'The beds just sat empty'
"It was hard to come back and see empty rooms," said Tracy Berg, the social services director at Marquis Hope Village Post-Acute Rehab.
"We weren't able to admit anyone, of course. (Typically), if someone passes, we'll leave it empty for a few days. Before COVID, we would allow the family to come in and take their time packing up the items. We would wait awhile out of respect and then fill the bed because we have more people who need our services," Berg said.
"But with COVID, the beds just sat empty."
Ten beds, to be exact.
That is the number of residents who lost their lives at Hope Village Rehab from COVID-19 complications during the months of June and July. One more died at home or perhaps at a hospital.
The facility specializes in post-hospital care and long-term nursing care; so, some of the residents are quite ill before they arrive. And the staff there are acquainted with death.
That did not make it easier.
"There were a couple of times where I made a phone call to a family member, and then I had to excuse myself and go walk outside for a couple minutes because I just am not used to making that many phone calls," Berg said. "And I did feel helpless at times. Families broke down on the phone, and I would have to try and keep it together for them.
"I was really close with some of these residents. There were some that I came and sat with when I was sick because we were both positive and I could sit there and hold their hand so that the family member knew someone was in there with them. So it was the little things like that where I think we kind of found moments where we felt like we were OK moving forward. And then there were definitely moments I think for myself, all of our staff members as well, where we had to take a minute and walk outside because we were not doing well with it.
"It was just a lot of people to lose really quickly."
It all started June 5 when two staff members and five residents at the Canby care facility tested positive for COVID-19. The pandemic already had made its presence known around the world, so the staff at the facility were prepared — but not wholly — for the disease to reach them.
"By the time it got to us, it happened so, so fast. I mean, we were all just reeling," Berg said. "Even with all of our measures in place, it just was very, very quickly upon us."
In all, 43 staff members, 33 residents and 37 associated people tested positive for the virus.
Berg was one of them.
At first, she kept working. Because so many at the facility tested positive for the virus, that was an option, and almost a necessity, Berg said.
She was the one to call families and let them know their loved one had contracted the virus, a situation in which Berg felt helpless.
"Family members were asking us, 'What are we going to do? What medications can they take? What is working for people?' And it was hard. You know, we handle the flu, or we handle pneumonia, or we handle a tooth needing to be extracted — all the time. But this was just such a new thing that it was hard to not have answers for them."
No, Berg did not have answers, and in many cases, she was hurting along with them.
"My job every day is to connect with the residents and with their families. Especially for our long-term residents, I had relationships with them and their families," Berg said. "And so it kind of felt like a family member of mine had COVID.
"We kind of walked through that together. But it felt like I was feeling helpless and anxious over 30-something people instead of just one family member."
Berg also spent time telling residents they had tested positive. Some did not fully understand the potential weight of that diagnosis, others took it in stride, and a few were distraught.
"There were a couple of residents, one of whom I told that she had tested positive," Berg said, "who was very scared and looked at me and said, 'Am I going to die? Is this going to kill me?' And that was difficult for me because I don't know, and we don't have a magic cure."
Those caring for the sick at the facility, including Berg, tried to stay upbeat while striking a balance between reassuring the residents and being honest with them.
Before long, the workload and the effects of the virus started to take a toll on Berg, and she had to go home to take care of her own body. She considers herself lucky, comparing her experience with COVID-19 to a bout with the flu.
"I would say for me it didn't really get much worse than feeling like I had the flu with a couple extra bonus symptoms," Berg said. "I did lose taste, but I only lost that for a couple of hours, which was different from a lot of folks. I had a couple days of some severe leg pain that made it really difficult to sleep, but besides those things, it was really flulike.
"I was really tired. I had muscle pain and ache. I had headache. I had a poor appetite. I was really lethargic. It was difficult for me to get things going. I was anxious, so I was having a hard time falling asleep, but I was definitely needing a lot of sleep. So, it really reminded me of having the flu."
During her time at home, Berg was able to stay in touch with those still working via twice-daily calls that Marquis had arranged. Then after a week of rest, she went back to work.
But some symptoms persisted, like fatigue and shortness of breath. Berg had asthma prior to contracting COVID-19, which is the reason she believes she is still experiencing shortness of breath months later.
"I consider myself a pretty healthy individual prior to that," Berg said. "The only thing that I can think of is the asthma, but it's still going on for me."
The harder part beyond the physical symptoms was the empty beds, and beyond that, watching her peers mourn.
A hospice agency came in and brought a gift for Hope Village Rehab — roses and vases.
"Every time a resident passed, we would write their name on a card and put it in front of a single rose in a vase," Berg said. "It was a little overwhelming to see that line of roses grow. But it was also very centering and grounding to be able to come in and look at the names and take a deep breath and remember all of those folks and why we do what we do before coming in and going back to work with the people who we still had here, and caring for them and trying to keep their spirits up and help them not be afraid even though their neighbor across the hall passed away."
The one thing that helped residents and families through death from COVID-19, Berg said, was preparation. Part of Berg's work at the facility includes having conversations with families to help them prepare for the worst — planning end-of-life treatment, making funeral arrangements and determining last wishes.
"That made the conversations a little easier because the family wasn't wondering, 'Gosh, should we be doing more? Should we be sending them out?' They weren't having to scramble for those things," Berg said.
In fact, Berg believes it is never too early to have a plan. At just 29, she said she has established an advance directive for herself, a statement of a person's wishes regarding medical treatment that may include a will.
"I think death is something that people are … it's really difficult to talk about," Berg said. "But as someone who deals with it and sees it as a natural part of life, my advice to families is it's never too early to have your wishes down on paper, kind of get your affairs in order — not to be morbid, but so that when crisis comes it's one less thing that your family is having to deal with, and they can just grieve and mourn and move forward."
Of course, it's not all death in Berg's business. Many of the residents who staff thought had taken a turn for the worse are alive and well, participating in the activities they did before they contracted COVID-19.
"When our facility was cleared to start accepting new patients, I think, was when we all kind of breathed a sigh of relief because by all standards and measures, we had been cleared to bring people in," Berg said. "I think that was a signal to all of us that, 'OK, we made it through.'"
Though just when the facility had moved forward, the Clackamas County wildfires and associated Level 2 evacuation orders added an extra layer of difficulty. Berg described the image of residents' go-bags sitting next to staff's personal protective equipment and cleaning supplies.
In the end though, the remaining residents and the staff members did make it through the difficult time. And many of the staff members, tried and tested, realized they were in the right business after all.
"You can't work in a facility like this, and you can't do this kind of work in any aspect unless some part of you genuinely loves it," Berg said. "And I think our staff all had that tested and have come through the other side knowing, 'Yeah, this is what I'm supposed to do. Even when we go through really hard situations like this, I want to be here, I want to be caring for these people.'"
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