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Defining the “New Normal” for Our Residents

To Our Sunrise Family:

The battle against COVID-19 is far from over. At Sunrise, we are responsible for protecting the health and safety of our elderly population, who are among the most susceptible to the virus. We are acutely aware of the challenges we face in the coming weeks and months, as we await development of a vaccine and treatments to safeguard us all from COVID-19. However, while it may be some time before things are back to “normal,” we now find ourselves entering the next phase of our COVID-19 response, with a “new normal” emerging.

One of our top priorities over the past several months, which will continue to be a priority in the future, is creating new ways of engaging our residents, and addressing the potential for loneliness and isolation. Under previously “normal” circumstances, our entire community—the dining, living, and activities rooms, the library, the courtyard—served as an extension of each resident’s suite. Our expectation under those circumstances was that residents would spend more time engaging with others in these warm, inviting areas than specifically within their suites. Enter COVID-19, and that has changed dramatically.

Person-centered care and services have always been foundational to what we do. But one silver lining of the current situation is that our team members have been challenged to think differently about the way we are providing personalized care and attention to our seniors. And, it is no surprise that they have risen to the occasion by finding new creative ways to support and engage all of our residents.

Maintaining the Human Connection

One of Sunrise’s Principles of Service is involving friends and family, and a key component of our efforts to meet residents’ need for human connection is by leveraging technology. As the importance for quarantining increased, we sent hundreds of additional iPads to our communities to help ensure our residents had the opportunity to regularly Skype or FaceTime with their families. Even for residents who aren’t as able to express themselves, this has had a profound impact on our families, who are so appreciative of the ability to just see their loved one smile. We’ve also heard from numerous team members who say that supporting these calls is the highlight of their day.

In our Reminiscence neighborhoods, we take a walk down memory lane with residents while assisting with care or activities of daily living. As an example, we’ll point out a picture of their daughter’s wedding and say “tell me about this day—it must have been so wonderful.” This and other brain stimulating activities activate neural pathways, and recalling happy events from the past can also improve well-being. We’ve encouraged families to drop off those framed photos, albums or keepsakes to help their loved one remember time spent with family.

Meaningful Interaction

A hug or a smile from a friend is one of the quickest ways to boost one’s spirits, but our caregivers are currently wearing masks and gloves and practicing social distancing, making it harder to offer physical affection and comfort. This has been even more challenging for our residents with memory loss, who may have trouble placing their caregivers on a normal day. To help residents recognize her, one of our team members has started wearing a laminated sign with a smiling photo of herself hanging around her neck, which she regularly sanitizes. So, when she walks into a resident’s room, they see a happy, familiar face instead of a mask.

Most experts agree that 70–93% of communication is nonverbal, so we’re having frequent conversations with team members about the importance of body language. We encourage them to make good eye contact—socially distanced as much as possible—and to avoid squinting, which can be misconstrued as a sign of disagreement. They try to wear a smile under their face mask so their eyes mirror that smile. Likewise, if a resident is expressing sadness or anger, we encourage them to mirror that expression so the resident can see and feel empathy and understanding.

We also talk about open body positions, keeping arms open rather than folded or fidgeting, and the importance of using hand gestures, which convey warmth. We also recommend caregivers use a warm tone of voice, and carry a white board—remembering to appropriately sanitize—if a resident is hard of hearing.

Finding New Ways to Connect

Suite Stops are now a cornerstone of our programming and resident engagement activity. We create individualized engagement kits in food storage bags that can be sanitized and dropped off at residents’ suites. These could include colored pencils and some adult coloring pages themed for an upcoming holiday, puzzles like word searches, or other cognitive activities based on our residents’ interests. Music is another tool we use to stimulate those pathways in the brain and, for our residents living in the Reminiscence neighborhood, music is one of the few things that outsmarts Alzheimer’s. Your connection to a certain song or melody is something that memory loss cannot destroy. So music therapy has been effective in lifting residents’ spirits when they are despondent, or soothing the feelings of angst and unrest that some of our residents feel as a result of quarantining. Connecting with nature can also be beneficial for one’s mental health and well-being. In some communities, where residents are asymptomatic and not in isolation due to COVID-19, we have offered 1:1 trips to our courtyard area for gardening. We’ve also found ways to bring nature indoors, and residents have enjoyed caring for their own windowsill gardens. Tending to plants and watching seedlings grow can boost one’s mood and feelings of hopefulness. 

Empathy above All Else

Despite all the measures we put in place, we need to understand and plan for the probability of someone with memory loss forgetting they need to stay in their room. And in these situations, we’re going to do all that we can to approach them with dignity and respect, and avoid making them feel as if they have less control. For our residents suffering from memory loss who are still able to carry on conversations, the Validation® Method teaches us how to tap into their prior coping techniques that helped them get through tough times in the past. We ask them if they can remember a time like this, when they were forced to stay in one place for a long time. Some of them recall a sprained ankle, or a time when our country was at war. We ask them how they got through that time. Was it friends? Was it your family? Was it God? And we remind them that we are their friends. We are part of their family. And we’re going to help them make it through this time also. Humans are very resilient—but we must acknowledge how difficult this time is and validate whatever expressed emotion they might have. Most frequently, we hear how much they miss a loved one, so we can reminisce with them about their mother, daughter, son, or spouse, and encourage them to share what they miss most about that person, actively listen to their concerns, and allow them to talk about that person, which provides them with great relief.

Overcoming Obstacles Together

Food is another way many of us show love, and mealtime is an important part of our residents’ routines. Right now, one of the ways we’re protecting our residents from the spread of the virus is by serving them meals in their rooms. Some residents were so accustomed to eating in our dining room, that when they were unable to do that, they didn’t want to eat. I’ve seen team members go so far as to bring a dining table into their resident’s room to help them feel more comfortable—whatever it takes to make this period feel more like the “normal” we were used to. We’ve also seen our Dining Service Coordinators create a favorite specialty meal for a resident who is showing signs of a decreased appetite, or schedule a Skype or FaceTime event with a fellow resident so they can dine together. In one of our communities, we had a resident who was refusing to eat for 24 hours, but developed a ravenous appetite when he was served his favorite steak and lobster dinner. Similar to local and federal governments, some of our communities will soon be ready to move into various phases of reopening, which could include the availability of outdoor visitation, small group programming, socially distanced meals in our dining rooms, and reopening of resident services such as beauty salons.

We know that this has been an incredibly challenging time for our families. Please know that your mom or dad or grandparent is loved by us, too. Our caregivers spend so much time with our residents that they become like their own families. This situation has challenged us all in ways we never could have imagined, but I can tell you that the individuals who are caring for your family are some of the most dedicated, caring people I’ve had the pleasure of working with in my career. We are going to get through this together and we cannot thank you enough for the trust you place in us each day. It is our honor to serve your family member.


Rita Altman, MSN, RN, CVM

Sunrise Vice President of Memory Care & Program Services

Sunrise Senior Living

Article By: Sunrise Senior Living

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