Pandemic parameters during the fifth wave

At the beginning of this pandemic, long-term-care homes were hit hard, with residents contracting the COVID-19 virus and many of them died of it.

Walter Sguazzin, executive director of the United Mennonite Home in Vineland, Ont., is happy to declare that not one resident had contracted, or died, of COVID-19 and its variants during the first four waves of the pandemic.

In September 1955, the United Mennonite Home for the Aged opened its doors to 47 residents. It was supported by the United Mennonite churches of Niagara, Hamilton, Waterloo and Toronto through financial gifts and board representation. In 1972, the home was licensed by the Ministry of Health.

A new home was built in 2004, consisting of 128 long-term-care beds, sitting on 4.5 hectares of land. This facility now also includes 48 apartments and 18 care-suites, with 48 townhouses next door.

The biggest challenge during this current fifth wave has been staffing. When staff members come to work, they do rapid-antigen screening, then wait for results before going on their shift. If the test is positive, the staff member leaves the building and goes home to quarantine for up to 10 days. Sguazzin believes that this protocol has prevented the virus from being passed on to the residents.

Staff that have chosen not to be vaccinated are on a leave of absence. Student placements for personal support workers and registered practical nurses-in-training recruited from Niagara College have helped fill the vacancies. Normal recruiting on recognized websites continues.

Currently, another challenge has been keeping up with the Ministry of Long-Term-Care directives and restrictions, including training, number of staff required for each shift, and limiting the number of visitors due to the contagious nature of the Omicron variant. Families are using iPads to communicate with their resident family members. During lockdowns early in the pandemic, meals were served in the residents’ rooms. At other times tables were moved in the dining room to allow for more distancing. This is no longer the case.

Swabbing and testing have been outsourced to a security company, in order not to overload the staff.

Keeping a well-stocked supply room of rapid-antigen tests and personal protective equipment (PPE) has been another challenge.

With COVID-19 one must always be vigilant, Sguazzin says, adding, “Communication is the key.”

The family of each resident receives an information package which includes advice on infection prevention and control; self-monitoring at home; proper hand washing; wearing PPE; and following government COVID guidelines with masking, distancing and visiting in rooms. Visitors are tested each time they come into the home.

Changes have come with the recent Ontario government guidelines that came into effect in mid-December. These included only two designated caregivers allowed to visit a resident; the pausing of all general visiting; a requirement that all visitors must be fully vaccinated; and the placing on hold of social-day absences for all residents, although medical appointments can continue. People can enter the home for palliative visits.

Sguazzin says there have been blessings as well as challenges. He congratulates the staff who came in to work and honoured their shifts by putting the residents first. Masks were worn at the home two weeks before they were mandated. Lessons in pandemic planning and keeping a month’s worth of supplies on hand were learned from the SARS outbreak of 2004.

Sguazzin says he believes “God gave us the foresight.”

David Gifford, the home’s chaplain, conducts religious services for the residents as a group, and he provides pastoral visits to individual residents. The biggest change for him during COVID-19 is not having large group worship services and Bible studies, but, instead, small groups gathered in individual sections. No longer is there a pianist for the services, so music comes via CDs. He does individual chaplaincy visits wearing PPE and doing physical distancing.

Gifford says, “In many ways I believe my role is less stressful than what frontline nursing staff face.”

Knowing his work is done for the Lord, and to serve the residents, gives him strength and peace, he says. Livestream Sunday services from his church and the connection with his life-group have given him support and strength.

Lorna Metzger, a resident of the home, says of the changes brought about by the pandemic, “It is difficult when family can’t come in to visit during lockdowns. I miss the programs, especially physiotherapy, that doesn’t happen during lockdowns.” She says the staff work very hard and are very busy, and give as much time as they can.

Frank Pravitz, chair of the home’s family council, has a mother with advanced dementia residing at the home. He does not receive much feedback from her but, from his personal observations when visiting his mother, he says, “I have always been impressed with the attention and care provided by individual staff and caregivers.”

Sguazzin says the bottom line is to have a balance: to continue keeping a quality of life for the residents while dealing with the pandemic challenges.