What Have We Learned After Two Years?

Looking back on February 2020, LeadingAge Texas had just completed a successful Leadership Conference in College Station. The focus of the conference: “Leading Through Change.” We had no idea how much of an omen that topic was when we planned the conference. 

News began circulating about a nursing facility in Washington state that had some mysterious deaths due to a virus. We paid attention, but we could not fathom what was to come. After all, there had been somewhat similar stories about serious viruses in the past – H1N1, Ebola and others. While they were concerning, and public health officials warned us, they largely became contained; never becoming full-blown pandemics. This COVID-19 virus was going to be contained – much like those other viruses… or so we thought. 

The staff returned to our office in Austin and members went back to their campuses across the state. The stories about the virus became more dire in the following days and weeks. On March 6, 2020, the South by Southwest Festival in Austin was cancelled. NBA basketball suspended their season a few days later. Businesses shut down. Schools cancelled. The final meeting of the 2019-2020 Leadership Institute was cancelled. People were instructed to social distance, disinfect surfaces, avoid large gatherings, and even reminded how to properly wash their hands to the tunes of various 20-second songs. 

As cases continued to surge, countries closed their borders. College students went home. States went into lockdown, including Texas. If we could contain the virus, things could get better. But as things reopened in a phased approach, cases surged. “Stop the spread” became “slow the spread.” Scientists were racing to find a vaccine.

Long-term care facilities fared the worst. Campuses locked down. No visitors allowed. Residents were isolated. Staff were afraid. There was not nearly enough protective equipment to go around. Of course, the media focused on deaths in nursing homes. What were long term care facilities doing to protect residents and staff?

The truth was, we were all doing the best we could given these ‘unprecedented’ circumstances. We improvised PPE, sometimes sterilizing and reusing equipment meant for one-time use. Campuses disinfected everything including mailed packages and grocery items. We were hearing ever-changing guidance daily about the best ways to protect residents and staff.

We made it through 2020 – and miraculously, a vaccine was developed that was going to quickly end the pandemic. Like many of you, I felt a profound sense of relief early in 2021 when I got my doses of the vaccine. There was a sense of hope in the air. Cases continued to trend down until a new variant (Delta) surfaced and issues like vaccine hesitancy increased.  

At this point it seemed we were facing a whole new set of issues. Many communities struggled with vaccination mandates while suffering an acute workforce shortage. Then, most recently, the Omicron surge happened. While senior living communities were much better prepared this time and had most, if not all, residents vaccinated, the challenges remained. The roller coaster ride that we have been on for two years has been taxing on the body, mind, and soul.

Yet, we continue to be hopeful that this will be the last significant surge of COVID. Signs point in that direction, but as we’ve learned, we must stay vigilant and be ready. 

There are many lessons that we’ve learned over the past two years. Here are a few:

We are resilient! I know this term has been overused lately but, – taking care of seniors has never been easy, and this pandemic took it to another level. We adapted and we survived. Even when we thought we couldn’t go on and deal with all the changing guidelines and protocols, we somehow managed to find energy reserves to carry on our mission.

We are innovative! We created solutions to problems we never thought we’d experience. Certainly, in the regulated parts of our campuses, we are very rule-driven. But this pandemic caused many of those rules to be tossed at least temporarily. We also have had to adapt to workforce demands. Things like flexible work schedules, job sharing, and other job variations have been instituted. We have had to adjust our thinking about issues we once thought were etched in stone.

Leadership matters! During critical times such as these, leaders emerge from the ranks. We often talk about leadership at conferences and workshops, and rightly so -- in the crisis we experienced over the past two years, our membership’s leaders produced extraordinary results. And they did it by creating amazing teams. To put it another way, where there is a great team, you can bet there is likely an inspiring leader. 

Sticking Together

Related to great leadership, is the recognition that we are part of a larger community of leaders within our association. If nothing else, the past two years proved that we cannot function effectively on our own. Communication channels among LeadingAge Texas members were never more utilized. One positive thing to note about the pandemic is that members realized the power of synergy.

Work Must Carry On  

While some businesses shut down or went remote, senior living did not have that option. All the things that senior living does – providing meals, social activities, health care, maintenance of physical plants, and much more – had to continue. Our members stepped up to the plate to serve our seniors throughout the pandemic, while navigating all the changing rules and guidance, and with a limited workforce.

No Longer Taking Things for Granted

The pandemic and its related issues (supply chain issues, workforce, etc.) made us value things that maybe we hadn’t before. One thing that stood out is the basic needs of human-to-human contact. Even within our association, virtual meetings were welcomed and embraced. Thankfully, last October during a lull in COVID cases, we were able to gather again in person. Remarkably, it was the Leadership Conference – the same event as our last gathering in 2020. There is a certain magic that happens when people are around other people. We certainly won’t take the simplicity of togetherness for granted any longer.

Work-Life Balance Took on a Greater Meaning

The pressures faced by all senior living providers during the past two years were self-evident. With a tight workforce situation, it became even more difficult to take time off. But, as the world changed and the idea of self-care was reinforced, the need for some balance between work and home life was never more necessary. When travel restrictions were in place, the need to get away from the day-to-day grind of work, even for short periods of time provided an essential respite. There continues to be a growing recognition of mental health issues related to working on the front lines of a deadly virus, and similar recognition to the importance of preventing pandemic-induced burnout.

Isolation Came at a Price – But Staff Provided Amazing Care 

While our immediate focus was on keeping residents safe, it came with the consequences of keeping people isolated from their families and friends. As the months of the pandemic carried on, so did the aftermath of the isolation. The health of many residents declined – not from the virus, but from the isolation from loved ones. It was a difficult thing for providers to navigate. State and Federal rules very much limited access to residents. Even outdoor visits were restricted. So, risking citations and fines came at the expense of breaking rules that were supposedly meant to protect residents, but at times had the opposite effect.

One of the bright spots of this crisis was the importance of the role that senior living staff plays in providing the human interaction necessary for residents’ well-being. Staff who were truly committed to taking care of seniors rose from the ranks. These were indeed tumultuous times when everyone’s lives were upended in some form or fashion. When schools and daycare centers were on lockdown, it created severe pressures on parents for childcare. Some companies were able to adapt to these pressures on their workforce by changing to remote work, but senior living communities and frontline workers did not have that luxury. For the direct-care workers, and particularly for those who viewed their jobs as a calling or mission, they stuck around and continued providing quality care to our senior Texans. This month’s #CareIsLove social media campaign, part of our 2022 Bright Spots calendar, is truly special as we highlight the extraordinary bonds that develop between older adults and aging services professionals who provide them care.

Reimaging Our Field

While this historic pandemic caused many to temporarily put their future strategic plans on hold, it also provided a (necessary) pause to really evaluate what the future of our field will be. And there are lots of questions to be answered. There are many who are looking at the future of the field. In fact, the entire February 2022 issue of the Journal of Post-Acute and Long-Term Care Medicine is devoted to research and recommendation on issues such as the long-term care workforce, societal issues, models of care, financing, payment, regulation, and services.

Where Do We Go from Here?

I’m sure most of you have inspiring stories to tell about how you and your teams coped during the past two years, and we’d love for you to share them in the Member Exchange in our new online LeadingAge Texas Member Community: community.leadingagetexas.org. We’d also like for you to share some of the innovations developed at your community and how you are moving forward from this pandemic.

One thing I know that separates LeadingAge Texas members from the pack is that our organizations are in it for the long haul. According to our calculations, we have had at least two communities who have now survived through two global pandemics! Many others have survived war time periods and other major historic events. What keeps our communities going is our continued focus on our mission to take care of senior Texans. Our many “long haulers” have continued to reimagine and refocus their organizations through good times and challenging times.

Our leadership in this field must continue to drive us to a better future for the people we serve.

George Linial, CAE
President & CEO, LeadingAge Texas