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Veterans home protocols holding COVID-19 at bay
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Veterans home protocols holding COVID-19 at bay

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LEBANON — March was a rough month for residents and staff of the Edward C. Allworth Veterans' Home.

The first cases of COVID-19 in the mid-valley were confirmed and the first of eight deaths of patients — two of whom had been receiving hospice care associated with the disease — were recorded on March 21.

But thanks to extensive protocols and increasing knowledge about how the disease is spread, there hasn’t been a confirmed case of COVID-19 at the 154-bed facility since April 7.

Although the facility is owned by the Oregon Department of Veterans Affairs, it is managed by Westcare Health Care Management Services. 

A staff member with some symptoms was tested this week and the results were negative.

Dr. Robin Richardson, Kelly Odegaard, vice president of operations and veterans services for Westcare and Abe Andrade, veterans' home administrator, recently sat down with the Democrat-Herald to talk about events of the last five months and what they have learned.

They all agreed that the learning curve was not only steep, but a swift one as well.

The veterans' home began to initiate COVID-19 protocols as early as late February. Visitors who recently had been in foreign countries were advised to not enter the building.

The first occasion of a resident with respiratory symptoms came on March 5.

“We took nasal swabs on March 9, but at that time, we couldn’t get him tested unless he was going to be hospitalized,” Richardson said. “We feared that we might overload the hospital if this spread.”

And, Odegaard pointed out, nearly all of the residents are in their 80s and 90s and were not eligible to be placed on a ventilator. He also pointed out that the survival rate of those who were placed on ventilators was less than 5%.

And survivors experience extreme damage to their heart and lungs, Odegaard said.

“I remember saying that we could lose one-third of our population, including staff,” Richardson said. “We certainly have the highest-risk population.”

Richardson, who said he has provided medical care to long-term care facilities for more than 40 years, noted that “this place is by far the best I’ve seen.” 

Symptomatic COVID-19 cases were confined to two 14-bed houses.

In all there have been 21 cases among residents and 17 among staff members.

The facility was placed on lockdown in March with virtually no outsiders allowed in, except for families when a resident passes away.

“No one should die alone,” Odegaard said. “We believe in compassionate care and we provide family members with proper personal protective equipment and isolate them.”

Methods used

Everyone who enters the building must go through a screening, which includes taking their temperature.

Staff members are assigned to specific houses and do not float among other houses.

Congregate activities have ceased unless they can be held outdoors or online.

“We’ve learned to be creative,” Odegaard said. “For example, we might have an art class, but residents participate by video in their own room.”

Isolation can be especially difficult for veterans, some of whom have been prisoners of war.

“Isolation is a form of torture,” Odegaard said. “Our residents have their own rooms. At our other facilities, they might have a roommate to interact with.”

Social Services provides counseling for all residents who might be feeling depressed or lonely.

Richardson pointed out the residents are “not prisoners. We can’t keep them from leaving, but if they leave the 13-acre campus, we have to make things as safe as possible if they return.”

Andrade said the educational process among staff is constant.

The temperatures of all residents and staff members are taken twice a day.

“We want to do a good job every single day and that includes staff training and sanitizing equipment,” Andrade said. “It’s all about communication and taking the proper precautions.”

During the height of the outbreak, an infection prevention committee met daily. Now it meets three times a week.

Richardson said the key to keeping the infection rate low is the three “W's”: wear a mask, wash your hands and watch your distance to others.

The facility is well-stocked with personal protective equipment (PPE) and extra staffers are available should employees get sick.

“We want to set the bar high for other facilities across the country,” Richardson said.

“We are the tip of the spear when it comes to best practices,” Odegaard said.

Andrade said the community has been “extremely supportive” of the home and understanding during trying times.

“Everyone wants to get back to normal. To have the events like our barbecues,” Andrade said.

Odegaard praised Linn County Commissioners Will Tucker, John Lindsey and Roger Nyquist for their support.

“Will Tucker drove all over the area finding PPEs for us,” Odegaard said. “Linn County Public Health has been outstanding, too.”

Tucker said Linn County is “blessed to have the leadership and skilled staff at the veterans' home. As issues have arisen, they have risen to the issue, and have delivered care for the honored veterans.

“Abe and Kelly are giants. They asked for help, they created new processes and procedures. They asked the staff to stretch during a time of infection concerns. They took the best paths forward during a time of uncertainly.”

A team effort

Tucker said the entire Lebanon community responded positively to the outbreak, nothing that: 

• The Boys and Girls Club worked with the Lebanon School district to open daycare for essential workers.

• Dozens of restaurants delivered food for staff.

• People brought cards and notes, cookies and more for  residents and staff.

“Something we should remember as we reflect on this time, is that we have some very caring people working at the home,” Tucker said. “The essential workers are themselves heroes for the role they played in containing the COVID-19 while putting themselves at risk.”

Odegaard and Andrade have been sharing the lessons learned and protocols put into place at the veterans' home with other facilities across the country.

The pandemic is also taking a toll financially on the operation.

The average length of stay is from one to two years and about six residents per month pass away. In a year, half of the population will have passed away.

No new residents are being admitted.

In 2019, the veterans' home received the Silver National Quality Award from the American Health Care Association and the National Center for Assisted Living.

It also was named one of the state’s best nursing homes by US News and World Report for 2018-19.

The factors that make the Edward C. Allworth Veterans" Home unique are also what may cause some issues of isolation for its residents.

The $40 million home opened in 2014 and was filled within two years, well ahead of schedule.

Residents have individual rooms, 14 for each of the 11 housing units totaling more than 133,000 square feet. Each room has 250 square feet and has its own big-screen TV, bed, easy chair and other amenities. Each room has its own shower and bathroomrestroom.

Breakfasts are cooked to order and if a resident wants a ham sandwich at midnight, they get it, just like if they were in a private home setting.

Lunch and dinner menus are prepared in a central kitchen, but if residents don’t like what’s on the menu that day, they can order something more to their liking.

When the facility opened, Odegaard, who was the facility administrator at the time, said he wanted the staff to “shoot for excellence, not just good.”

It’s a motto that his successor, Andrade, continues to support.

Prior to the COVID-19 pandemic, residents also were taken on excursions around the community and the state, including visits to the casino in Florence.

The average age of a resident is 85 and all have an acute health care need.

There is an on-site barber shop and beauty salon for residents and spouses, who are eligible to live there as well. There’s also a “canteen” for snacks and hot or cold refreshments, including milkshakes.

The facility has partnerships with Samaritan Health Services, COMP-Northwest and nearby Pioneer School, as well as local veterans groups.

Linn County made a major push to get approval for the facility in Lebanon. Veterans officials were looking at several other sites, including Roseburg.

But Frank Moore, former Linn County Public Health director, and Ann Steeves, formerly with Samaritan Health Services, with guidance from county administrator Ralph Wyatt, developed an impressive 250-plus page application.

And a partnership including Linn County, Samaritan Health Services and the city of Lebanon, sealed the deal. Linn County residents also showed their commitment by approving a property tax levy of 19 cents per $1,000 of assessed property value to assist with funding.There is one year remaining on that levy.

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