MSF concludes COVID-19 program in Houston nursing homes

Supporting caregivers and staff was a key focus

A resident at Focused Care at Beechnut, a long term care facility in Houston, Texas, watches TV inside his room. MSF conducted infection prevention and control (IPC) training and mental health and wellness training with medical and non-medical staff at Beechnut and other nursing homes in Houston during the summer and fall of 2020.
USA 2020 © Christopher Lee
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Houston, Texas, October 16, 2020The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) concludes its program supporting nursing homes in Houston today. Over the past two months, MSF visited 24 nursing homes carrying out infection prevention and control (IPC) assessments, conducting in-person IPC workshops for clinical and non-clinical staff, and providing more than 28 psychosocial support sessions for staff. 

Supporting residents and staff in nursing homes has been a high priority for MSF because the COVID-19 pandemic has disproportionately affected people living in elder-care facilities and endangered those who care for them.

When we began our outreach to nursing homes, we were there to boost the efforts on IPC measures, along with offering wellness programs,” said Whitney Ward, emergency coordinator for MSF’s program in Houston. “But after working seven consecutive months in a high-risk and high-stress environment, administrators wanted more staff health and wellness support as they saw the toll on their staff’s wellbeing. Due to safety measures that restricted all visitors, residents had no social contact with loved ones. It was hard for staff to witness patients becoming isolated or abandoned, or falling ill and dying of COVID-19. Many staff expressed feelings of sadness, frustration, guilt, fear, and helplessness.”

MSF focused on caring for caregivers and staff based on its experience working in more than 750 nursing homes in Belgium, France, Italy, Spain, and Portugal when the pandemic first swept across Europe, leading to an alarming number of COVID-19 infections and deaths among residents and staff in long-term care facilities. When the pandemic spread in the US, about 40 percent of coronavirus deaths were among older adults living in nursing homes.

In early June, MSF began responding to the need for improving infection-control management in care facilities in Michigan to stop the spread of the virus. Over two months in Detroit and the surrounding area, MSF provided on-site IPC support in 50 care facilities. A primary lesson learned from this experience was that the mental health of staff is critically important to maintaining high overall resident care.

“When COVID-19 arrived in our community, it was the beginning of the unknown,” said Adelia Patterson, wellness and life enrichment director of Focused Care nursing home in Houston. “We were understaffed most of the time because everybody was affected. I personally was affected. Everybody picked up other duties, in different departments. We were overworked, trying to do all the right things, trying to care for these residents to the best of our ability with the little strength we had at that time. We're just a caregiver at heart. We don't take the time to care for ourselves. The seminars MSF gave us on how to talk about stress and manage our stress were very helpful.”

MSF wellness specialist, Perry McAfee, conducted group sessions to help staff understand their particular stressors and be aware of how stress affected them personally, their work, workload, workday, and work environment. He provided techniques to help them with stress-management and self-care.

“The majority of staff at the nursing homes we worked in are people of color, and we know that communities of color have been at a much greater risk of contracting COVID-19,” said McAfee. “Staff make low wages, may not have health insurance, and some have underlying conditions that place them at higher risk. These additional factors were enormous stressors, forcing some of them to make hard choices: maintain a 16-hour work day or care for their family.” 

As MSF ends it programs in Houston, the facilities are returning to some sense of normalcy.

“Thanks to Doctors Without Borders, we were able to talk about our stress and to find out that the same feelings we have, our coworkers have,” said Patterson. “We can now talk about stress as a group, and help each other, lift each other up. I now look at my peers as my support system, instead of just co-workers. We share the same burdens. I'm looking forward to a better future for us.”

 In the United States, MSF has carried out several specific COVID-19 programs—all of which have now closed—including for migrant farmworkers in Florida, people who are experiencing homelessness in New York, the elderly and residents in nursing homes and care facilities in Michigan and Texas, vulnerable and marginalized people in Puerto Rico, and Native American communities in Navajo Nation and Pueblos.