Seniors have been among the hardest hit by the COVID-19 crisis around the country. The impact on older adults and people with underlying health conditions became quickly apparent when the virus swept through a nursing home near Seattle in February.
COVID-19 has since invaded other nursing homes around the country. More than 3,600 deaths nationwide have been linked to coronavirus outbreaks in nursing homes and long-term care facilities, according to an AP report. And, it’s also struck some residents at affordable senior housing communities.
Amid this emergency, affordable housing owners and service providers have had to adapt the way they assist residents, especially seniors and other vulnerable populations.
National Church Residences serves about 24,000 seniors across a broad spectrum of housing types, with approximately 20,000 living in the nonprofit’s affordable housing communities. The organization also operates skilled-nursing and assisted-living facilities, adult day centers, and a home health-care program.
The Ohio-based firm has launched a Rapid Response Service Coordination program to help meet the unique needs of its many residents. National Church Residences has had a robust service coordination program in place at properties that have Department of Housing and Urban Development (HUD) involvement. However, properties financed with low-income housing tax credits are generally not eligible for service coordination funds from HUD.
“One of the first things we realized is the value of service coordination—whether residents can see you face to face or talk with you on the phone,” says Michelle Norris, executive vice president of external affairs and growth strategies at the organization. “That value is critical. How can we make sure that all of our buildings have access to a service coordinator no matter whether they’ve been HUD financed or tax credit financed?”
To fill that need, the nonprofit instituted its rapid response program to make contact and check on senior residents, including ensuring they have enough food and medication.
“This is allowing us to touch base with our residents every day or every other day so we can keep in touch with them to make sure they have their needs met,” says Norris, who leads the organization’s COVID-19 task force that includes chief operating officers for senior living and affordable housing, a chief medical officer, and other team members.
Food scarcity is an issue for many people during this time. In Atlanta, Goodr, a tech-enabled sustainable food waste management company, is helping feed seniors. It delivered 120 hot meals to Big Bethel Village and free groceries for residents at Betmar Village last month. National Church Residences was also awarded a $250,000 grant from the Fulton County COVID-19 Emergency Relief Fund to finance food deliveries to the organization’s seniors in the county.
Volunteers of America (VOA) is another prominent affordable housing developer and owner with a significant senior housing portfolio of 181 senior properties serving approximately 20,000 residents. The majority of residents are female, white, 75 years old, and have two chronic diseases. The top three chronic diseases are hypertension (36%), arthritis (27%), and heart disease (26%). About 10% of the organization’s residents are considered frail.
In an effort to keep residents safe from the virus, the organization has taken a number of steps, including closing common areas, restricting visitor access, and increasing cleaning protocols in addition to educating residents about social distancing.
VOA has deployed its own Critical Response Team through its Housing Operations Response Plan to give its management staff “on-demand access to urgent support and guidance when residents, staff, or visitors are symptomatic or COVID-positive,” says Pat Sheridan, executive vice president of housing.
The response plan has a number of preventive measures to minimize exposure, and the Critical Response Team is activated when there is an elevated risk of an outbreak at properties. “The team is able to provide operational, legal, and moral support for those on the front lines of the pandemic, and the team works with staff to make decisions right when the crisis arises to assure needed resources are immediately allocated,” Sheridan says.
During the health crisis, the VOA team has had to change the way it communicates and helps its residents. Instead of face-to-face interactions, there is communication and assistance being provided by telephone, flyers, email, and text.
“Service coordinators are talking to residents and answering questions outside of their normal working hours as more residents are anxious and having problems sleeping due to stress and anxiety,” adds Sheridan.While National Church Residences, VOA, and others are working to make sure their older residents have necessities like food and medicine, they are also concerned about residents’ social needs. Even before the pandemic, many seniors were at risk of loneliness and isolation.
It becomes an even bigger issue now because social connections have been disrupted and group activities have been canceled in an effort to avoid the spreading of the virus.
“We were worried about it before,” Norris says. “Now, we are even more worried about it.”
She notes that the AARP Foundation is working on creating a toolkit or a set of best-of-class ideas. Norris has heard about developments hosting hallway bingo, where residents sit in the doorway of their apartments to play bingo while still practicing “social distancing.” Other creative ideas to keep residents connected have included a letter-writing program and yoga sessions, where residents can watch and follow an instructor from their windows.
In another move, National Church Residences has set up a chaplain call-in service to provide spiritual guidance to both residents and staff across the nation. It’s made up by volunteers and led by the organization’s corporate chaplain Jim Zippay.
The VOA team has also taken innovative steps, including creating games and activity packets for residents and working with local restaurants to provide meals.
An unanticipated outcome of COVID-19 is the increase of residents embracing and using technology. They now want to know how to use their smart phones, apps, Skype, email, text, shop, and even pay bills online, according to Sheridan.
The Role of Technology
Other service providers also emphasize the importance of technology during this time.
Rainbow Housing Assistance Corp., a nonprofit that provides services to residents, serves 21 communities dedicated to seniors. In addition, many other communities have a senior population.
“We are fortunate to be well-positioned during this time to serve our residents with Web-Based Resident Applied Programming (WRAP), technology-based programming. Much of our work has been uninterrupted by the need for social distancing since our delivery methods can reach everyone with Wi-Fi capabilities nationwide,” says Flynann Janisse, executive director of Rainbow Housing.
Like others, Janisse’s organization has increased its telephone and email outreach at all senior sites and communities with greater risk of exposure to the virus.
Compared with other households, seniors living in low- and moderate-income apartments are less likely to have access to computers and high-speed internet, says Kristin Byrnes, CEO and president of Project Access, which provides health, education, and employment services to affordable housing residents. It serves eight senior communities with about 1,055 older households in addition to seniors living in multigenerational communities.
The seniors often depend on services like Meals on Wheels, lack funds to buy supplies in bulk, and have mobility issues.
To help, nonprofit Project Access has launched a Disaster Relief Squad, with members making calls to every household to assess their immediate needs as well as translate COVID-19 information and updates into many languages, including Spanish, Korean, Mandarin, Cantonese, Vietnamese, Russian, Farsi, and Arabic. It’s also delivering food and other essentials and helping residents set up prescription deliveries.
In April, the organization began delivering virtual and phone-based workshops and activities so seniors can stay connected. It was also working to create activity packets to keep seniors engaged, says Byrnes.
Advice for Owners
Norris emphasizes the importance of establishing clear instructions and protocols for property managers and others to follow during this unprecedented time.
Directions on how to care for residents, how to work with staff, how to ensure a building is clean and maintained are all critical. This is a how-to guideline for property management amid COVID-19.
The second critical part is to detail how to care for a frail population that is now in a period where they may not be able to access their usual support systems. “There’s the human and compassion side as well as the very specific operational side,” Norris says.
Affordable housing owners must be very clear with operators about how to handle every potential situation.
“Have a written plan that has both clear on-demand protocols and some flexibility in response based on what level of risk your property is experiencing,” agrees Sheridan. In its plan, VOA outlines the different levels and breaks down protocols based on job duty (management, service coordinators, and maintenance).
Having an easily readable plan that is specific to the situation at the property (the level one to four approach) allows staff to immediately take preventive action and calms their anxiety around feelings of unpreparedness if a crisis arises at the property. Also, make sure management staff has access to key decision-makers so they can take action quickly without being delayed by traditional non-crisis communication channels.
One move that owners can make now is to proactively check on residents. “Many have shared with us that they don’t ask for help because they don’t want to burden others,” says Byrnes. “Our minds are our most powerful coping mechanism, and long-term isolation can have a significant negative impact. A call from someone on your staff makes a huge difference reminding seniors that you are thinking of them and care about their well-being.”
Engage in programs and services that are attainable during a crisis, adds Janisse. “This way, residents can remain connected to housing resources, emergency services, and up-to-date critical information,” she says. “Obtain phone numbers and email addresses as a best practice in communicating with your community.”
