Department of Public Health
These agencies are responsible for tracking and reporting data to the general public, as well as conducting contact tracing.
We also provide regular updates via text and email to all our residents and their extended families with all the latest news about testing, positive cases, changes in protocols, and what we are doing to lift the spirits of residents and staff.
Can I get daily updates on Mom's health?
Yes. Our community nurses are in regular contact with the families of residents who are ill for any reason, symptomatic or who have tested positive for coronavirus. If your loved one becomes symptomatic, we will call you immediately.
Can we get updates on residents' conditions?
Yes and no. During this time of unprecedented crisis we ARE releasing information publicly on the number of positive cases in our communities. However, we are prohibited from providing “Personal Health Information” about individual residents who have fallen ill due to coronavirus or any other reason, including their medical status or even their apartment number. HIPAA is a federal law that very specifically protects residents’ rights to privacy when it comes to their personal information. This law is still in effect even during this pandemic.
Are you reporting deaths?
The federal HIPAA statute applies here too. With family permission we could disclose that a resident who tested positive has passed after we receive official confirmation. Even in this new environment, we may not always be privy to a resident’s specific cause of death. That information would have to be provided to us by the physician, hospital or the Department of Public Health (the agency charged with confirming and reporting on deaths related to coronavirus). This official confirmation of deaths tied to Covid-19 can take up to a week. In cases where a family publicly acknowledges the connection, such as in an obituary, we could confirm it then. It has never been our policy to alert the general public (or even families with loved ones living in our communities) when a resident dies, although we do let residents and staff know so that we can honor their life and contributions to our community.
Are staff members infected with the virus?
Staff members in some of our communities have come down with the coronavirus. Beginning March 13th, every staff member, every day, must pass a health screening (including a temperature check) at the beginning of their shift. If they exhibit any symptoms they are sent home with instructions to see their doctor and request testing, with a 2-week quarantine. It’s a fluid situation, and we are bound by HIPAA not to release personal identifying information about associates, including health information. We are pleased to say that numerous residents and associates across the SLR family of communities, who were symptomatic and asymptomatic, have also tested negative for the virus.
What about testing?
Testing options are expanding.
In MA, the Mobile Testing Program for long-term care facilities and Assisted Living communities, which is managed by the National Guard, is now providing community-wide testing for any associate or resident in an Assisted Living community whether or not they have symptoms of Covid-19. This program allows for safe, onsite sample collection in the resident’s own apartment by trained personnel. Our requests for tests through this program must first be “prescribed” with a physician or local public health agency ordering the testing. Most of our MA communities have scheduled testing, and results are being shared with residents, staff and families.
Additionally, some of our associates have taken advantage of drive through testing in MA and NH.
When we observe symptoms in a resident related to Covid-19 , we notify families and physicians immediately and urge testing. Under current state policy in MA, NH and CT, only a government agency or physician may prescribe a test. We do not have the authority to obtain testing for an individual resident or staff member.
Is testing mandatory?
No, testing is not mandatory. In MA when we arrange community-wide testing through the National Guard program we strongly encourage everyone to be tested, and most have opted to.
Due to the enhanced availability of testing and the wider criteria for eligibility, it is now much easier to obtain a physician order for a test. We are fully involved in coordinating communication with physicians to make sure that any resident who exhibits symptoms gets tested.
It is now widely known that many seniors do not exhibit typical Covid-19 symptoms, such as fever, dry cough and shortness of breath. Instead, seniors are experiencing a range of symptoms, such as lack of appetite, feeling weak and fatigued, increased sleeping, confusion, vertigo, poor balance, increase in falls and dehydration. We are closely monitoring residents for ALL of these symptoms.
Are you separating positive and non positive residents at the community?
We have read in the news of nursing homes creating “covid-positive” wings or floors. In an assisted living community your apartment is your home, furnished with your treasured personal belongings. We cannot move residents out of their personal home into someone else’s personal space. We do, however, isolate residents who have a Covid-19 diagnosis, symptoms or recent direct exposure, and they must be cleared of and/or deemed “recovered from” Covid following a Test-Based or Symptom-Based Strategy following CDC guidelines before their quarantine is lifted. We also have an exception for residents who share an apartment suite. If one of them is symptomatic or tests positive for Covid, we would move them to a temporary fully furnished respite apartment for the duration of their quarantine.
FOR MORE INFORMATION:
Do you have enough masks and gloves?
We have a shortage of gowns right now, and are purchasing creative alternatives recommended by public health authorities, such as full-sleeve ponchos and lab coats. Like every other Assisted Living community, Nursing Home and Hospital in the country we are working hard to source PPE (personal protective equipment, which includes gloves, masks, gowns, goggles and booties). Senior Living Residences’ (SLR) Home Office staff is keeping track of inventory at all SLR communities. SLR has been successful at obtaining back-up supplies which they provide to communities if/when needed. Also, local public health agencies, including Boards of Health and Emergency Preparedness Departments have been very helpful providing resources to some of our SLR communities.
If you can donate any PPE, especially gowns right now, we would gladly accept it. So many have donated cloth masks to our communities (thank you!)
Are there any food shortages?
No. We want to reassure families that our food supply is in excellent shape. Although you may see empty shelves in your local grocery store, the commercial food supply chain which caters to businesses like ours ordering in bulk, has been less impacted by this crisis. Especially with restaurants not ordering food, there is plenty available. We are lucky to be part of a nationwide group purchasing organization through our management company, Senior Living Residences, that provides us with plentiful options. Even with the news that a large meat processing plant has shut down due to an outbreak of coronavirus, we are still able to source all types of meat. Additionally, through our partnership with Baldor, a New England company that represents dozens of local farms, we will continue to have access to a variety of fresh fruits and vegetables that change with the season. Farmers have been deemed essential workers.
Are there any issues with medications?
No, residents’s medications continue to be prescribed, filled and dropped off at our communities by local pharmacies, or dropped off in filled weekly pill-packs by families. Many of our residents are on a medication management program and our Resident Care Department continues to provide daily reminders to take their medications at the right time, in the right doses. Some residents handle their medications independently, and we are checking in with them to ensure that they are receiving their medication refills on time.
Please call your community directly for answers to these questions
- Can I bring dinner to my Mom?
- Does the community have enough cloth masks / are we still accepting donations?
- What is the best time to drop off supplies / packages for my loved one?
- Who is the contact person to arrange a Zoom / Facetime meeting?