Sing-alongs with Santa, families gathering for Christmas parties, visiting carolers and other performances have long been among the ways residents of senior care facilities celebrate Christmas with each other, with family and with staff. The coronavirus may change all of that. But Abilene’s senior care facilities staffs still hope to make the holidays memorable for residents who can’t celebrate with family during a pandemic.
Restrictions designed to prevent the spread of COVID-19 among the most vulnerable create a challenge for administrators and activity directors. State-mandated restrictions have eliminated or changed many social gatherings and activities, and prohibited visitors who ordinarily would participate in Christmas activities with older loved ones.
Still, Dr. Suzie Macaluso, director of the Pruett Gerontology Center at Abilene Christian University, says holiday traditions are especially important for older adults.
“We like to have those observances to remind us of something else – family time, religious adherence, maybe even childhood memories,” Macaluso said. “It’s really the same for older adults in senior living centers, but almost more important because they’re in a new environment and were taken out of the family home and the other places those memories of the holidays were associated with.”
When facilities can provide special connections to those memories and traditions, or help create new memories that allow residents to connect, older adults feel more at home in their new place, she explained.
The last holiday residents could celebrate with families was probably Valentine’s Day. Two weeks later, in early March, the Centers for Disease Control began recommending more restricted screening of visitors to nursing homes and other senior living centers. On April 22, Gov. Greg Abbott issued an executive order that halted visits to long-term care facilities. Necessitated by the spread of COVID-19 in nursing homes nationwide, restrictions increased the loneliness and isolation for those populations when family members could no longer visit.
By September, the order had been modified to allow limited visitation of one caregiver if other conditions were met.
SilverSpring is Abilene’s newest skilled nursing and rehabilitation facility. Before Covid, about 90 of its 120 beds were occupied, but the number decreased over the months of restrictions to about 75. Cindy Walker became activities director at SilverSpring in September 2019.
Since quarantine requires residents to remain in their rooms, Walker will take the Christmas party to the residents. She’s planning a North Pole themed season of activities.
“Each hall will have a theme — Santa’s Workshop, Rudolph Crossing, Candy Cane Lane. At the Nurse’s station we’ll have a Cocoa Café, a cookie corner and Santa mailbox,” Walker said.
But Santa and Mrs. Santa will deliver treats door-to-door, assisted by elves passing out gifts rather than gathering residents together and inviting families.
Walker has grown accustomed to the door-to-door activity plan, having reimagined Bingo and other activities so residents can participate sitting in their doorways. “Even if there’s two in a room we space them out so they’re six feet apart,” she said. “One is by the door and the other is six feet away.”
Macaluso says finding safe and secure ways to help residents connect is important.
“Isolation is having a huge impact on older adults in these facilities,” she explains. “There aren’t easy answers. You worry about opening things back up. COVID is very serious, especially for older adults. But isolation and loneliness can also lead to terrible outcomes.”
Barbara Lampert is executive director of the independent living center at Wisteria Place, which she describes as a small community. About 50-55 older adults currently reside there.
Because her residents are independent, and so long as there are no cases in the facility, they may leave their apartments but must wear masks and socially distance any time they do, including when they’re visiting with family outdoors on Wisteria’s front porch. Family members are not allowed in the building unless it’s for a medical purpose such as organizing medications, and then they are screened and fever-checked before entering.
“With COVID, we can’t socially gather, so we had to become creative. For holidays, we have to start planning now,” Lampert said. “There will be Christmas bingos, wrapped gifts for each resident.”
Bingo is played virtually, Lampert explained, with numbers displayed on TVs throughout the building. Residents have cards they play themselves and can turn them in for prizes.
In past years, the activity staff planned 25 days of Elf on a Shelf as a Christmas scavenger hunt. This year Christmas crafts are planned so residents can do them in their rooms. Supplies are being gathered so they can make stockings to hang on their doors.
“One of their favorites is hot chocolate and reminisce,” Lampert said. “Reminiscing is so important at all times but especially now. They easily think of things from the past and this helps with mental stability and fights depression. Sometimes we’ll take a group of 10 and socially distance – one person per table –so they can kind of get together and visit.”
Questions like “Do you remember your first Christmas?” “How did you meet your spouse or loved one?” always prompt discussion among the participants. During Christmas, questions will all be Christmas focused.
During a more typical holiday season, Macaluso said facilities plan activities that can involve families, and especially
things that kids will find enjoyable. “It’s hard for kids. They can’t do what they want. They aren’t used to seeing someone in a hospital bed. If you have things planned that families can do together, it can make interaction between grandparents and grandchildren more meaningful.”
At Windcrest Health and Rehabilitation Center, Jessica Stokes is planning for ways to accomplish those connections. The Tour of Trees has been a longstanding tradition at Windcrest. In the past, the public was invited to visit and local vendors and non-profits decorated Christmas trees throughout the facility. When family came to visit, residents could take their guests on a Tour of Trees.
Last year, the Pruett Center for Gerontology was one of numerous local organizations that participated. “It’s really beautiful,” Macaluso said. “Everywhere you turn there’s a beautifully decorated tree.”
Stokes said they are brainstorming on how to be creative, how to show the public what Windcrest has to offer and keep the public involved while honoring COVID-19 restrictions.
“The holidays are hard anyway,” Stokes said. “And we want to keep it a time to celebrate, not a time to feel secluded.”
Plans for holiday pictures, decorating rooms and helping residents prepare gifts the staff can send out to loved ones will help keep Windcrest residents involved and, she hopes, connected.
“We already do virtual calls once a week, and we’ll probably do a Christmas video for loved ones,” she said.
Calls make a difference, Macaluso said, and not just calls from the residents, but also to the residents.
She advises families who have a beloved older adult in a care facility, “Even if you can’t physically be with loved ones face to face, don’t discount the role of telephone calls or sending packages and handwritten letters. Old timey mail can brighten a day and let them know they’re thought of, loved and remembered during the season.”
So instead of choirs and singalongs, perhaps residents will enjoy virtual sing-alongs this year. Who doesn’t get a smile or a chuckle from hearing a family singing a beautiful – or not-so beautiful – rendition of “We Wish you a Merry Christmas” over the telephone? No, it’s not the same. But the difference it makes is real.
By Cheryl Mann Bacon