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Not being able to get a hug from family members is the hardest part of living in a senior care facility during this time of the COVID-19 pandemic and social distancing.

"The residents with dementia don't understand," said Natalie Zeleznikar, owner of Diamond Willow Assisted Living. "The families are frustrated. They are doing window visits, but it is not the same."

Federal and state government guidelines have directed residential care facilities to restrict visitors - including family and friends - and volunteers from in-person visits since late March. Many senior care facilities closed their doors to visitors even sooner than that, to help stop the spread of COVID-19 to their elderly residents, who face the highest risk of dying from the disease if infected.

"They are 85 to 100 years old and have conditions such as diabetes and congestive heart failure," Zeleznikar said. "The average death rate of COVID-19 victims is 85. The risk factor for influenza, pneumonia and COVID-19 is very high."

As of May 25, 717 of the 881 COVID-19-related

deaths reported in Minnesota were those who resided in long-term care or assisted living facilities, just more than 80 percent.

Because infected people can transmit the coronavirus for days before showing any symptoms - and some remain asymptomatic - residential care facilities have been and remain on high alert.

At the same time, care workers say it's important to consider residents' mental and emotional health. Facilities are finding new ways to connect families while still keeping their residents safe.

"We continue to keep the residents uplifted throughout this period, and families have been wonderful for keeping their connections going," said Toni Hubbell of Sunnyside Health Care Center.

Hubbell said the Cloquet health care center has changed its visitor protocol as the pandemic continues.

"Family encounters have switched from a resident looking down from the second floor to friends and families to face-to-face doorway visits," she said. "The family is on one side of a glass doorway or window and the resident is on the other side."

When Sunnyside residents have scheduled doorway visits, they are required to wear masks once they leave their second-

story unit to go through the adjoining Community Memorial Hospital to get to the doorway. The door remains closed throughout the visit so no barrier is broken. They communicate by cell phone or speakerphone.

"We only allow two family members at a time, to adhere to social distancing guidelines," Hubbell said. "The resident is required to have a mask on throughout the visit."

The doorway visits have become popular.

"We had doorway visits each week and through the weekend, especially for Mother's Day," Hubbell said. "They were scheduled back-to-back in half-hour time slots. The entryway was disinfected after each visit. The residents have really enjoyed being able to see their families right in front of them. Virtual hugs and kisses are given with the glass in between. Some families have made awesome signs to show their loved ones."

Zeleznikar and Hubbell said residents are allowed to go outside when it is warm enough.

"All of our homes are nestled on beautiful wooded lots," Zeleznikar said. "It is important to the residents to get outside and enjoy nature, see the birds and have a cup of coffee. That's good for everybody."

"One resident at a time has been able to enjoy an outdoor stroll," Hubbell said. "As the weather warms up, I believe that this will be another favorite for the residents."

In addition to finding ways to keep residents connected with family, both health care facilities are focusing on cleanliness and health checks.

"We are used to keeping surfaces disinfected to prevent our residents from contracting influenza and other viruses," Zeleznikar said. "I just purchased a bleaching ionization machine that wraps around a surface for each of our 10 facilities. We have a pretty good system."

The health of the staff and the residents is checked daily.

"For the staff, we do a pre-screen when they come to work," Zeleznikar said. "We take their temperatures, pulses and oxygen levels and ask questions, such as have they lost their sense of taste or smell. We've only had one employee away from the area that didn't pass the test. She stayed home until she recovered and then came back to work. The system has worked well."

Residents are tested daily as well.

Staff members wear personal protective equipment such as masks, face shields and gowns, Zeleznikar said.

At Sunnyside they are also checking temperatures for staff and residents daily.

"Staff are required to wear surgical masks along with goggles with any direct care," Hubbell said. "Residents are offered the option daily if they would like to have a cloth mask to wear for protection. Daily tracking is done for each resident's room so we have a record of which staff has entered each room."

As the pandemic continues and with a vaccine unlikely to be approved before the end of 2020 or even 2021, many families and residents still want to find a way to connect in person with their loved ones.

Contributed photo

"The families know the risks but they want to see their loved ones before they die, especially for residents in their 90s," Zeleznikar said. "Technology doesn't replace face-to-face visits, it just doesn't. Those people are in the last chapters of their lives and their families want to be a part of it."

Zeleznikar said she tells those people to contact their elected officials, and ask for change.

"I believe family members can be screened with the same protocols as we do for employees. Families should be allowed to visit unless they elect to delay visiting until a vaccination occurs. We offer alternatives to visits, like Zoom, window visits and phone calls but, at some point, the feeling of a hug can't be replicated."