The moments before one closes his eyes forever should feel very similar to the moments when he opens them for the first time. This means he is surrounded by the same familial love, feeling comforted, and even celebrated. Simply put, the last day of life is just as important as the first. This is one of the core tenets instilled in the caregivers at Sunrise Senior Living.

Under normal circumstances, caregivers in senior living communities—many of them nurses—work alongside each other in lockstep with residents and families, and often with local hospice partners, when residents are nearing end of life. Team members spend just as much (if not more) time with their residents than they do with their own families. They know residents’ routines and preferences. They know when and how often families typically call or visit with loved ones.

This knowledge, paired with their caring hearts, expertise in their field, and resources and hands-on support from some of the best hospice care providers in the country, creates an environment where a beloved resident’s final days are filled with familiar voices, faces, sights, and sounds.

But COVID-19 has challenged the familiar, presenting challenges and hardships that no one could have anticipated. As human beings, this virus has forced everyone to redefine “normal” and reset expectations for everyday life.

Still, nurses find a way to honor the commitment they make to residents and families. 

The rapid progression of COVID-19 in seniors—who are among the country’s most vulnerable populations—is unlike anything seen before. Additionally, the overall demand on the health care system, including hospitals, hospice providers, supply chains, and others, has created a situation where the needs of residents must be anticipated days and even weeks in advance. Both of these challenges are exacerbated by social distancing guidelines that help keep residents and team members safe.

Resident care directors, nurses, and caregivers are ever-present, working with residents, families, and residents’ physicians to ensure they have the necessary supplies to keep them comfortable and to ensure that they are cared for holistically—mind, body, and spirit—in their final days.

In some instances, essential medication, as well as equipment like hospital beds and oxygen tanks, are being procured when a resident becomes ill. Whenever possible, nurses work diligently to meet the needs and wishes of a resident who wishes to remain in his or her home, provided emergency care is not necessary, or when a resident does not want to seek further treatment.

Nurses and teams are also focused on communicating with families frequently to ensure they are comfortable with the care being provided and feel informed and prepared to make necessary decisions regarding their loved one’s care.

Caregivers move beds closer to windows so families can see each other and smile. They send photos and make phone calls each day. They use Skype and FaceTime. They answer calls in the middle of the night and stay long past their scheduled shift to sit with residents—both healthy and sick.

Nurses in senior living communities have always been an extension of the family unit. But now, they act as surrogate sons, daughters, grandchildren, and friend for families who cannot be there in person. And for those who aren’t able to say goodbye in person, nurses sit by quietly, making sure masks, gloves, and gown are fitted property so families can focus on what matters most, while protecting themselves and their families at home from the virus.

Katie, a Sunrise nurse in New Jersey, recounted sitting bedside, holding the phone to a resident’s ear so her daughter could say goodbye. And while our resident was too weak to respond, both mother and daughter found peace in these final words.

Mary Anne, a nurse in New York, was doing one of many frequent checks on a resident who had been diagnosed with COVID-19. Recognizing her resident didn’t seem herself, Mary Anne sat down and was holding the resident’s hand as she took her final breath. Her son’s first question, when Mary Anne called him was, “Was she alone?” She was able to tell him, “No. She wasn’t alone. I was there.” Caring and compassionate—that is a Sunrise nurse. It is in their hearts.

This is what the world cannot see right now as senior community doors remain closed to protect loved ones inside. Amid sadness and loss, acts of love shine through. Smiles are still seen, beaming like rays of the sun at sunset. Many residents recover. Laughter is still heard on the other end of the phone. Even in the face of challenge, love for the people served motivates caregivers to support them in new and different ways, because that is what the situation requires. It is what they do, and always have done.

Day-by-day, and sometimes hour-by-hour, nurses are facing COVID-19 head on, while bridging the physical chasm the virus has created between residents and their families. The last day of life is just as important as the first.

On behalf of the nurses and caregivers at senior living communities across the country, please know they are doing everything in their power to nurture the mind, body, and spirit of residents and keep the promises made to you and your loved ones, because they are also loved by us.

 

Sue Coppola is chief clinical officer at Sunrise Senior Living.