Kathy Dinkel's grandsons put on an impromptu concert not long ago outside a window at Aksarben Village Senior Living.
Adults paired Bluetooth and iPhones so residents in the center's Meadowlark unit could hear the toddlers, who sing on cue with little prompting, Dinkel said. Her dad, resident Tom Moorman, has dementia.
The boys launched into "You Are My Sunshine" and residents joined in as they looked onto the lawn from the second floor.
It was a touching — and fleeting — moment. "They wanted to sing other songs the residents didn't know, like 'Baby Shark,' " Dinkel said.
The "window visit" was one of several ways friends, families and care providers are trying to lift the spirits of residents in Omaha-area senior care facilities as the coronavirus pandemic continues.
Staying home and avoiding contact with others is hard on all of us, but senior-care workers and mental health professionals say it's especially difficult for many older people who already are isolated and lonely.
"One of my colleagues made the comment that if this is how we feel now, this is how our elders feel all the time," said Mindy Crouch, a licensed counselor who owns Pando Geriatrics, which provides mental health services to senior living facilities across the Omaha area.
All senior living homes in the area are restricting visitors as cases of COVID-19 increase. Most will admit only those who perform services for residents, such as health care workers and therapists, though they make exceptions on a case-by-case basis.
Nearly all will allow family members to be with dying loved ones, at least for the time being, said Emilee Jochim, co-owner of Clare Senior Advisors, an Omaha business helping families navigate the admissions process for assisted living and skilled-care facilities.
That means window visits — portrayed elsewhere as sad goodbyes for relatives separated by a pane of glass — so far are more uplifting than sorrowful here, she said.
Some Omaha-area facilities are still admitting residents, Jochim said. One notable exception is in Blair, where Carter Place is under quarantine after two residents tested positive for COVID-19.
"Seniors don't stop needing care," she added. "They don't stop being discharged from hospitals, unable to return home."
Agencies such as Clare continue to help clients find the best residences, though they're not taking tours of the facilities.
Administrators and personnel at area senior homes have made numerous adjustments to keep people safe and mentally healthy.
Workers' temperatures get taken when they arrive at work (it has to be below 100 degrees for them to stay) and wash their hands immediately before any contact with residents, said Colleen Jones, administrator of Aksarben Village Senior Living. A concierge makes sure everyone entering the building is on a list of approved visitors.
Other homes have similar practices.
Residents still can congregate in the lobby at Aksarben, providing that there are fewer than 10 at a time and they observe the proper 6-foot distance. Many group activities have been canceled, however, and communal meals are suspended. Workers now deliver food to residents' rooms.
"They definitely miss their happy hours," Jones said of the residents.
Workers have been reassigned to housekeeping to keep up with a constant disinfecting protocol, and drivers, who now take residents to fewer appointments, clean elevator buttons and other frequently touched surfaces.
Homes also have found creative ways to safely provide activities.
At Ambassador Health, a rehab and skilled-care facility, residents sit in their doorways for programs. Workers stage dance parties down the hall and conduct a popular horse race game in which residents "bet" on a horse, then roll dice that determine how far their horses go.
It requires some ingenuity, said Stephanie Farmer, director of customer relations for Nebraska City-based Ambassador, which also has other area facilities. One example: They use walkie-talkies to convey directions to people who can't hear well.
Family, friends and community members also help. Residents at Ambassador are hanging paper Easter eggs on their windows for a neighborhood "hunt."
A vendor for Aksarben put cards on the east and west sides of the building with encouraging words: "Thinking of you" and "We miss you."
Many residences provide technology such as iPads, FaceTime and Skype to help residents stay connected with family.
Hillcrest Health, which operates several facilities in the Omaha area, streams worship services on phones and iPads for residents, said Elizabeth Stratman, director of communications. Hillcrest also is offering unusual events to help residents get through their days: one-on-one spa sessions, live concerts by staffers and TED Talks on an in-house TV channel. They also are making chocolate runs and distributing activity packets with puzzles, word games and trivia.
The nonprofit Merrymakers group, which sends professional musicians to perform at senior homes, made a video of Gram-my-nominated country singer Billy Troy for its clients because he can't appear in person.
And Sharon Moorman, Kathy Dinkel's mom and Tom's wife, brings 6-year-old Speck to the window so residents can watch him do tricks.
She said the all-black terrier-Chihuahua mix has dancing, walking on his hind legs, rolling over and saying his prayers — and more — in his repertoire.
"Residents know him," Moorman said," because I used to be able to take him in."
All these things boost spirits, but Crouch, the mental health professional, says she still sees an increase of depression, anxiety and agitation among residents. Administrators and staffers work hard to combat that, but sometimes it requires counseling sessions, especially when it's caused by something as rare and scary as a pandemic.
"The majority of these mental health issues can be attributed to a new lack of control, because they don't know what the immediate future looks like: When can we socialize again, when can we have visitors, when can we leave our rooms?" she said.
Talking with a professional helps residents deal with fears and find resources. The earlier the intervention, the easier it is for people to regain control of their emotions, she explained. Don't wait for a major event or feeling.
"It's healthy to vent and express yourself and get objective feedback," Crouch said.
Caregivers and family members also need to be mindful of mental health. Sharon Moorman has been making quilts to cope, and, with Dinkel, used scraps to make 38 "designer" masks for Meadowlark's memory care residents.
She writes letters to Tom and, one day, she sent him kisses through the window. He sent them back.
"It's tough," she said. "The one thing I can say is that I know his care is as good as it can be."
SENIOR LIVING STATISTICS
Nebraska has 214 nursing facilities with a total of 16,041 licensed beds. The current occupancy rate is 74% or about 11,875 residents. The state has 285 assisted living centers with 13,277 beds. The occupancy rate is unknown. In Iowa, there are 357 assisted living programs and 11,898 units. Iowa has 427 skilled nursing facilities and 28,600 beds. Occupancy rates were not available for Iowa.
Sources: Nebraska Health Care Association, Iowa Health Care Association
MAINTAINING MENTAL HEALTH
There are several things you can do to hang on to your sanity in the era of social distancing, says licensed counselor Mindy Crouch. These tips are for caregivers and family as well as residents of assisted living and skilled-care facilities, but Crouch urges people to remember that many seniors were isolated and lonely long before coronavirus. "I have high hopes that this will spark opportunities for change, for us to reorganize our priorities," she said.
Find a way to regain control. One way a caregiver can help seniors do this is by offering choices about how to spend their day, when to do things, etc.
Boredom mirrors depression. If someone seems to be losing interest in things he or she normally enjoyed, initiate an activity and that person usually will follow your lead.
Remember that it's OK to have a bad day and try again tomorrow.
If you're fearful, find a distraction. Turn off the news. Watch a movie. Exercise. Books are fantastic because they take you to a different place without actually having to go there.
Keep expectations realistic for yourself and for others. Allow other people to have a bad day.
Consult a counselor before you're feeling overwhelmed. There's no right or wrong about the timing.