Touch for Elders is Needed Now More than Ever

The AGE-u-cate Training Institute supports aging services providers as they respond to the isolation crisis facing their elderly residents and clients.

The title of this article seems counter-intuitive during this time of quarantine.   Touching an unrelated person is not a popular notion right now.  But, caregivers for the frail elderly are becoming more aware of the effects that isolation has on those in their care.

Human contact now consists of gloves, gowns, face shields, and masks.  The frail elderly live in an unfamiliar world.  Also, many do not possess the cognitive ability to make sense of it all.

Family members and friends can’t be with loved ones in elder care communities. The term “skin hunger” was new to me, but now I understand.  Touching others through a hug, holding a hand, a stroke of the arm or shoulder is virtually non-existent these days.

Consider this with the fact that touch deprivation is already a reality for the elderly.  Now we have a bigger problem on our hands.

Touch in Quarantine

The great news is that we can reduce the effects of extreme isolation with expressive touch.  We need not be afraid to offer a back, shoulder, hand, or foot rub to those in our care.

More than ever, touch is essential and life-giving for both caregiver and receiver, especially during this quarantine.  With infection prevention protocols,  we can and should offer touch as a way to ease anxiety, fear, and loneliness.

“The current COVID-19 Pandemic is creating an isolation crisis for the vulnerable elders of our country.  We need the transformative power of human connection and touch now, more than ever,” Pam Brandon, Founder and President of AGE-u-cate Training Institute.

Touching Moments Scholarship

The AGE-u-cate Training Institute is awarding a Compassionate Touch Certified Community training to one Assisted Living, Memory Care, Nursing Home, Home Care, or Hospice Agency in all 50 states and the District of Columbia.

That’s 51 organizations that will have a powerful tool to meet the isolation crisis that is happening in elder care nationwide.

The online application process is simple and the form along with more information can be found at  https://ageucate.com/index.php?main_page=touching_moments.

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  Julie provides training and educational programs on elder caregiving for family and professional caregivers.  In addition, she is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.

Giving in to Grief and Loss: Permission to Be Vulnerable

COVID-19 has created many changes. We are washing our hands frequently, wearing masks, and staying at home. Unfortunately, these changes may be permanent. As a result, we cope with grief and loss in many ways. Current events have made our grief and loss more intense, leaving us vulnerable.

What Do We Do Now?

How do we take care of ourselves while coping with everything around us? How do we take care of others who are affected by internal and external grief? Can we find meaning in this grief and loss?

What is the Purpose?

When we think about the why behind the changes, is it any easier to cope? As the saying goes, “He who has a why can bear any how.” Thinking about the continued meaning and purpose behind the precautions, isolation, and continued restrictions may help. If I understand that by wearing a mask, I am protecting others. If I remember that washing my hands reduces risks, it may be easier to continue.

Giving In to Vulnerability

In some cases, a coping mechanism may be to compare our grief, loss, and situations against what others are coping with. Is it easier to cope when we think what others are facing? Are we denying our own grief and loss to help accommodate others’ grief and loss?

By focusing or superseding one person’s loss or grief over our own may help others, but if we continue to deny ourselves the ability to be vulnerable to our pain and anxiety, it is not healthy. What helps others may help you. Is it laughter? Is it enjoying something? It is more than permissible to find joy amidst pain and sorrow.

Letting Go

Help yourself by letting your feelings and pain matter as you help others do the same. Give yourself space to grieve when you can. If need be, forgive yourself for being vulnerable. It may be easier to keep a façade of strength but that can only last for so long. And it will not likely outlast the COVID-19 quarantine.

Kathy Dreyer, Ph.D., is the Director of Strategic Projects at AGE-u-cate® Training Institute, which develops and delivers innovative research-based aging and dementia training programs such as Dementia Live® and Compassionate Touch®, for professional and family caregivers; kathy.dreyer@ageucate.com

Easing COVID-19 Restrictions: Going Forward…Moving Ahead?

The Centers for Medicaid and Medicare Services (CMS)  recently released recommendations  for state and local officials to gradually reopen nursing homes. The CMS recommendations guide officials to evaluate the feasibility to ease COVID-19 restrictions. State survey agency and state and local health departments participate in the decision-making process. CMS provides questions to answer to assess next steps.

Decision-making questions to answer

The key questions to answer are:
What is the COVID-19 case status in the surrounding community?
What is the COVID-19 case status in the nursing home?
Does the nursing home have adequate staffing?
Does the nursing home have access to adequate COVID-19 testing?
Is there universal source control (e.g., residents and visitors wear a face covering)?
Does the local hospital have the capacity to accept transfers from nursing homes?

Also, the recommendations include additional criteria for implementation, visitation and service considerations, and surveys that will be performed at each phase.

Easing COVID-19 Restrictions

AARP provides additional information about the next steps in reopening nursing homes. Fortunately, progress is already taking place in some states. For example, in Massachusetts, visits are allowed in some communities when scheduled in advance and must take place outside.  Also, visits must include an employee.  Additionally, only two people can visit a resident while wearing face masks.

In some ways, the new recommendations offer a glimpse into the new normal.  It is likely that infection control procedures will continue indefinitely. The CMS recommendations only address protection for older adults and staff,  not the effect of the COVID-19 restrictions. As a result, it is mandatory to implement plans that focus on the long-term effects of the COVID-19 quarantine.

Supporting Staff and Residents

We must address the effects of the COVID-19 quarantine on residents and direct care staff.  Residents’ routines are disrupted. For example, residents cannot participate in group dining.  Also, family and friends are unable to visit.  As a result, residents are isolated. Furthermore, staff members work overtime to compensate for residents’ additional emotional needs. Also, staff members cope with exhaustion and compassion fatigue. Furthermore, direct care workers are not valued but are unquestionably invaluable.

Going Forward – the Next Steps

Now is the time to learn from the COVID-19 restrictions experience. We must support residents and staff to cope with the after-effects of the COVID-19 quarantine. Moreover, we must provide higher wages and more respect for direct care workers. Most importantly, they provide critical care and compassion to older adults in long-term care.  As Julie Boggess’ blog emphasizes, “these workers and the residents they care for deserve better – much better.”

Kathy Dreyer, Ph.D., is the Director of Strategic Projects at AGE-u-cate® Training Institute, which develops and delivers innovative research-based aging and dementia training programs such as Dementia Live® and Compassionate Touch®, for professional and family caregivers; kathy.dreyer@ageucate.com

Compassion Fatigue: Watching for Symptoms, Finding Solutions

As summer approaches, there is a gradual easing of COVID-19 restrictions in some states. Unfortunately, caregivers at home and in long-term care still continue to face repetitive days of providing care and support.  These individuals are at risk to develop compassion fatigue.

Compassion fatigue involves a caregiver’s taking on the trauma and distress of others. Risk factors include exposure to suffering and empathic response. According to the American Institute of Stress, it is a process that takes time.  With the advent of COVID-19, things are different.

THE EFFECT OF COVID-19

How does COVID-19 play a role? The rapid onset of the COVID-19 quarantine has accelerated the compassion fatigue process. Other factors include changes in residents’ routine, and the addition of infection control measures and personal protective equipment. The multiple effects of additional work loads and caring for residents living a new, restricted lifestyle, can and will take its toll.

SYMPTOMS TO WATCH FOR, WAYS TO COPE

Caring for loved ones and residents can be difficult. With the presence of COVID-19, the caring load is greater. The effects of continued care for extended time are troubling. The American Institute of Stress lists compassion fatigue symptoms such as loss of morale, depression, exhaustion, and anxiety. COVID-related compassion fatigue can develop quickly in long term care workers. They take on additional work hours and multiple roles  to care for residents and family members. It is important to find ways to cope with this challenge.

Meditation and mindfulness can help ease compassion fatigue. Self care is critical.  As the saying goes, “You can’t fill another person’s cup if yours is empty.” Self care can be talking to others who are going through the same challenges. Sharing frustrations can help. It might be watching cat videos or taking a hot bath. Whatever method is used, compassion fatigue needs to be identified and addressed in those most at risk.

Kathy Dreyer, Ph.D., is the Director of Strategic Projects at AGE-u-cate® Training Institute, which develops and delivers innovative research-based aging and dementia training programs such as Dementia Live® and Compassionate Touch®, for professional and family caregivers; kathy.dreyer@ageucate.com

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