Editor's note: This story is part of the 2021 "Essential to Jamestown" special edition of The Jamestown Sun. The annual Progress Edition features stories on essential workers, agencies and businesses during the coronavirus pandemic.
Shar Trevithick is a registered nurse and the manager of JRMC Home, Health & Hospice at Jamestown Regional Medical Center. She doesn’t do much in-home care these days with people, instead supervising a staff of 17.
But when an elderly man hospitalized with COVID-19 at JRMC was not expected to survive, Trevithick was among staff who stepped in to help a husband and wife say goodbye.
“... we realized it was pretty urgent that we give them the opportunity to communicate,” Trevithick said. “And because my agency had been in the home and were familiar with that patient’s wife and already had established a relationship with her I just went out on my own and connected her via Zoom to her husband who was in the hospital.”
On the other end, at JRMC, nurses helped their patient connect to his wife over Zoom.
“They were able to say goodbye … it was probably the most heartbreaking thing that I’ve experienced in my career,” Trevithick said. “And so that was probably, for me, one of the darkest weeks of the pandemic was watching things like that happen in our community. ... And the wife and the family were so appreciative of that opportunity and he did pass away that afternoon after that.”
Katie Ryan-Anderson, JRMC marketing manager, noted Trevithick has worked in hospice for a long time.
“She has experienced these kinds of things … and yet COVID was especially challenging,” she said.
Trevithick said the pandemic felt different for people.
“Nothing in a pandemic feels fair,” she said.
Trevithick said in her experience with hospice, one of the greatest joys about it is those connections with people during a challenging time in life: a time with a lot of emotion, feeling and grieving that happens before the end of life.
“The challenging part of this pandemic has been that people don’t have that togetherness,” she said. “They’re not able to do that together. Especially our long-term-care patients that have been on hospice. It’s been a big challenge to be able to really make meaningful connections with their loved ones at the end of life. That’s been, I think, the biggest difference for us.”
Trevithick said hospice usually serves 10 to 15 patients at a time while home health usually has about 50.
Care is provided for people wherever they are living, Trevithick said.
“It’s not just private homes,” she said. “We see patients in assisted-living facilities and long-term care facilities and wherever it is the patient resides we’re able to bring care to them.”
She said local facilities such as Ave Maria Village, Eventide Jamestown and Edgewood have been “tremendous” to work with.
Sue Swanson of Sauk Centre, Minnesota, said her late mother-in-law, Alice Swanson, received home health services for some years from JRMC Home, Health & Hospice and later hospice services until she passed away on Sept. 21, 2020. The family is grateful for those services, she said.
“We have nothing but respect for them and appreciation for everything they did and how responsive they were,” she said. “They always treated Alice with just a lot of loving tenderness and concern and she liked them.”
Sue said the personal contact through home health was reassuring to her family, particularly when Alice was still living on the farm after her husband’s death in 2008. Although Alice was self-sufficient and didn’t let them do too much, home health services continued being part of her life until 2020, when hospice became involved in her care. By then, she was living in an apartment.
“We were fortunate enough to be able to be with her, to help her stay in her home through those last months on hospice when she couldn’t be by herself,” Sue said of the family.
Agency’s cases increased in fall
Related to COVID-19, the agency didn’t see a high influx of those cases until the fall, Trevithick said. In October-November, there were COVID-19 patients returning home after being in the hospital.
“Those were challenging cases because they were very, very sick and the hospitals were pretty full and the nursing homes weren’t able to accept new patients because of the COVID issues that were happening in long-term care as well,” she said.
Referrals during the pandemic increased because the population of people they care for is the people who have trouble getting out of their homes when it’s not a pandemic, Trevithick said. Physicians were also telling some patients not to come to the clinic, home health staff would come to them.
“So that’s where our really strong screening protocols came into effect,” Trevithick said. “That we made sure that we were sending people in there who were safe, who were not sick, who had been careful not to be exposed to anybody who’s been sick. We had really strict policies as an organization here about that. And then we also screened the households and places that we were going into to make sure that our staff weren’t going to be exposed to something by providing care there.”
Trevithick said she spent many hours during the coronavirus pandemic doing research on protocols and processes to ensure that JRMC Home, Health & Hospice employees and their patients were safe. While that seems simple, it wasn’t early on.
“... there was really very little guidance anywhere related to protocols and infection control processes and ways to mitigate risk in a home care environment,” she said. “There was a lot more toward hospitals and long-term care facilities but it was really hard to find anything for home care.”
While hospitals and clinics can have more control when patients come into those facilities and manage risks, Home Health employees work in more uncontrolled settings, she said. JRMC Home Health & Hospice developed what Trevithick said were “some really solid processes ... and we’ve been relatively unharmed by COVID in our employee group and our patient group as well.”
Hospice: a calling
Morale during the height of the pandemic wasn’t an issue, she said.
“If you’re working in hospice it’s only because you truly love it and it’s because it’s really a calling for you,” Trevithick said. “And for those of us who do it, it can be very emotionally draining. We do get attached and we get connected to our patients and their families to the point where we almost feel like part of the family when it’s over.”
She said the pandemic made staff more “driven” to be that connection. She said everyone at one time came to her office in tears, saying “‘I can’t do this, I just need a minute.’ And we would have a minute. We all did it.”
But they all did their job and they all adapted to changing processes, Trevithick said.
“They are absolutely incredible people and I couldn’t be more fortunate to lead a group of people like that,” she said.
Trevithick also said the “silver lining” in the pandemic was observing the health care leadership in the community and thanked the health care community for its support and partnership in care.
“I think we all came together and supported each other and we wanted all of us to make it, we wanted all of us to be safe and we worked closely together and we did little things for each other that the rest of the community doesn’t know about …,” she said.
She noted leaders in the community had to make decisions that were “wildly unpopular with the public a lot of times and they did it from a place of understanding disease prevention. ...They could have taken the easy way and maybe not been very strict with infection prevention policies in our community but they did it right and because of that we’ve come through it pretty well in our area.”