May 22nd, 2020
Masks – Our New Normal.. A message from our VP of Operations, Therese Achatz
We are at a somewhat exciting moment! Our communities are entering a new phase of planning and it will allow us to slowly start coming together again. Community leadership will share plans as their teams have all required pieces in place and local community guidelines give us the go-ahead.
As we come together more, an increased risk to each other is simply a reality. But a crucial piece for safely coming together again is the donning of a mask. Previously, our communities have advised and encouraged residents to wear masks outside of their apartment home. Hopefully, we have answered all resident questions about properly ‘donning and doffing’ a mask to avoid bringing contamination to it, and to your face. (Hand hygiene is critical to never touching a mask with dirty hands!)
In order to protect everyone, we are teaming up to have all residents wear a mask outside of their apartment home. We know some residents must have an exception for medical and tolerance issues. That is okay – we will work with those residents. It is also true that as dining rooms and cafés return to service, masks do not work while enjoying a meal.
We are keeping our communities safe and healthy and we are standing together as a family.
We are so excited to enjoy these next steps! Residents and family members, please stay tuned for specifics from your campus leadership and please stay safe and well.
Therese Achatz, VP of Operations
May 15th, 2020
Staying Focused and Thinking of Others
Wishful memories hit me hard every once in a while. Thoughts of having family over, dining with my husband at our favorite now closed restaurant, meeting with friends, and getting nails done create longing for liberties just not possible in this new ‘normal’. Some days it takes more effort to redirect my mind from missed things toward all the things I am grateful for, so our culture topic this month, gratitude has come at a very good time. But as we see the country slowly open up, those longings, I expect, will continue to grow.
For all that I feel the pull, I do keep focused on doing the right things. It helps to think about you and how every effort means something. I think about our residents and model the strength and patience I see. I think about our staff and, as they do, count to 20 while handwashing. I think about families with loved ones on our campuses and how that trust requires that I too wear my mask and practice social distancing. I am grateful for the encouragement thoughts of you bring. Our diligence is critical to keeping our loved ones, our fellow residents and coworkers, safe.
You may have questions about ‘when’ – when community visiting opens up again, when it is safe to engage with outside family and friends for a drive, when will scenic drives and salons return, and when we can host community celebrations again. With abundant caution, we are preparing for the future and preparations are in motion for the weeks and months ahead. Community signage will be placed in the next week to remind us to physically distance and properly and frequently wash hands, committees are working on how to organize safe small group Vitality activities, and strategies for dining rooms are coming together, along with how to welcome visitors back to the community in a safe manner. Please know our focus firstly is always the safety of our people. We will follow guidance from our local health departments and as authorized state and local “phasing back” stages, but we look forward to having some answers to share for many questions of ‘when’.
Community Updates: We have updated the Generations web site to reflect any positive cases of COVID-19 in staff and residents. Please see the COVID-19 link on each community website or go to www.generationsllc.com.
The following are some continued and ongoing actions:
- We remain in communication with health officials to ensure we stay in alignment and have been ahead in our practices.
- We continue with recommended and best practice infection control procedures, internal teams have enhanced regiments of disinfection, and we continue to refresh protocol training, such as PPE procedure and hand hygiene.
- In the event of a potential exposure on campus, our initial response strategy, to be done with thoroughness and care, includes immediately investigating facts; meeting with leadership to ensure accurate information and consistency of response; contacting those/the families of those possibly exposed and ensuring appropriate actions and monitoring; meeting with our entire staff family to share facts, answer questions, reinforce infection control protocol, and discuss any additional measures to be taken; and communicating with our entire resident family and their families to share facts, response strategies, and invite questions.
- We continue to monitor residents in care daily, keeping a sharp and educated eye out for all symptoms and changes in behavior or condition.
- Though not needed for symptoms, we have a universal requirement of facemasks for all staff and visitors and ask essential visitors to provide their own where at all possible. We continue to invite volunteers with sewing skills to support this inventory. Anyone interested is welcome to reach out to firstname.lastname@example.org.
- We continue to screen everyone who enters.
- We continue to not permit visitors (with end of life exceptions) and invite engagement by facetime, phone, family connection window stations, etc. Our team can assist!
- We are maintaining important critical emergency supplies and are sustaining them.
- Our Vitality teams continue to focus on engaging our residents to limit physical contact, but are encouraging engagement. As social distancing policy continues and group activities remain suspended, hallway activities from doorways continue. Memory care teams focus on lots of one on one time.
- We assign duties to limit staff to specific areas (“cohorting”) to reduce campus-wide interaction.
- We are prepared to shelter staff who wish it, to limit potential of their being exposed to coronavirus in public, off-duty, or at home, or to better support their team.
- We continue to actively hire to ensure a good back up so only healthy staff are serving.
- We have taken steps to cherish our employees through the unique needs of this challenge, providing free shift meals, getting creative with our hours, and ensuring a full complement of leadership all days of the week.
- Members of our Generations Home Office are phoning-a-friend, working through our resident phonebook, just to check in, see how they are doing, and what we can do to facilitate connections with loved ones.
- We continue to manage drop off locations for online orders/delivery, using the main campus entrance address and ensuring internal transfer to residents.
Thank you for standing with us and thank you for keeping me strong.
All my best,
Melody Gabriel, CEO
May 9th, 2020
Celebrating Our Mothers~ A Message from Chip Gabriel, Executive Chairman
This Sunday we celebrate an amazing gift to all of us – mothers. It won’t be the same, as we won’t be able to get together as normal, hug, give (or, for some of you, get) presents, share a meal, or any number of other traditions we each have. Nonetheless, celebrate we will as we adopt to the needs of the moment.
For all that I wish we could postpone Mother’s Day until it can be celebrated with our favorite traditions and closeness, maybe this holiday brings us something we need right in this moment. As a I child, I remember when I was scared, my mother was there to hold me, talk to me, and make me feel better. When I was sick or hurt, mom was be there, with care and kindness to start the healing process and provide calm and comfort. In my childhood memories, my mom was amazing. With the perspective of adulthood, she remains an amazing person I am lucky and blessed to celebrate. Watching my wife be such a similar pillar of strength and love for our children, I cannot help but feel awe for the incredible gift it is to have such a person in your life.
While Mother’s Day is about cherishing and honoring those women we love, right now as our world is rocked like never before, maybe there is a gift hidden in the holiday for us too. Reflecting on a lifetime of strong caring woman in my life brings memories of their influence during turmoil. I am reminded both of times of fear and uncertainty, but also what overcoming and healing past it looked like – and so much of that was in the example they set or with the good sense they imparted.
I do not know exactly how we get through this, but I do know that we will and I take strength from what my mother showed me growing up. She would say if we stick together with love, respect, and discipline, and do the right things for all of us, we will ALL be better for it. She is usually right.
This Mother’s Day let’s thank and love every mother. Let’s remember to do it while adhering to best practices for dealing with this nasty virus. Wash hands, physical distance, wear a mask, and respect guidelines that protect residents and staff.
And, to our mothers out there, I send awe, love, and a wish for a very happy Mother’s Day to you all.
Chip Gabriel, Executive Chairman
April 29th, 2020
Hand-washing, Wearing Masks, Social Distancing, and a Generations Update
Every day that new scientific research on COVID-19 is released we have the opportunity to better understand and learn more. As good information gives us the power to make the best choices, we are working to stay on top of developments and I have outlined some interesting recent highlights below, along with a general update on our Generations Universe.
Highlights from recent studies:
The one thing that remains clear in all new information is the importance of practicing tried and true infection prevention measures – proper use of personal protective equipment (PPE) such as facemasks, social distancing while outside our homes and in the workplace, and proper and frequent handwashing.
• About the Virus Infection Cycle: A positive person with symptoms is infectious, but that person is also infectious 2.5 days before symptoms, with a peak of infectiousness at 17 hours before symptoms. (And, of course, a positive person with no symptoms at all can be infectious.) It is not clear yet how many days past onset of symptoms is considered safe from being infectious – and this will vary by the individual. (We follow CDC and Health Department guidelines, in consultation with our Clinical Director on a case-by-case basis.)
• About Symptoms: There is a wide spectrum of symptoms, possibly related to variation/subsets in the virus, and a person can go through the entire COVID-19 infection cycle with no symptoms at all/ever. The CDC has just expanded the symptom list to include two (2) items we previously did not include. (Staff/Visitor screening have added ‘repeat shaking with chills’ and ‘headache’ and we continue to add #10 eye redness/redness around eyes/eye pain.) Full list:
3. Shortness of breath
5. Sore throat
7. Muscle pain
8. New loss of taste or smell
9. Repeated shaking with chills
• Can You Get Sick Again? Short answer, yes. You may have not developed sufficient immunity from initial COVID-19. If exposed to the virus again, your set of antibodies/ population of cells with memory may not get revved up effectively enough fast enough.
Highlights from Generations Communities:
Company-wide, we are doing our damnedest to keep our people healthy and happy in a safe environment. At our Montage Heights, Montage Hills, Montage Ridge, and CherryWood Village communities we have some positive staff, all following protocol self-isolating at home and checking in with health updates as they recover. Some recovered staff have slowly worked their way back to good health and through their quarantine windows, as appropriate to their individual case and medical recommendation, returning to join our onsite healthcare heroes. We could not be more proud of our employee family of coronavirus warriors. One mantra that has sprung up is “keeping it negative!” and the sound of that in the voice of our staff brings a smile every time.
Our residents are also putting in extraordinary efforts toward strategies against this coronavirus, but we do have some cases of COVID-19. At Paradise Village’s Cedars Assisted Living, one positive resident remains offsite for care. At CherryWood Village’s Parkview Memory Care, one resident is quarantined as we seek out options for care offsite. At Montage Heights our two positive residents are offsite as they receive care. At Montage Hills we have four positive residents located on our SNF isolation wing with dedicated staff. At Montage Ridge our last two positive residents have both recovered. There are many ways to receive updates, including on our COVID-19 webpage, but please note that at all campuses leadership have scheduled regular Zoom calls (please reach out if you would like an invitation) and any campus with a positive resident will have those update calls more frequently.
The following are some continued and ongoing actions:
We remain in communication with health officials to ensure we stay in alignment and have been ahead in our practices.
We continue with recommended and best practice infection control procedures, internal teams have enhanced regiments of disinfection, and we continue to refresh protocol training, such as PPE procedure and hand hygiene.
In the event of a potential exposure on campus, our initial response strategy, to be done with thoroughness and care, includes immediately investigating facts; meeting with leadership to ensure accurate information and consistency of response; contacting those/the families of those possibly exposed and ensuring appropriate actions and monitoring; meeting with our entire staff family to share facts, answer questions, reinforce infection control protocol, and discuss any additional measures to be taken; and communicating with our entire resident family and their families to share facts, response strategies, and invite questions.
We continue to monitor residents in care daily, keeping a sharp and educated eye out for all symptoms and changes in behavior or condition.
Though not needed for symptoms, we have a universal requirement of facemasks for all staff and visitors and asking essential visitors to provide their own where at all possible. We are inviting volunteers with sewing skills to support this inventory. Anyone interested is welcome to reach out to email@example.com.
We continue to screen everyone who enters.
We continue to not permit visitors at this time (with end of life exceptions) and invite engagement by facetime, phone, family connection window stations, etc. Our team can assist!
We are maintaining important critical emergency supplies and are to sustain them.
Our Vitality teams continue to focus on engaging our residents to limit physical contact, encouraging engagement from within resident apartments. As social distancing policy continues, group activities remain suspended, but hallway activities from doorways continue. Memory care teams focus on lots of one on one time.
We are assigning duties to limit staff to specific areas of the community (“cohorting”) to reduce levels of campus-wide interaction.
We have prepared for the potential of sheltering staff who wish it, to limit potential of their being exposed to coronavirus in public, off-duty, or at home, or to better support their team.
We are actively hiring to ensure a good back up so only healthy staff are serving.
We have taken steps to cherish our employees through the unique needs of this challenge, providing free shift meals, strategizing childcare, getting creative with our hours, and ensuring a full complement of leadership all days of the week.
Members of our Generations Home Office are phoning-a-friend, working through our resident phonebook, just to check in, see how they are doing, and what we can do to facilitate connections with loved ones.
We continue to manage drop off locations for online orders/delivery, using the main campus entrance address and ensuring internal transfer to residents.
There was a quote shared with me recently, “Real miracles happen when you stop trying to avoid your present.” I love the hope infused in this recognition that when we have clear eyes for our reality, we are able to take clear action that makes all the difference. Thank you to our healthcare heroes, our employees, for reorganizing everything you do to make our mission work in an environment of enhanced, restrictive measures. Thank you to our residents that are holding fast to endure self-isolation and social distancing policies, knowing that we struggle now together so that when we gather again, no one is missing. Thank you to our resident families undergoing the heavy weight of worry for loved ones and sacrificing precious in-person togetherness. We are all working for the little miracles to build a better present, a little at a time.
Thank you for standing with us.
All my best,
Melody Gabriel, CEO
April 24th, 2020
When to do group testing for COVID-19
Community organized testing is decided in consultation. Various factors contribute to the decision, but whether or not testing is executed, current community precautions will remain in effect.
Why Not Test Everyone?
Indiscriminate testing without cause is not wise nor realistic given current circumstances. The decision to test and leverage resources and relationships to achieve it is made prudently.
- The test is only a snapshot, the data is an incomplete picture and ages quickly. It tells us who is probably not infected at the time of collection, but not who may become infected after, already has antibodies, or may be too early in infection to show positive at test time. The information, gathered without cause, can increase confusion and a false sense of security.
- Testing without cause may diminish resources needed later, including PPE/risk for testers, funding, willingness of staff and residents to undergo repeated tests, coverage by resident insurance carriers, and/or willingness of healthcare providers to re-sign off on resident Physician’s Orders.
- The test is uncomfortable and not an experience anyone would wish to be subject to repeatedly.
Deciding Who and When to Test
Group testing will be done for specific cohorts of potentially exposed staff and residents when:
- there is a positive test result for COVID-19; and
- the positive individual has been on campus in the last 14 days; and
- circumstances warrant a Generations or the Health Department recommendation to test.
We have partnered with Magnolia Diagnostics. In some markets, there are other local testing options available that we may utilize.
Process for Test Execution: Test kits are overnighted. A trained nurse on campus performs nasal swabs. Nasal swabs take 10 seconds to collect. The test is not painful but causes some discomfort. Specimens are sent to and analyzed by Magnolia Diagnostics’ lab.
Results: Lab result turn around is ~72 hours after received. Results are given to the community via lab portal. Staff are each contacted with their individual result, with special instructions and support given for any positives. Resident results are relayed individually as appropriate to the specific resident group. Result totals are shared with the greater community family (all staff, campus residents, and resident families) by leadership.
Preparation: All staff and residents must sign consent, though a resident’s legal guardian may give consent as appropriate. The lab will require basic staff and resident information, including resident insurance for billing.
Cost: Staff testing is covered by the Community. Resident test cost will be billed to their insurance.
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