Nurse assisted living

Social distancing is a term many Americans were likely unfamiliar with just over a month ago, but today, businesses, churches, and millions of Americans have now familiarized themselves with the term and have incorporated its guidelines into everyday life.

Social distancing is, of course, a measure used to help stop the spread of coronavirus, which as of Thursday, has seen 4,634 confirmed cases in Tennessee and nearly 1.7 million worldwide.

Restaurants have shifted to only offering takeout and delivery, insurance companies such as AIG have moved to have its employees work from home, and some businesses have shut down altogether. There’s one industry, however, that faces a unique set of challenges when it comes to implementing social distancing, and that is assisted living homes.

As assisted living homes primarily care for the elderly, which the Centers for Disease Control (CDC) has described as one of the most at-risk groups for COVID-19, the virus already presents severe challenges for their staff. Nurses at assisted living homes in particular are presented with an even greater set of challenges: practicing social distancing while still providing a level of intimate care.

Assisted living homes are “truly like a family”

One person that exemplifies that struggle is 37-year-old Stephanie Cooksey, a nurse who works at an assisted living home in Spring Hill. Cooksey, who has practiced nursing for more nearly 15 years, called the new set of circumstances at her workplace brought on by the coronavirus pandemic “surreal.”

“We train for these things, but in reality, it's been definitely a huge change,” Cooksey said. “It's stressful, and the situation is so fluid and ever-changing that we have constant new regulations and procedures that are coming through. It's frightening for sure.”

Stephanie Cooksey

Stephanie Cooksey is a licensed practical nurse whose almost 15-year career primarily involved internal medicine and women's health.

Among one of the more stressful changes, Cooksey said, was the appearance of her assisted living home’s staff - everyone now wears protective gear such as masks, gloves and gowns.

“One of the things to me that is most different there right now is the fact that normally, we do not have the look of a medical facility, it's a home - we are guests in their home,” Cooksey said. “So it is very different now to see everyone wearing [personal protective equipment], because it now has the look of a hospital.”

Trading the homely feel of her assisted living home for a harsh, clinical look was difficult enough for its residents, but perhaps even more difficult, Cooksey said, was maintaining a form of intimacy and caring often seen in patient/nurse relationships.

“Social distancing is great, but there are situations that [make it] challenging, especially when you work with people that have cognitive impairment,” Cooksey said. 

“Part of my assisted living facility is a specialized unit dedicated to memory support, and as a nurse working specifically with seniors requiring memory support, one of the most difficult challenges I have now is social distancing. It's a hard task because my patients want to hug me, and they trust and feel secure with me - when an individual's distressed, they're often turning to a nurse or a caregiver looking for affection. The sense of touch is a really important piece in the nursing patient relationship, and people don't often think of that.”

Cooksey said that having to limit your affection with patients was one thing, but having to do so with patients suffering from dementia was even more difficult to manage.

“When you're working with someone who has dementia for instance, sometimes that person just wants to hold you, or hug you,” Cooksey said. “Sometimes they literally bury their head in my bosom and just cry. Part of my job and role is to comfort, and that oftentimes involves touch. I pray to god that [the virus] doesn't get back there, because even though our facility is working hard to keep individuals socially distant, it's challenging.”

Currently, Tennesseans are under a mandated stay-at-home order, which limits outside travel to only essential tasks such as grocery shopping and exercise. Assisted living homes in Spring Hill and the state at large have imposed severe visitor restrictions, all done so with the goal of protecting the most vulnerable population.