Julie Thorson

Heartbreaking decisions, no easy answers, the best of the worst, and lost hope. Welcome to the spectrum of emotions that now fills our days in long-term care. And the kicker to it all is, there is no end in sight. 

Despite the country opening up, the pandemic isn’t over. For us, there is still plenty of fighting left. 

How do we lead during a time when spirits, of both residents and employees, are at an all-time low? How do we lead when personally we find ourselves in a daily struggle? I will not begin to give advice on this topic today. Today is hard, today is not fun, and today frustration is taking a center stage and all reasoning is behind the curtain. 

I want to make sure I offer this in a way that all will understand. Due to the pandemic, the Silent Generation, the Greatest Generation, has become the Forgotten Generation. It appears to be relatively easy for folks to look away rather than examine what is really happening in our field. Safety at all costs has clouded any sense of judgment related to what is truly best for seniors. 

We have not allowed them to make choices for their lives; we have told them what they can and can’t do for 100 days. The outrage isn’t there because after all, they are the most vulnerable. We certainly take our roles as protectors seriously, but we can, and should, do better than this for those we respect. 

Today I asked team members to paint a picture of what is really happening inside our walls:

  • I have watched most of our long-term care residents in my neighborhood suffer from isolation every single day.  I’ve been asked questions like, “What did I do to deserve this?” I have heard statements like, “This is probably the last months of my life and I have to go without seeing my family and friends,” and “I’d rather risk getting the virus than sit here and rot away.” This is despite all of our efforts to keep them in contact with their loved ones by video chat and window visits. Residents have asked me for hugs and when we embrace, they don’t seem to want to let go. It’s completely heartbreaking. It truly makes you wonder what’s worse… the isolation or the threat of the virus? 
  • I have watched several residents pass away. Yes, they have loved ones at their side in their final hours when they can no longer respond or open their eyes, but in their last coherent moments, they are completely alone. 
  • Staff do the best they can, but they cannot replace family. I can’t even imagine the impact it’s having on those family members. I can think of one instance specifically where a resident was passing away but the wife could only come visit with him starting at 8 a.m. He passed away before she could get down to see him one last time. Having dementia, it was difficult for her to process anyway, but not being able to be near him made it all the more difficult. I’ve heard reports of her still being extremely emotional even a month later. Again, it’s heartbreaking. 
  • Residents who were extremely social — going to church, visiting daily with friends and loved ones, having lunch in the common areas, and more — I have seen them decline mentally in just the past couple months. I can honestly say that if this continues through the end of the year, I can see many of the residents here giving up and passing away.
  • I have watched those who used to be sharp and witty now look at me with a dazed, confused look. They seem very perplexed when we play the same games we’ve been playing for a year now. Something as simple as rolling dice has become a challenge. I’m finding that fewer people want to participate in hallway games, and more are opting to stay in their rooms or if they are lucky and it’s nice, they choose to go outside.

Our stories are not unique; this is happening all over the country. Here in Iowa our reopening guidelines are such that it will be extremely difficult for us to “reopen” based on potential COVID-positive cases and adequate personal protective equipment. (If we are able to obtain it, we are spending hundreds of thousands of dollars to do so.) To hear, “We are listening, we understand,” is hard to believe. This is a true injustice to our seniors. We need to do more now. 

I’ve always prided myself on being positive in challenging situations, but it’s hard to stay positive these days. It has been a true test of leadership strength and perseverance. 

We owe it to those we serve to paint an accurate picture of what is happening. We continue to fight to protect our residents, but are we doing enough? 

Simply: No. 

We can do better. Emotional well being has to be a priority for all, not just for those living outside of the walls of a nursing home. 

I’ve talked to peers across this country, and when I hear my colleagues say they feel like wardens in a prison telling the inmates when they may or may not leave, something is wrong! We are advocates, we are leaders and we must fight. 

Julie Thorson was the 2018 recipient of the LeadingAge Dr. Herbert Shore Outstanding Mentor of the Year award. Thorson is currently a coach for the Leading Age’s Larry Minnix Leadership Academy.  Her “Living Leadership” blog was named the 2016 “Best New Department” Bronze Award winner by the American Society of Health Publication Editors. The president and CEO of Friendship Haven, a life plan community in Fort Dodge, IA, Thorson is a coach’s daughter at heart. A former part-time nursing home social worker, she is a licensed nursing home administrator and recently completed Leading Age’s Leadership Educator Program.