Hello. I'm Morgan [inaudible]. We are really delighted to have Mary Underwood here, to discuss strategies to support resident well-being during COVID-19. Mary is Vice President of Memory Care Services for Artis Senior Living. She has 31 years of experience in senior care with a primary focus on memory care, and has received many accolades in this field, including receiving the Alzheimer's Association, outstanding Caregiver Of The Year award on two occasions and the Connecticut Assisted Living Distinguished Service Award. She is a certified dementia practitioner, Alzheimer's disease and dementia care trainer and Montessori dementia care professional. Mary, thank you so much for being here today. I have had the pleasure of seeing some of the work and the innovative methods that Artis Senior Living has used to support the well-being of their residents during this incredibly difficult time. We really appreciate you taking the time to share some of these strategies with us. Well, thank you. It's definitely my pleasure. I wanted to ask you first, from your perspective, what has been the most challenging part of this pandemic for the residents in your community. I think probably for the residents it's just such a change of lifestyle from where they're used to being as Artis Senior Living. Our communities are designed for just a great deal of movement and freedom and independence. Our residents can eat in whatever neighborhood they wanted to or they can go into whatever area they wanted to. Also, they were very involved in the day-to-day of studying the tables and helping with task and chores and things within the community. I need to say, because of everything going on, we do have to restrict things a little bit more for them. I think for them that's been the biggest challenge. Of course, not seeing as many people has been an absolute challenge, somewhat for residents, but a little bit more so for our families, which I know we're going to talk about in a little bit, but for our residents, not seeing their loved ones as frequently as they did despite other things. It's definitely been a challenge for everybody, for the residents, for the associates, and for the families. But for our residents, I would say it's the lack or the limited ability to just have the freedom that they used to have before and then the second is not being able to see their loved ones in-person like they used to in the past. Yeah, I totally understand that. I guess in that same being, my question for you would be how have you helped to connect residents with some of their family members that they've been separated from for so long now? Well, the things a lot of people are using nowadays is the technology? Because of our population, we really weren't sure how we would do with FaceTime and Zoom and the technology. To our pleasant surprise, many of them have adjusted quite well. They've been able to do FaceTime; they've been able to Zoom. We've done Window visits with our families and depending on where our facilities and our communities are, we've been able to do some in-person outdoor visits and all that. We've been trying to do that, but we also do things that are very familiar with our residents. We have a program called I'm All Write, and the write is, W-R-I-T-E, where our residents [inaudible] sit down and write letters and send cards to their loved ones. We encourage their family members to do that back for a couple of reasons; it's very familiar to our residents to write a letter and to receive a letter. Also, a letter is something we can continue to show our residents, unlike a visit that happens and then it's over, a card or a letter, we can show the resident repeatedly to help remind them of what's happening. Also, we've had our families send short videos saying, "Hello" and we're able to show them that. But besides the family members, we have church services done in our communities weekly that haven't been able to happen, so also [inaudible] been happening via Zoom. We've been doing pet visits, we've been doing dance classes, all through the use of technology. Again, I'm pleasantly surprised how well many of our residents have adapted to that technology, while, it's also again, doing the familiar of the letter writing and the sending cards, which they really have enjoyed. I love that. You'll see some pictures here. I really do think you guys think of very innovative way to keep the residents lives really the same and also exciting during all of this. What about family members and their peers? Has there been anything you guys have used help alleviate fears of family members who may not be able to see their loved ones due to visitation restrictions? I think this has been quite harder on our [inaudible]. They have a concept of time. They know how long it's been since they've seen their loved ones. Luckily, our residents, they haven't seen their loved one, but they don't have the concept of time. I think the greatest thing is to communicate, communicate, communicate. Through pictures, through videos. We have great Facebook pages with so many great activities and programs going on that our families are able to see their loved ones engaged. We've also had family members that are able to Zoom into some other programs within the community so they can participate. But for our families, it really is, we're communicating as much as we can. I don't think any of us thought we'd been months into this. The challenging part is for our residents, they're going to decline because of the disease process. It's making sure our families are aware of where their loved one is, each step of the way so that when they do get to see them again, it's not a surprise and they know really where they are, socially, functionally, cognitively, but it is over-communicated. Actually, in several of our communities, what they have done is the management team owns seven or eight residents, and that director is the contact for the family and they check in weekly and they send updates so that it's not overwhelming to too many of the associates and also the families they know who to get in touch with directly in regards to their loved one. That's amazing and I think you've touched on a very common theme throughout this course. There's really the importance of over-communicating, and I have noticed that in the communities that I've worked with, a one that really are stressing this communication and keeping the family members abreast are really the ones that you're not seeing as much pushback from family in terms of the restrictions because they really have an understanding that all of the decisions you're making is really for the safety of their loved ones, and I know you guys do a lot of town halls for the family members too, which I think have been really successful as well. I guess to touch on the memory care a little bit, most of your residents are in memory care unit. How has it been? What have the challenge been in terms of explaining some of these new restrictions? How have you managed that? I know that this is a real government setting. Ninety nine percent of our residents are memory care. That's what we do. We do memory care assisted living, and the message we stress with our associates about caring for people with dementia is, their brain is broken, but their heart is not and that is our solid message. Some of our residents have the ability to understand the facts, but many of them don't or if they do, it's soon forgotten. It really is about getting the residents to understand that this is serious, but we're in it for them, they are safe, they are cared for. It's really making sure the emotional aspect is understood more than the factual. Some of them do understand and again, I'm shocked by how most of our residents, actually, they don't question the masks, they don't question the face shields any longer because we're able to keep our staff emotionally calm and centered with our residents, and I think our residents respond to that, that they feel cared for, they feel safe. They may not understand the facts of what's happening around them, but they understand the emotion of, it's okay, it's serious, but it's okay, and that's really been our main strategy, but we do have some residents who understand the facts of it, and they ask about their masks and they're pretty attuned to what's happening, but it really is, and we try to stress with the families too. Our residents react off the emotion of what's happening and not the facts of what's happening. It's really keeping them reassured and comforted. Having that comfortable feeling for sure, and I know I have really seen this from everyone I have worked with artists that is such a huge stress and something that you continue to do throughout all your community. That's so great. Any other examples that you want to share of ways you have tried to make the lives of the residents meaningful during this time? Any other advice you have? I think you really shared a lot of really good strategies for other communities and we so appreciate you taking the time with us. Though it's my pleasure, I think for a resident, it's again, about making things as normal as possible as you can. Even before COVID, it was just make the moments that's why our philosophy is positive partnerships the artist's way because it's about giving as many positive moments as we can. In one of our communities, they actually did a spa day where they turned the studio and the community into a spa, and they did facials and they did pedicures and the residents came in these lush robes and if we've just looked at the pictures and you never even imagined that COVID was out there. It's still celebrating those birthdays. If somebody thinks it's your birthday today, then today's your birthday and we're going to celebrate that. It's just taking those positive moments and again, I understand for our families and I was a family member myself, my dad within a community with when he had dementia and it's so hard for families, but it's giving those wonderful moments whatever that looks like for the residents too. We've had Irish step dancers come outside of our community and we lined the residents up in their windows to be able to watch that, and it's just those positive moments in spite of a horrible disease in this pandemic. Well, thank you so much for joining us today, Mary. We really, really appreciate all these thoughts. Thanks again. [inaudible] and here's the 2021.
