What does the owner of the property in which you live owe you and the other residents in terms of telling you what is going on? Whether you live in an apartment house or condo, assisted living or a retirement community, you no doubt have seen an ambulance pull up in front of your building with first responders dressed in full PPE. Can you find out who it was and why they were being taken to the hospital? Probably not, because privacy of information is something the management will invoke, whether or not it is actually a HIPAA issue. The informal grapevine will likely tell you what has happened, but wouldn’t it be better if the management of your property communicated to you directly and honestly?
The issue of communication has become critical for people living in congregate care facilities like nursing homes, assisted living facilities and retirement communities. So far, the way in which the owners and managers are communicating to residents and families has left something to be desired. Some places refuse to tell residents anything; others send out perfunctory notices or emails that only fan the flames of distrust and anxiety because the information is vague or incomplete.
Covid-19 is a crisis, and principles of crisis management apply directly to this problem, just like any emergency. These principles are just common sense, and they are not meant to be linear — all must happen more or less at the same time.
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- Be First 4. Express Empathy
- Be Right 5. Promote Action
- Be Credible 6. Show Respect
Many facilities have failed the first principle, “Be First.” Some facilities panicked when a case of Covid-19 turned up in their organization, and the first impulse was actually to avoid and deny. By the time communication began, levels of trust had dropped and there was a great deal of misinformation floating around. Relying on local health departments and the Centers for Disease Control (CDC) is critical for management to have any credibility at all. Being “right” means getting the science right and getting proper infection control started. Shutting down facilities to outsiders has been the first response, but since health aides are still entering the facility from outside, the virus remains easily transmitted to residents. Testing aides, isolating or quarantining aides as well as residents once they test positive — these are all critical aspects of infection control and credible communication. Taking the temperatures of aides or residents on a daily basis is of little to no value, since by the time a fever is present, the person has likely been infectious for a few days.
Finding the right person to communicate the message is also key. Sometimes it will be the Executive Director. Other times it might be a nurse or a doctor or even a chaplain. It probably should not be a marketing person or someone who is paid to make things look good anyway. What residents and families want is honesty and transparency. How many residents have been found to be positive? Who did they have contact with? Are they being isolated or sent to the hospital? When can other residents get tested themselves? What is the facility or building doing to keep people safe? Does the HVAC system filter out bacteria and viruses between apartments? Are elevator buttons, railings, common spaces being cleaned regularly? Is there hand sanitizer of over 60% alcohol available on every floor? These are questions that require answers and action. Residents have every right to ask for action from the owners and managers. In the case of Covid-19, it’s not just a “nice to have” — it’s a “must have.”
The final tool of effective crisis management is showing respect. Whether you are younger and living in an apartment building or older living in assisted living, you deserve respect, because in one way or the other you pay for your space. Respect means explaining restrictions based on science in a clear way. Paternalism has no place in this type of communication. No patting on the head is necessary. Most of us older folks understand rules and will follow them if we understand the basis on which they are made. If we come up with sensible recommendations, we should be encouraged to pass those along and have them considered seriously. In the midst of a pandemic, those in charge often forget that the people for whom they are caring want to be heard and respected. Families should also be informed about how many infections exist, how those are being handled, how their loved ones are being protected, and be given ways to communicate as safely as possible. Perhaps in-person visits will not be allowed for a period of time in many areas, but that should not prevent families from being able to call, FaceTime, Zoom, etc. with their loved ones.
The key elements of any communication strategy by management should include the following:
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- All communication should start with empathy and indication of concern for the health of the residents and the staff.
- Weekly or even daily communication should be delivered via email, paper notices delivered to rooms (if email is not available), social media, or all of the above. This communication should be provided to residents (and family members if possible).
- Status of current infection in the building/facility should be quick and clear. How many residents have tested positive? Are they quarantined? Are they in the hospital? Our facility has a tablet in every room where you can find out how your neighbors are doing (with their consent obviously). Who is in the hospital? Who is in another facility? Who has come home?
- Management should communicate the status of testing for all residents. Where will testing be done? How often? How much does it cost? What are the aggregate results (X are negative; Y are positive – no names needed)?
- Limitations imposed on movement within the facility should be clear and consistent. Can residents visit each other’s rooms? Can residents sit outside spaced six feet apart with masks? When should masks be required? Can residents leave the facility freely? If they do, what should they do upon their return?
- Social activities in the time of Covid-19 are not likely to include more than a few people, but balcony singalongs or exercise activities can help alleviate loneliness and isolation. Use of YouTube and other media to post exercise classes, examples of humor, stories, etc.will help residents accept the “stay at home” requirements.
- Opportunities for input and feedback by residents are of critical importance. This ties back to the need for respect. Good ideas are not always top-down; in fact, they seldom are. The best ideas for coping in this time will come from those who are experiencing the isolation themselves. How can residents communicate their feedback? Is there an email address they can write to? A place to put a “suggestion card”? Zoom meetings? In places where not everyone is computer savvy, is there someone to help use tablets and computers and email?
What do you want to know about what is happening around you? Not everyone wants to know details, although some will. How do you want to hear this information? Ideally, it should come from a credible source you can trust. Gossip will always prevail in situations where information is scant. You are not a troublemaker if you make your wishes known as constructively and clearly as possible.
“A lot of problems in the world would be solved if we talked to each other instead of about each other.” (Nickey Gumbel)