A little more than one year ago, the Berkley Care Centre in North Vancouver was in the throes of a COVID-19 outbreak that saw five residents lose their lives to the coronavirus over the 2020 Easter weekend.
It was "devastating," said the care home's manager Patricia 'PJ' Jappy-Loker. "I think it's the word you want to use."
This past Easter weekend was a far different scene.
This year, residents at the Vancouver Coastal Health-operated facility were busy getting re-acquainted with the therapy pets—dogs, cats and a rabbit—that would drop by for regular visits in pre-pandemic times, but had been missing from the care home's programming since the onslaught of the coronavirus pandemic one year earlier.
"There were lots of laughs, lots of smiles, lots of cuddles," Jappy-Loker said. The therapy rabbit, in particular, was "very popular" over the Easter holiday, she added with a laugh.
"I'm just hopeful that now that this is happening, we're going to see a lot less depressed people. It's been pretty lonely for some of our folks."
Residents' reunion with therapy animals is just one marker of a gradual return to a new normal for the care centre, made possible only by the development of vaccines and a rollout that initially prioritized long-term care facilities.
To date, about 98 per cent of Berkley Care Centre's 189 residents have received both doses of a COVD-19 vaccine, said Jappy-Loker, in addition to all essential visitors.
Around 90 per cent of staff have received at least one dose of the vaccine, with a second dose on the horizon. While employees aren't required to be vaccinated in order to continue coming to work, "I've found that our staff has been very, very willing to get it," Jappy-Loker said.
While the third wave of the pandemic continues pummel much of the province this spring with near-record rates of hospitalizations and a host of new restrictions, the storm appears to have passed in long-term care homes like Berkley.
'Things have changed, the world's changed, how we do things has changed'
Comprised of five distinct "neighbourhoods" each named for a North Shore community, the Berkley Care Centre is a robust facility that cares for residents with a wide array of needs— complex care, dementia and behavioural issues, to name just a few. Currently, its youngest resident is 28 and its oldest is 106, "so we have a full gamut of services," said Jappy-Loker.
Before the COVID-19 virus crossed into B.C.'s borders, residents from across those neighbourhoods would gather frequently for group activities like happy hours, dances, concerts, movie nights, and music therapy classes. Visitors could come and go as they pleased. Every few months, the care home would host celebrations to honour the lives of residents who had recently passed on.
"We would invite family members back, we would read some poems and sing some songs and just share memories," the manager explained.
But when it became apparent that the coronavirus would start by hitting long-term care homes hardest, that all changed.
Happy hours were put on hold, and residents were sequestered to their respective "neighbourhoods." The end-of-life celebrations started taking place over Zoom, residents visited with family and friends through tablet screens or windows, and the facility's music therapist started performing songs and posing trivia questions over the intercom system.
Staff still hugged residents and held their hands, but only after donning a fresh set of personal protective equipment.
"We did note that anecdotally we saw residents that were more depressed when their loved ones couldn't come in," Jappy-Loker said.
"When you find somebody like that it's our job to make sure that we try and figure out how we can support them. Does that mean an extra visit a week, or do we change the individual who was visiting from a social visitor to an essential visitor? I think there was lots of room for us to create that support for the residents and the families themselves."
Reflecting on the deadly outbreak, "it was such a difficult time, that when we were off outbreak, there was this sense of, 'OK, how do we carry on?' We've lived through the worst, and are slowly getting back—not to normal, but I think it's now a new normal," said Jappy-Loker.
"Things have changed, the world's changed, how we do things has changed."
Part of that new normal entails finding creative ways to fulfil the need for social interaction, particularly since the facility's outbreak came to an end in June and restrictions began easing in accordance with provincial and medical health officers' guidance.
Today, a team of staff is still responsible for scheduling pre-booked visitation, including outdoor courtyard meet-ups. "I have 189 residents, so you can imagine how many visits that is," Jappy-Loker explained. "They're doing a Herculean effort."
Family and friends entering the facility still need to undergo screening, provide contact-tracing details, wear a medical mask and practice proper hand hygiene, but today, hugs and hand-holding are once again allowed.
Residents can now go for a scenic drive or leave for a visit at home with their loved ones, while cross-neighbourhood group programming resumed last month. Now, when the care home's musician comes to perform for residents, he does so from behind a plastic shield.
"It almost looks like a rough bar," Jappy-Loker said with a laugh. "But we have that in place and we can now bring residents in from other neighborhoods. It's the vaccines that made the big difference."
That said, she added, "As it is today, has life changed and will it stay changed? I think so."
From the beginning of the pandemic until now, Jappy-Loker said she's proud of her team and how they've come together to support residents during an unimaginably difficult year.
"We can always get so caught up in the day-to-day and stuff like that, but really it's about that experience," she said. "It was really important for us, especially at Christmastime or for the residents' birthdays, to ensure that we did something special for them, because it may be their last birthday, or it may be their last Christmas."
She continued, "The length of stay in long-term care ... can typically be 18 months. We've had a pandemic that's spanned almost that time. I've had people move in and pass [away] with us during the outbreak. So [the focus is], how do you support those folks—not just at the end of life, because of course we have compassionate services and things like that—but ensuring that there's a quality of life there for them?"