Tales from Wilton’s Healthcare Frontline: COVID-19 and Senior Living Facilities–The Greens & Wilton Meadows

A family member sending cheer and love to a resident at The Greens at Cannondale assisted living amid coronavirus fears.

This interview is part of a series GOOD Morning Wilton will be doing with healthcare providers working during the COVID-19 pandemic.

Ron Bucci

Ron Bucci is the senior executive director overseeing the two senior-living facilities on the Cannondale Campus–The Greens at Cannondale (senior assisted living and memory care) and Wilton Meadows (rehabilitation, long-term and nursing care). We spoke with Bucci on Monday, March 30, a few days after he notified the community about a resident at the Greens who had been hospitalized after testing positive for COVID-19. Since then additional residents are being observed for COVID-like symptoms.

Below is what Bucci told us, in his own words, about what it’s like for him and his staff to be healthcare workers during the coronavirus pandemic [edited and condensed for clarity and brevity]:

What’s Critical for People to Know

Speaking from the perspective of a global pandemic, we haven’t seen anything like this since 1918. It’s a highly infectious disease.

It’s very important that we don’t operate under the premise that everybody’s a negative; we operate under the ethos that everybody’s positive. And when I say we, I mean healthcare, our community, anybody.

The news story isn’t that there might be a positive here or next to you in the grocery store or at the gas station or wherever. We have to treat everybody as though they’re a potential positive. I don’t mean on this campus, I mean in the world–everybody needs to be presumed a potential positive. That will save lives.

If statistics are true, we’ll use rough numbers:  300 residents live on our campus, so statistically speaking that means 60 residents would be positive based on the current estimates out there. Wilton is roughly 18,000 people? That means I probably passed two or three on Rte. 7 this morning and maybe one at the gas station. It’s more infectious than any of our authorities ever anticipated. I know it sounds like a silly reference, but if the Prince of Wales gets it, there’s lots of positives out there.

How He and His Staff are Doing

I’m going to come to work seven days a week. I don’t care if every single resident here is positive. I’m coming to work and I’m going to take care of these people. This is how healthcare people feel. So I’m in the foxhole. I don’t care if I get COVID-19, I really don’t. I want to be on the right side of combating this.

Our team here is doing amazing work every day.

We’re closer than ever. Some staff members are redeployed to nonstandard tasks. We do have a full staff. We’re working harder than ever, but I think the sense of common good and common mission has empowered them. They’re just a very dedicated team. We get strength from each other.

Right now we have adequate supplies, as I talk to you today. Strategically speaking, we’re looking at making sure we can take care of as many people as we can, in the weeks and months that follow. So the answer is, today we’re good; two weeks from now, we’re taking inventory almost daily to make sure that we have what we need. We’re okay right now.

One of the few silver linings is we’re coming together. People are dropping off masks and love notes, and manufacturing companies are changing their processes.

The Timeline with the first resident diagnosed as COVID-19 Positive

[Editor’s note:  We are taking extra precautions to mask identifying details, including gender, to preserve privacy.]

On March 19, we had a resident present with a low-grade temperature and was seen within hours by a physician in his/her room and treated for a urinary tract infection. S/He had no symptoms that would lead the physician to believe s/he had anything other than a urinary tract infection. In fact, s/he had tested positive for the UTI.

S/He was monitored, isolated on Thursday [March] 19 to his/her room–isolated means that s/he doesn’t leave the room. The only people that go in are clinical staff members that are wearing personal protective equipment just as if s/he was in a hospital.

His/her temperature and vital signs were taken every shift–that’s three times a day until such time on that Sunday, [March] 22, his/her temperature increased. Within, I would say, two hours, s/he was brought to the hospital. As you might imagine, both the resident and the EMS personnel were wearing PPE and s/he went to the hospital for treatment on that Sunday. It wasn’t until, I think it was March 25, that we got the result from the hospital that he was positive.

As of this phone call [Monday, March 30], I don’t have any other positive tests. At any given day there’s going to be people in the hospital or under surveillance for some medical condition. But I don’t have a positive at this particular moment.

*Bucci responded to our request for an update on the number of positive cases at The Greens or Wilton Meadows as of Wednesday, April 1, writing:  “There are zero in the building at the present moment. We do have residents at the hospital with various symptoms including some with conditions completely unrelated to COVID. Other residents are hospitalized and under surveillance for COVID.” An update from Gov. Lamont released Wednesday evening noted that one Wilton Meadows patient was positive.

Preventative Steps the Facility Takes

Restriction of all visitors: no one can enter our building unless they’re essential healthcare personnel, and our Greens Cannondale staff work at the Greens and not at other communities. Essential healthcare personnel may enter, but they have to be screened. The screening includes questions such as:  ‘Have they been in close contact with somebody under surveillance? Do they have any signs or symptoms themselves?’ And we take their temperature, and anything over 99.4, the person is isolated or sequestered until such time that they either retake their temperature or they can be positively screened, or that they’re sent home.

Residents are, unfortunately, having to remain in their rooms until this wave passes through Fairfield County. We’ve been doing room service prior to any health department edict to do so–the week before any of that started with that resident. All of our practices follow the social distancing guidelines. Residents are provided meals in their rooms. If they want to eat out of the room, they have to remain at least six feet from each other–but thus far, I haven’t seen anybody doing that. The servicewear is disposable.

Aside from all the other deep cleaning we do, we’ve tripled the number of times that we deep clean, particularly focused on doorknobs, handrails, elevator buttons and so forth. All of our chemicals are rated by the EPA and CDC to kill Coronavirus; regular in-servicing to staff on washing hands, washing them the right way, how to use personal protective equipment. If any resident is suspicious of any symptom–a temp, cough, gastrointestinal, fatigue–they’re immediately isolated in their room until such time that we have direction otherwise from the physician or the health department.

Every staff member is screened when they come in the door. They’re asked the same questions I mentioned earlier. Also we take their temperature–anything over 99.4, any symptoms, anyone not feeling well, they’re sequestered until such time that they’re either cleared or sent home. All of our staff members are wearing masks now, even though the CDC does not recommend that. We wanted to go a step further. The reason the CDC doesn’t want us to go to universal masks is because in each case it’s really not warranted, and also, globally we’re trying to preserve equipment. But we’re going to presume that everybody’s positive at this point. So whether it’s that staff member that was screened and is over 99.4 or otherwise, they’re wearing a mask and, when appropriate, full PPE.

Anybody that’s even slightly suspect is sent home; they’re not allowed to come back until they’re screened by an infection control nurse.

The Difficulty Some Patients have Understanding What’s Going On

As it relates to the emotional or social aspect of it, it is more of a challenge in memory care than it is among our independent residents. Our independent residents get it. We’re doing lots of Skyping. We have a club of residents who are making masks–they actually want to get involved and they’re going to start making masks themselves. Those are independent ones. So that’s kind of the good stuff.

From memory care, it’s hard because staff are wearing masks, they don’t get to see our faces like they usually would. But there remains plenty of music and celebrating and personal contact. But no I don’t think all of our residents fully understand.

Communicating with Family Members

“The best vehicle for family communication is though our weekly town hall meetings on a call-in line. They have been well attended and allow for dialogue rather than just written word. The leaders in each of our buildings remain by our phones after each session for those that want a one-to-one chat.

I think they feel reassured that we are doing everything possible and that the measures we have taken have been implemented earlier than recommended and more vigilant than “standard” recommendations.

The Stress and Difficulty for Caregivers

Yes, of course. But we’re trying to protect lives. Everybody gets it. I’ve seen a tremendous amount of unity and cooperation–that part of it is heartening. I’m sure that you see in here a lot of that locally and globally, people coming together.

We’re blessed to be in a town where there’s so much support. Our families have been nothing but understanding, helpful, kind, sending warm wishes. It goes a long way to energizing the team.

We’re also blessed because our local [Wilton] health officials are fantastic. The Department of Public Health has been nothing but supportive. The Wilton Health Department is available, tireless. If I text [health director] Barry [Bogle], he texts me back within minutes. As it relates to guided support, communication, we’re blessed to have those resources and supports around us. We’re going to be fine, we’re going to get through this together, but we’re blessed to have those supports and to have a team with all these years of longevity. We’re in it for whatever it takes to protect our clients.