Almost 20 percent of COVID-19-related deaths in the United States have reportedly been in nursing homes, and Jewish facilities are grappling with how best to protect both residents and staff during this unprecedented crisis.
“It’s a difficult time,” Don Shulman, president and CEO of the Association of Jewish Aging Services, tells Haaretz in a phone interview. “It’s also like the worst of both worlds: We have tremendously increasing expenses with no revenue because no one is coming in, there are no admissions.”
His association – an umbrella organization of some 100 nonprofit member groups providing Jewish senior care across the United States and Canada – has been offering support for the nursing homes facing the pandemic. Over the past several weeks, Shulman has been working with different senior communities on sharing best practice on combating the coronavirus challenges, as well as getting personal protective equipment to staff.
He and his team, aided by the Jewish Federations of North America, have been able to obtain over $2 million-worth of equipment to help member organizations over the past three weeks.
“Through contacts, we’ve been able to find the product overseas, all over the world, and one of the philanthropists we work with has a warehouse in Fort Worth, Texas, that he does distribution out of,” Shulman says. “So everything gets to Fort Worth, and then from there everything gets shipped out individually to the facilities.” But the process isn’t always smooth, Shulman admits, as sometimes products have either come in late or are delayed at U.S. Customs.
Understaffing has also been a challenge for some facilities where staff have tested positive for the coronavirus and are unable to come to work, he relays.
“A lot of our staff may also work at one community from 7 A.M. to 3 P.M. as a nurse’s aid, and then they go down the street from 4 P.M. to midnight as a housekeeper in another nursing home, so they are back and forth,” he adds.
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Elderly Jewish community
America’s Jewish community is older on average than the rest of the country: 26 percent of the community in the 48 contiguous states is 65 or older, compared to about 20 percent of the general population, according to a survey released last October by Brandeis University’s Steinhardt Social Research Institute and published in JTA.
Nearly one in 10 nursing homes in the United States – some 1,300 facilities – has publicly reported coronavirus cases to their local health departments, according to a Washington Post investigation earlier this week. (The published numbers do not show the complete picture, as many states have yet to release such details.)
And Jewish facilities have not been spared by the pandemic, which has a higher fatality rate among the elderly. Earlier this month, 32 residents at two Jewish senior living facilities that are part of the same nonprofit network – Chelsea Jewish Lifecare – died in Massachusetts, and scores of other residents and staff have tested positive for the virus.
In California, one of the hardest-hit states, 258 homes defined as “skilled nursing facilities,” including two Jewish ones, reported having one or more COVID-19 cases affecting a resident or a health care worker as of April 17 – this is out of 1,224 such facilities across the state.
In New York, the epicenter of the pandemic and home to America’s largest Jewish community, some nursing homes and long-term care establishments have been reporting their COVID-19 cases and related deaths to the state’s health department, which made the data available on its website. Among the Jewish facilities on the list, which was last updated April 21: The New Jewish Home in Manhattan, which has reported 25 deaths; the New Jewish Home Sarah Neuman in Westchester (16 deaths); and the Gurwin Jewish Nursing and Rehabilitation Center on Long Island (six deaths).
But the highest death toll was recorded at the Parker Jewish Institute for Health Care and Rehab in Queens, where 46 residents have died from COVID-19-related causes.
That Long Island facility came under fire last week after one of its workers anonymously told The Daily Beast that nurses were wearing trash bags as makeshift gowns and treating patients without the required N95 respirators.
In response to the report, the institute issued a letter on its website Monday, denying the claims. “At no time were our staff instructed or expected to wear garbage bags as gown replacements,” the statement said. “Parker has expended enormous effort and spared no expense to secure Personal Protection Equipment (PPE) for our staff, often at grossly inflated prices, and we continue to regularly secure and issue all of the PPE for nursing homes.”
The institute is a member of the Association of Jewish Aging Services, and Shulman stresses that he sees “no credibility” to the allegations published in The Daily Beast. “In my heart I just don’t believe it,” he says. “I know their team. They’ve been in place for years and years; they’re doing such great things.”
In general, Shulman says, if a particular nursing home is especially hit by the pandemic, this should not be viewed as a reflection of the quality of the facility.
“Look at college campuses – they closed them all. Why? Because the students live in dorms, they live on top of each other,” he explains. “We can’t send our mothers and fathers home, we have to take care of them – and they come in with comorbidities, they are not the healthiest on a good day. And when we put this together, what we have is really scary.”
Nursing home, alone
As the coronavirus continues to spread across the country, and with lockdowns in place, facilities caring for seniors have closed their doors to the outside world. Residents have not been able to receive visitors for the past month, which can create unique problems. This has been a challenge for the team at the Jewish Home for Rehabilitation & Nursing, a luxury, 150-bed skilled nursing facility in Freehold, New Jersey. Its administrator, Yehuda May, says that addressing the psychosocial well-being of residents missing their families has been a key focus. “Everyone on our staff understands this and is helping to fill this ‘comfort’ gap,” he says.
“We are also finding new ways for our residents to connect with family and friends, such as window-side visits and FaceTime,” he adds. “For example, Leon, a 99-year-old resident, sings to his family over FaceTime; it is sweet and uplifting.” And over Passover, the Jewish Home’s staff had to run a virtual seder for the first time, forgoing the annual celebration with families and friends of residents.
“We also understand that this is an incredibly stressful period for families with a loved one in a communal living environment, particularly a skilled nursing facility,” May notes. “We are communicating regularly with family members to keep them updated.”
Shulman, meanwhile, says that thanks to the PPE sourced by his association, some facilities can now offer visitations to hospice care residents. “So at least if you have a mom or dad in hospice, we can gown you up and you can be there to rub their back,” he says. “The human touch at that point in life is so important.”
He also notes that the most upsetting time of all for family members is “when their loved one dies and they can’t go in the room and see them. That’s tragic, that’s heartbreaking – that’s the difficult part.”
For May, working at a nursing facility during this health crisis and taking care of the most vulnerable has proved a humbling experience. “We know we will get through this together,” he adds.
But if the struggle to keep residents and staff safe hasn’t been enough of a challenge, anti-Semitism has also come knocking on the door of at least one Jewish nursing home.
A man was arrested earlier this month and charged with attempted arson after he allegedly tried to detonate a homemade bomb at Ruth’s House, located in Longmeadow, Massachusetts. The assisted-living center is within a square mile of several other Jewish facilities – including three synagogues, a Jewish private school and a Jewish community center – and was one of the two facilities mentioned earlier where 32 people have died. The Longmeadow facility has seen 21 resident deaths due to the coronavirus.
“To say it’s sad isn’t really enough,” Shulman reflects, before pivoting back to the wider picture. “I can feel my chest tightening sometimes from hearing the stories, seeing what’s going on.” He pauses before adding, “There’s going to be some emotional scarring coming out of this.”