Beating COVID Isolation

By Jaren Soelberg DOR, Desert Blossom Health & Rehabilitation, Mesa, AZ

pandemic was that both residents and staff became accustomed to isolation. Residents got used to, and comfortable with, staying in bed or in their rooms for most of their days. For many of our CNAs on our LTC unit, most of whom were hired during or after the pandemic, it was completely normal for patients to stay in their rooms. We decided we needed to change the culture of our LTC unit and help facilitate an environment where our residents and staff could thrive, not just survive. As a rehab department, we decided that our role would be to consider any and all ways that we could engage with our residents to encourage them to want to get out of bed and get engaged in life

One of our DORiTOs coordinated a “get up” schedule for the CNAs, with a large visible schedule for each resident's room number and their preferred time of day to get out of bed. Our OT staff began to focus on psychosocial well-being and how to help our residents identify and pursue leisure activities. Our PT/OT staff posted communication boards in each room that communicated to the Nursing staff how much assistance each resident needed for ADLs and how much help they needed to safely transfer, as well as recommended DME or weight-bearing considerations.

During the height of the pandemic, we received a new LTC admission. She was Mandarin-speaking only but had difficulty communicating even with translators or family assistance due to her advanced dementia. Functionally, her therapy prognosis was grim, as she had recently undergone bilateral above-knee amputations. If anyone had an excuse to stay in bed all day, it was her. She had no way to effectively engage or communicate with people due to her dementia and language barrier. She had no way to transfer or mobilize herself due to her bilateral amputations. However, we decided as a Therapy team to set basic goals for her to begin getting out of bed, initiate wheelchair mobility, and to attempt to engage her in leisure activities that were important to her.

One day, one of our COTAs, Arin, had come in to work on a Saturday and happened to have this resident on her schedule. Earlier in the week, we had done a large group activity, painting little pots for gardening. This resident missed the activity because she generally didn’t participate in groups due to her language barrier as well as her lack of motivation to get out of bed.

Arin decided to use some of the leftover supplies from the group activity to see if it would be of any interest to this resident, and to everyone’s surprise, this resident immediately lit up and very naturally began painting the pots and preparing soil. She generally presented with flat affect and showed little positive emotion, but on this day, her face lit up, and she was grinning ear to ear. Not only was she happy and engaged, but she also demonstrated significant improvement in her posture, trunk control, and bilateral upper extremity initiation.

Thank you, Arin, for your persistence and consistency in using skilled intervention to find activities that are both meaningful to our residents and give them the opportunity to increase their physical activity! This was a great reminder that sometimes we need to slow down and identify what is important to our residents and use that as a mode to facilitate improved physical function.