COVID-19 outbreaks at Upper Valley nursing homes take a toll on staff, residents and family

  • Charlene Truell, of Unity, N.H., shows her mother Beverly Whiting on Dec. 11, 2020, the deer Truell recently shot during their first in-person visit together since Whiting, 88, tested positive in mid-October for COVID-19 at the Woodlawn Care Center in Newport, N.H. In total the outbreak included 33 residents and 24 staff members (Valley News - Geoff Hansen) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Valley News photographs — Geoff Hansen

  • Sitting behind a bulletin board displaying the number of staff and residents who have currently tested positive for COVID-19, Amber Williams works at the reception desk at Woodlawn Care Center in Newport, N.H., on Dec. 11, 2020. Williams is also a licensed nursing assistant at the facility. (Valley News - Geoff Hansen) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

  • Photographed on Dec. 11, 2020, Chris Martin has been administrator at Woodlawn Care Center in Newport, N.H., for 18 years and owner of the facility for the past decade. (Valley News - Geoff Hansen) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Geoff Hansen

  • On Dec. 11, 2020, the Woodlawn Care Center in Newport, N.H., is allowing families to visit residents after the facility had yielded no results of COVID-19 in a Nov. 27 test. In total, an October outbreak included 33 residents and 24 staff members. Four residents died after testing positive. (Valley News - Geoff Hansen) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Valley News — Geoff Hansen

  • At Hanover Terrace Health & Rehabilitation Center, Keri-Ann Coutu, activities director, left, and Martha Ilsley, Hanover Terrace’s temporary administrator, are photographed outside the center on Saturday, Dec. 12, 2020 in Hanover, N.H. Behind them ropes extend around the building for socially distanced window visits for family members. ( Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Valley News — Jennifer Hauck

Valley News Staff Writer
Published: 12/12/2020 10:39:24 PM
Modified: 12/12/2020 10:39:21 PM

As a firefighter in North Carolina, Nicole Vigneault is comfortable with certain types of risk.

“I will run into a burning building any day,” said the 31-year-old Vigneault, a Claremont native and 2007 graduate of Stevens High School.

She encountered a threat of a different kind, however, when she arrived at Woodlawn Care Center in early November to lend a hand, working as a temporary nursing assistant, as the Newport nursing home faced a COVID-19 outbreak, one of two that have struck Upper Valley nursing homes in recent weeks.

“This was different — not being able to actually see it,” she said of the virus.

Nursing homes, which in the best of times take care of some of the most vulnerable people, have become hot zones in the COVID-19 pandemic. In New Hampshire, nursing homes and other long-term care facilities have been the site of more than 80% of the state’s 600 total deaths attributed to COVID-19. In Vermont, more than 60% of the state’s 93 deaths as of Friday were in long-term care facilities.

The outbreak at Woodlawn, which began on Oct. 21 and officially ended last week, included a total of 57 cases; 33 residents and 24 employees. Four residents died after testing positive. Five residents were hospitalized. Two per diem members of the nursing staff also tested positive late last week, according to a Saturday post on the nursing home’s Facebook page. One had not worked during the period they are considered to have been infectious, but the other did work at the facility during that time.

Elsewhere in the Upper Valley, a larger COVID-19 outbreak at Hanover Terrace Health & Rehabilitation Center is ongoing. The Hanover Terrace outbreak, which began late last month, included 97 people, as of Saturday. That total includes 68 resident infections, among them three people who died and another resident who was discharged after testing positive. In addition, 27 workers and two essential workers employed by an outside vendor have tested positive. Ten residents and 12 workers had recovered as of Saturday.

“It just really is bone-chilling,” said Chris Martin, Woodlawn’s owner and administrator. “COVID is really the perfect killing machine. It comes in undetected (and) spreads like wildfire.”

With so many workers out, Martin issued a plea for help. The remaining staff worked long hours, some in roles they weren’t used to, and recruited others to the family-owned facility. Vigneault’s mother, for instance, works as the social services director at Woodlawn, and the anxiety apparent in her mother’s voice in one phone call brought Vigneault to assist. Martin, who also is a licensed nursing assistant, helped residents make phone calls and interacted with them directly during the outbreak.

“It was kind of ‘all hands on deck’ there for a while,” he said.

Nursing staff took infected residents’ vital signs three times a day, looking for any signs that COVID-19 might be progressing, because it “can happen quick,” he said. “I think it’s one of the most stressful things I’ve ever been through.”

Family separations

Outside of work, staff members had to adjust as well. Martin, who has five children in Grantham and Lebanon schools and whose wife is a nurse elsewhere, said he quarantined himself in a nearby Airbnb for a time. He waited to return home until he had tested negative twice and the rate of new cases had come down.

Enfield resident Keri-Ann Coutu, Hanover Terrace’s activities director, said her 5-year-old daughter Lucy, a kindergartner at Enfield Village School, is staying with Coutu’s parents until the worst of the Hanover Terrace outbreak is over. Coutu’s 5-year-old stepson also is staying elsewhere during the outbreak, she said.

“I’ve never been away from my daughter this long in my life,” said Coutu, also a licensed nursing assistant.

She said she hopes they can be reunited by Lucille’s sixth birthday on Christmas Eve. In the meantime, they keep in touch via FaceTime. The calls sometimes end in tears and other times in laughter, Coutu said.

The separation from her daughter has helped her to empathize with what family members of Hanover Terrace’s residents are experiencing, she said. She helps to arrange window visits and phone calls for residents and families.

In spite of the challenges employees may be facing at home, Coutu said they are all endeavoring to stay positive at work. She tries to keep residents occupied in their rooms with coloring books and even math worksheets. Some of the residents like to keep up with the news on TV, but others have been enjoying holiday programs and music, she said.

“We’ve become part of their families,” she said. “I’m afraid for them to be scared.”

Even if they have few or no symptoms, nursing home residents in an outbreak are confined to their rooms and interact only with staff who are wearing personal protective equipment, such as masks, gowns and face shields.

For 84-year-old Herb Hansen, who moved to Woodlawn earlier this year with his wife, Susan, the outbreak meant that they were quarantined in separate rooms and couldn’t see each other for two weeks. “Of course, that’s not something that we ever wanted to do,” he said in a phone call.

Hansen, a Dartmouth College graduate who later served in the military and then had a career in business, tested positive but never developed symptoms, while his 87-year-old wife had mild symptoms including a cough and runny nose, he said.

The quarantine gave Hansen extra time to read and do crossword puzzles, he said. He keeps in regular touch with two daughters, who both live in Brooklyn, N.Y., via Zoom.

He’s recently been able to return to more of his normal routine and share meals with his wife. He credits Martin and the Woodlawn staff with caring for residents and helping them through the outbreak in a “loving (and) caring” way.

Community response

In addition to being separated from family members in some cases, nursing home employees also have faced stigma from the community related to COVID-19. Coutu said she doesn’t go out to pick up lunch and instead relies on delivery or brings a lunch to work.

“It’s hard walking around in scrubs right now,” she said.

Claremont resident Geoff Kroberg, Woodlawn’s dietary manager, said employees quit during the outbreak due to the harassment they experienced when getting groceries, such as being told that they couldn’t be in a store because they worked at Woodlawn. He also said people on the street would try to avoid crossing paths with Woodlawn workers during the outbreak.

Martin said some schools and employers asked that Woodlawn workers, even if they hadn’t tested positive, keep their children home from school and that their spouses stay home from work.

“I didn’t anticipate the hysteria,” Martin said. “You don’t quarantine contacts of contacts.”

At the same time, both the Newport and Hanover nursing homes have been given meals for their workers, as well as cards, snacks and flowers for residents. Such gestures from community members has helped workers at both facilities get through some long days, they said.

“Everybody has just been super and so supportive,” said Martha Ilsley, Hanover Terrace’s temporary administrator, who took over leadership on Dec. 3 when permanent administrator Terry Ann Gainer left for planned time off. “I can’t really tell you from the bottom of my heart how much this means.”

Testing issues

Some family members do have concerns about state testing protocols.

East Thetford resident Tara Bamford’s 71-year-old sister, Donna, has lived at Hanover Terrace since Brookside Nursing Home in White River Junction closed three years ago. Donna Bamford, who has a traumatic brain injury, tested positive earlier this month.

Tara Bamford said she wonders if more testing in November could have prevented the Hanover Terrace outbreak.

New Hampshire initially was testing 100% of nursing home workers and 10% of residents every 10 days, said Jake Leon, spokesman for the New Hampshire Department of Health and Human Services. But in September, after the Centers for Medicare & Medicaid Services established national standards, the state reduced its requirements and stopped testing residents absent a confirmed case in the facility.

Nursing homes in counties with a COVID-19 prevalence rate below 5% began testing just 10% of nursing home staff weekly and 100% of nursing home staff once a month.

In accordance with CMS guidance, testing ramped up to once a week for nursing homes in all counties in New Hampshire as of Nov. 30, when the prevalence of COVID-19 increased above the 5% threshold across the state, Leon said. If the prevalence goes above 10%, nursing homes will increase testing to twice a week, he said.

During an outbreak, all staff and residents are required to be tested once a week until two weeks pass with no new cases, he said.

Hanover Terrace’s initial response also was challenged by delays in receiving test results. Dr. Daniel Stadler, the facility’s medical director and a geriatrician at Dartmouth-Hitchcock Medical Center, attributed those delays to the fact that Hanover Terrace’s outbreak came about the same time as several others around the state and it was discovered around Thanksgiving.

Based on contact tracing, it appears that in both cases — Woodlawn and Hanover Terrace — the outbreaks were due to at least one staff member, or in the case of Hanover Terrace it may have been an essential worker employed by an outside vendor, bringing the virus in without knowing it, according to Martin and Stadler. Though visitors and staffers are screened for symptoms at the door of long-term care facilities, some people who are infected have no symptoms.

Bamford, for her part, doesn’t blame Hanover Terrace for the outbreak, saying the limited testing wasn’t going to catch all cases.

“The testing system was set up to make them fail,” she said.

Communication is key

Family members of residents at both facilities said that regular communication from nursing home staff has been critical to helping allay their anxiety about their loved ones’ health.

Hanover Terrace first notified families that two staff members had tested positive for COVID-19 around Thanksgiving. A few days later, on Nov. 29, Enfield resident Elyse Pringle Payson learned that her 62-year-old mother, Gail Pringle, who lives at Hanover Terrace, had a cough and had been moved to the quarantine hall. Pringle’s test results were delayed, so it took several days for Payson to learn that her mother had tested positive.

Pringle, who has lived at Hanover Terrace for 6½ years, has multiple sclerosis, which has restricted her mobility to some limited use of her left hand and arm. She can get around using a motorized wheelchair but needs assistance with all activities of daily living.

“My mom’s body is not in the greatest condition to fight off a virus,” Payson said. “It’s definitely very scary.”

Twice-weekly group Zoom calls Ilsley holds with family members help to ease Payson’s mind. She’s also able to get daily updates on her mom’s health status from staff by phone.

New London resident Karen Ebel, a Democratic state representative, said she was in her car when she learned that her mother, a Woodlawn resident, had tested positive for COVID-19 on the Saturday before Thanksgiving.

“My heart just sunk,” said Ebel, whose 94-year-old mother, Doris, has lived at Woodlawn for 2½ years.

Though Ebel’s mother ended up having few if any symptoms, she didn’t know that would be the case at the beginning. Nightly Zoom sessions with Martin, as well as regular Facebook updates, helped Ebel feel informed throughout the outbreak.

“From the perspective of a family member going through this, the communication piece is about as important as anything,” she said.

Now, at the other side of the Woodlawn outbreak, Ebel said it feels as though the “sun is rising a little bit. You can breathe a sigh of relief.”

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.




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