Since its COVID-19 outbreak, San Juan Living Center has worked hard to turn the corner and keep residents safe — as well as to try to boost morale, as residents lost access to many in-person visits and activities they enjoyed pre-pandemic.

In April, the center had enough COVID-19 cases that the state classed it as an outbreak site; at the time, 13 residents had tested positive for the viral disease. SavaSeniorCare, San Juan Living Center’s parent company, also said five facility residents died at the hospital.

But as of last week, the center — which also accepts COVID-19 patients from the region and is on standby for overflow from Montrose Memorial Hospital — did not have any long-term residents suspected or diagnosed with the disease.

The total cases among residents had been 15 confirmed positive of 24 suspected and, now, 18 recoveries, administrator Michelle Salstrand said.

“Our staff has worked so diligently to not only adhere to Centers for Disease Control and Prevention guidelines and ever-changing rules, but they are doing a good job of identifying changing conditions with our residents. For us to really be able to get ahead of this was noticing the subtle changes with our residents,” she said.

That meant going beyond recommended screenings and paying attention to even little things, for example, a resident suddenly skipping his or her favorite meal of the day, Salstrand said.

Also, because of the living center’s physical layout, those suspected of having COVID-19 can be effectively separated from others in the home. San Juan Living Center has two “mirrored” units, separated by doors, each with its own dining room. While the residents are able to interact through the glass, staff have felt a heightened sense of community among residents since the pandemic began.

“I have been in long-term care for over 25 years and I’ve never experienced anything like this where there is such care and compassion between roommates,” Salstrand said. “They’re people on paper that you would think wow they won’t get along when you look at the age difference and the physicality difference and yet, there’s such a deep connection, especially when they’re in a room together with somebody.”

After community visitation was closed, Salstrand said the residents embraced technology as a source for staying connected with loved ones during the pandemic. While some of the residents aren’t what Salstrand would consider “tech savvy,” she said they have used the pandemic-caused situation to adapt.

“So many of our residents aren’t tech savvy,” she said. “You know they haven’t had to use computers or tablets, but it’s really amazing how they’ve adapted and how they kind of enjoy doing it.”

San Juan Living Center staff are available to support residents through these programs to help facilitate communication externally from the building.

Residents also developed deeper connections with their roommates and nearby residents as they look after each other. While residents may not get to mingle in the dining area, many enjoy sitting at their bedroom’s doorways and visiting with residents across the hall. But if they notice the person isn’t there as much or not as social, they notify staff.

Unfortunately, there are residents who have had to quarantine for 14 days due to testing positive for COVID-19. For the roommates and neighbors, it’s hard not seeing that person. Sitting in the empty room, a resident wonders how their friend is doing and remains hopeful for their return.

As a way to combat loneliness, staff increase family and friend calls for the residents. Another way to combat those lonely feelings is through writing pen pals.

Salstrand said they have a number of residents who are interested in that kind of correspondence. The community is encouraged to address their letters to Dear Pen Pal and send it to the San Juan Living Center where the staff will deliver it to a resident.

As soon as the person recovers, the residents celebrate with a socially distanced clapping parade.

“They worry because it’s their friend,” she said. “It’s their friend who has been gone for 14 days and they worry if they’re going to make it back. Being able to celebrate that recovery with everybody has been great and so fun to watch.”

The staff also began having themed dress-up days, line dancing down the hallways and socially distanced scavenger hunts for residents to lighten the mood.

“The staff has no problem putting themselves out there to be laughed at by the residents,” Salstrand said. “They really do come to work every day to serve the residents because they want to make them happy and provide physical and emotional support for them.”

The staff hopes the celebrations give residents hope.

The layout of San Juan Living Center also made it ideal for accepting non-residents with or recovering from COVID-19.

As part of Montrose County’s pandemic response, Montrose Memorial Hospital’s ICU capacity was increased; a COVID unit was established, along with a surge facility, and San Juan Living Center was designated as the tier 3 site to which patients could be sent, if necessary.

The county has not had to implement its strategy for addressing a “surge” on hospital resources.

San Juan Living Center has, however, accepted patients beyond its own residents and Salstrand said it’s her understanding the center is the only long-term care, skilled nursing facility on the Western Slope that is accepting community patients, including those from the Navajo Reservation in New Mexico, which has been hard hit by the virus.

“Fortunately, we haven’t seen our hospitalizations reach capacity, but there is still a need,” Salstrand said, referring to both people with COVID-19 and those in need of rehabilitative care afterward.

“We have taken people from the reservation, from New Mexico, because there’s not a lot of options where they can go.”

She also said the county and MMH have been good partners, ready to assist with additional supplies and staff.

The hospital referred questions to Dr. Joe Adragna, the county’s pandemic specialist, who did not return calls made Monday and Thursday.

“We’re really the only long-term skilled nursing facility on Western Slope that is equipped to take COVID-positive patients from the hospital,” Salstrand said, adding that it helps keep hospital beds free.

“We really reached out to all the centers in the area. We’re happy to take their COVID-positive patients and reduce risk of their patients becoming sick or them becoming an outbreak facility.”

Even for residents who did not contract the virus, extra care is important, Salstrand and others said.

State-imposed restrictions aimed at cutting the spread of the disease meant those who call San Juan Living Center home could not see loved ones in person, and that their interaction within the facility was severely limited.

“They’re troopers. Not only do they have to deal with the pandemic, but for a while, pretty much all the residents in all care centers were staying in their rooms to reduce risk,” said Salstrand.

“They haven’t had family visits or hugs from loved ones since March. It’s been tough. Staff is working really hard to engage the residents.”

San Juan Living Center used electronic devices to help residents stay in touch with family members. About a month ago, visitations outside were allowed, although with rules to ensure safety.

The staff organized vehicle parades for residents on holidays like Mother’s Day. Viewing the parade from their rooms, residents were able to see family members decorated vehicles and signs wishing them well as a reminder they haven’t been forgotten and are still loved.

Long-term care has changed because of the pandemic, with new rules and guidelines coming out — and undergoing frequent updates.

“The threat of COVID is real for all of us. We work with a particularly vulnerable population. Our staff is diligent about following recommendations and doing things right,” Salstrand said.

“That’s not to say things won’t change in any community. There are so many variables and COVID is so tricky. We’re just doing our best to try to keep everybody safe.”

Katharhynn Heidelberg is the Montrose Daily Press assistant editor and senior writer. Follow her on Twitter, @kathMDP.

Katharhynn Heidelberg is the Montrose Daily Press assistant editor and senior writer. Follow her on Twitter, @kathMDP.

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