Senior Living Centers Adjust to the Covid Era

When it’s time for exercise at Crane’s Mill, a senior living community in West Caldwell, N.J., Nicole Smith dons a mask and rings a bell in the hallway. Residents gather in their doorways, and soon arms and legs are waving in sync as Smith calls out moves on her portable microphone.

“We’ve become very creative,” laughs Smith, director of community programming at Crane’s Mill, which is operated by Lutheran Social Ministries of New Jersey. “We do some yoga on Zoom, some exercise in the hallways, one floor at a time.” For al fresco concerts, Smith strolls with her mic alongside but socially distanced from the musicians, announcing selections to an audience watching from individual patios.

Masks, social distancing and balcony concerts: Welcome to the Covid era at senior living centers. Room service has replaced dining rooms; groceries and prescriptions are now delivered. While much attention has focused on the particular devastation wrought by outbreaks at nursing homes — nearly half of U.S. coronavirus deaths are linked to such facilities — Smith and her colleagues want you to know that along with keeping everyone healthy, communities like Crane’s Mill are also making sure residents remain as stimulated as possible within the confines of the current moment.

At facilities throughout the region, adaptations include not only hand sanitizer stations, mask-wearing and frequent Covid tests for staff and residents — but also Facebook Live worship, hallway bingo and outdoor family visits. “One of the keys that has gotten us through thus far has been to stay positive,” said Maryellen McKeon, senior vice president of operations at The Bristal Assisted Living, which has 20 communities in Westchester, New Jersey and Long Island. Once the pandemic health protocols were established, “our recreation team immediately began coming up with clever ways to keep residents active and engaged each day.”

There have been silent dance parties, car parades for birthdays and holidays, personal pizzas and “Mom”-osas served for Mother’s Day. The Bristal’s dedicated television channel broadcasts workout routines and armchair-travel videos. “Zoom became a staple,” added McKeon — used for everything from live exercise classes to cooking demonstrations. But tangible connection to the outside world remains important; The Bristal launched a web page that allows families to send telegram-style messages, which the staff prints and hand-delivers.

“We knew we had to continue to connect with everyone,” said Gloria Walsh, associate executive director at Harrogate in Lakewood, N.J., which has 253 independent living apartments and 68 skilled nursing units. For Cinco de Mayo this year, the independent living and nursing residents of Harrogate enjoyed music from a mariachi band that strolled the hallway, handing out margaritas and maracas. Other days, residents have painted rocks with inspiring messages that were then hidden around the campus, “so that when people were doing their exercise walk, they could find them,” Walsh explained. During the initial lockdown, staff distributed activity bags full of puzzles and brain teasers, “just to keep people active.”

Harrogate has been lucky, with no Covid deaths thus far connected to the facility. “I think we fared well because we were one of the first to shut down,” in the second week of March, reflected Walsh. “Those that waited the weekend suffered more losses. It was a very hard decision, and some people felt it was overkill. But now they appreciate it.”

Harrogate initially shut down all communal activities and banned visitors as it dusted off a 2010 state pandemic plan. Like other facilities, it coordinated with the State Department of Health, the Centers for Disease Control and other authorities; Harrogate also took advantage of resources offered through Life Care Services, a senior living management company. “Those first weeks, we were in hourly contact, getting as much information as possible as far as best practices and protocols,” recalled Walsh. “I think we were naïve in thinking this would run its course like a normal virus.”

Even in those facilities spared the virus, the cognitive, emotional and even physical toll of prolonged isolation can be profoundly deleterious. At Harrogate, staff conducted daily wellness checks to assess not only potential Covid symptoms, but also cognitive changes and physical deconditioning from lack of movement.

As the tri-state area began reopening in June, Harrogate introduced gradual changes in keeping with its three-phase plan. “They’re baby steps,” Walsh explained. Weekly housekeeping, sorely missed as bath tiles gathered grime, was phased back in. Bingo, music and topical discussion groups resumed in reduced numbers. And gray roots were finally touched up when the on-site salon re-opened: “That was a big one!” Walsh laughed.

In West Palm Beach, MorseLife Health System held its first-ever virtual Passover seder via Facebook Live in April; more than 1,000 families around the world tuned in to break matzah with residents during lockdown. “We’re spending nearly $450,000 a month on new safety protocols and lifestyle enhancements for our residents,” said President and CEO Keith Myers of the campus, which offers independent and assisted living as well as skilled nursing, memory care and other options. With virtual reality quickly becoming the “new normal,” MorseLife introduced technology concierges who assist residents to connect electronically with family as well as entertainment.

Zoom is how the many Jewish residents of Crane’s Mill commune for weekly Shabbat services. “The only thing is they’re not able to have their wine and challah,” noted Nicole Smith. In lieu of restaurant outings, Crane’s Mill brings takeout from local favorites; garden club members now get plantings delivered from the staff horticulturalist. The facility is edging toward a phased re-opening, though recent Covid spikes in the Sun Belt have given pause. Crane’s Mill, like other facilities, has begun allowing outside visitors with strict protocols — 20-minute limits and six-foot social distancing in outdoor environs.

At The Bristal, staff members have arranged telehealth visits to limit residents’ contact with outside people, McKeon said. Electrostatic sprayers and ionization units purify air and surfaces inside buildings. And plexiglass dividers have been installed in the dining room, for when dinner service is once again safe. Social activities are slowly resuming, with masks and social distancing.

Walsh said her goal was to ensure that residents enjoy a similarly enjoyable lifestyle to the one they left behind, whether it be pre-Harrogate or pre-pandemic. “It’s one thing to survive,” she reflected. “It’s another thing to thrive. We aim for that, every day.”