Lengthy-Time period Care Staff, Grieving and Below Siege, Brace for COVID’s Subsequent Spherical
By Judith Graham, Kaiser Health News
In the middle of the night Stefania Silvestri lies in bed and remembers the screams of her elderly patients.
“Please do not leave me.”
“I need my family.”
Months of caring for older adults in a Rhode Island nursing home ravaged by COVID-19 put a heavy burden on 37-year-old Silvestri, a registered nurse.
She cannot sleep while repeating memories of residents who got sick and died. She gained 45 pounds. “I’m afraid. Some days I don’t want to get up, “she said.
Now that the coronavirus rises across the country, Silvestri and hundreds of thousands of workers in nursing homes and assisted living centers watch with a sense of fear as cases in long-term care facilities increase.
Many of these workers struggle with grief over the suffering they have experienced both at work and in their communities. Some, like Silvestri, were infected with the coronavirus and recovered physically – but not emotionally.
According to the latest KFF data, more than 616,000 residents and employees of long-term care facilities have been affected by COVID-19 since the beginning of the pandemic. Just over 91,000 have died when the coronavirus entered nearly 23,000 facilities. (KHN is an editorially independent program of the KFF.)
At least 1,000 of these deaths represent certified caregivers, nurses, and others who work in facilities that care for older adults. This emerges from a recent analysis of government data by Harold Pollack, a professor in the University of Chicago’s School of Social Service Administration. This was almost certainly an undercount, he said, as the data was incompletely reported.
How are caregivers affected by the losses they suffer, including the deaths of colleagues and residents who have cared for them, often over many years?
Edwina Gobewoe, a certified nursing assistant who has worked at the Charlesgate Nursing Center in Providence, Rhode Island for nearly 20 years, admitted that “it has been overwhelming for me personally.”
At least 15 Charlesgate residents died of COVID-19 from April to June, many of them suddenly. “One day we hear that our resident has breathing problems, needs oxygen and dies a few days later,” she said. “Families couldn’t come in. We were the only people with them who held their hands I was very, very sad. “
Every morning Gobewoe prayed with a close friend at work. “We have asked the Lord to give us strength so that we can take care of these people who need us so much.” When this colleague was hit by COVID-19 in the spring, Gobewoe prayed for her recovery and was glad when she returned to work a few weeks later.
In early September, however, grief followed: Gobewoe’s friend collapsed and died at home complaining of unusual chest pain. Gobewoe was told her death was caused by blood clots, which can be a dangerous complication from COVID-19.
She would “do anything for every resident,” Gobewoe recalled with a sob. “It’s too much, something you can’t even talk about,” described her grief.
I first spoke to Kim Sangrey, 52, from Lancaster, Pennsylvania, in July. She was dismayed by the deaths of 36 residents in March and April at the nursing home where she worked for several decades – most of them due to COVID-19 and related complications. Sangrey, a recreational therapist, asked me not to name the house she continues to work in.
“They know residents like family members – their likes and dislikes, the food they prefer, their families, their grandchildren,” she said. “You are dependent on us in everything.”
When COVID-19 hit, “it was awful,” she said. “They went into the residents’ rooms and they couldn’t breathe. Her families wanted to see her, and we had Zoom with full gear and head set up, tears pour under your mask as you watch this person you loved to die – and the family mourned by a pill. “
“It was utterly devastating. It goes through your memory – you think about it all the time. “
Most of the time, Sangrey said, she felt empty and exhausted. “You feel like this will never end – you feel defeated. But you have to keep going, “she told me.
Three months later, when we spoke again, Pennsylvania COVID-19 cases were on the rise, but Sangrey sounded determined. She had had six sessions with a grief counselor and said it had become clear that “my goal at this point is to harness every ounce of strength I have and move through this second wave of COVID.”
“As humans, it’s our duty to be there for one another,” she continued. “You tell yourself, OK, I made it through the last time, I can get through it again.”
That doesn’t mean there is no fear. “We all know that COVID-19 is coming. Every day we say, ‘Is today the day it will come back? Is today the day I’ll find out I have it? ‘It never leaves you. “
To this day, Silvestri is appalled when she thinks in late March and early April at the Greenville Center in Rhode Island, where up to 79 residents have contracted COVID-19 and at least 20 have died.
The coronavirus moved through the facility like wildfire. “You put a patient on oxygen and the patient in the next room is on the floor, but you can’t go to them yet,” recalled Silvestri. “And the patient in the hallway has a fever of 103 and they are screaming:” Help me, help me. ” But you can’t go to him either. “
“I went from work crying every day. It was heartbreaking – and I felt like I couldn’t do enough to save her. “
Then there were the body bags. “They put this person who feels like family in a plastic bag and roll them through the furnishings in other residents’ rooms on a frame with wheels,” said Silvestri, who cannot smell certain types of plastic without revisiting those memories to experience “When I think back on it, I feel physically ill.”
Silvestri, who has three children, developed a relatively mild case of COVID-19 in late April and returned to work a few weeks later. Her husband Michael also fell ill and lost his job as a truck driver. After a few months of unemployment, he is now working on a construction site.
The family no longer has health insurance since July 1st. “So I can’t get advice on how to deal with the emotional side of the action,” said Silvestri.
Although her nursing home has set up a hotline that employees can call, it does not address her. “Talking on the phone to someone you don’t know doesn’t do it for me,” she said. “We definitely need more emotional support for health care workers.”
What helps is family. “I relied a lot on my husband and he was there for me,” said Silvestri. “And the kids are fine. I’m grateful for what I have – but I’m really worried about what’s ahead of me.”
The Navigating Aging column last week looked at how care homes respond to grief in their facilities.
Visit Judith Graham for a Facebook Live event about grief and grief during the coronavirus pandemic on Monday, November 16 at 1 p.m. ET. Here you can follow the conversation and ask questions in advance.
Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation that is not affiliated with Kaiser Permanente.
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