As the pandemic drags on, it seems its toll on mental health keeps growing, especially among seniors and caregivers who feel cut off from their loved ones.
“We're seeing an increase in isolation,” says Dennis Wildman, a social worker and the Alliance Director at Sunshine Terrace, in this podcast interview. "We're seeing the increase in infections, we're seeing an increase in stress, we're seeing a decrease in support, and all those things cause more risk factors ... As a clinician, I probably see 33 percent more mental health issues now than we ever have before in 30 years."
Technology can help, with high-tech solutions like video communications and with low-tech ones like personal protective equipment. But while the Utah Assistive Technology Program is usually all about technology, our conversation with Dennis Wildman of the Sunshine Terrace Foundation pointed out some low-tech ways to connect. He talks about “curbside counseling” and having face-to-face conversations, properly distanced, while using an important piece of low-tech assistive technology: a mask. “I'm going to tell something that will be a little shocking to people, but PPE works,” Wildman said. “Bottom line is, our personal protection equipment that we put on, we know works.”
To hear the whole conversation, click on the player.
Thank you so much for having me on today. JoLynne. This is a very exciting time. It's a very important subject. And I'm honored to speak to this. My name is Dennis Wildman. I'm a certified social worker. My title here is Sunshine Terrace is the Alliance director, I get to work with all six of our companies. And that's our way of connecting to the community and reaching out and giving back because we're a foundation. So I'm excited to still be an active and participating clinician, I think that's very important. It helps me to lead the teams, because then I'm able to walk the walk and talk the talk, sometimes you have five groups altogether going on in the foundation, only two of which were not actually participated as we speak. So one of those groups is the one that's probably closest to my heart is our peaceful healing group. That is a grief and loss support group. And that is a group that we've had going for 24 years. So we've been meeting every Monday for the last 24 years, it's my way of donating my time and giving back to the community. So we meet for right around 60 minutes a week. And right now as we speak, we're live with that one, there was a two and a half month period that we had to zoom that in, but we have strategically and strategized a way that we actually can keep social distancing. Still have them go through testing and screening before they come into our outpatient clinic. And so we facilitate a group with social distancing, everyone wears a mask everyone sanitizes before and after. And we're at least eight if not 10 feet apart all of us. The other group is the caregiver support group, which at this point, we're still on a zoom platform. Prior to COVID, I was facilitating that group now for 16 years in conjunction with Bear River associated governments. And that group was focused on caregiving, and not just education, but support that group we were meeting every other week for 90 minutes. But during COVID we moved that. Obviously, our caregivers are feeling the brunt of this COVID. And so we've moved that to weekly, but we zoom that in, just because that is a terribly at risk population with their diagnoses, comorbidities and or immune system deficiency. So we can't have the caregivers get sick, because obviously that would be the patients that would get sick.JoLynne Lyon:
Right? I don't know that I plan on asking you about this. But if you have a sense of the effects of the whole COVID quarantine on caregivers, what are you hearing from them?Unknown:
Well, I would I would categorize this JoLynne, both my patients and our caregivers, one can even add in. Because you can say I'm an administrator as well, I'm gonna add in our healthcare professionals, we're seeing an increase in isolation, we're seeing the increase in infections, we're seeing an increase in stress, we're seeing a decrease in support, and all those things that cause more risk factors. As a clinician, I probably see 33% more mental health issues now than we ever have before in 32 years. I just met with the hospital administrations of both hospitals last week and some of their lead teams. And it was evident to us, JoLynne, that we see that probably close to 30% of our admissions right now were more psychosocial rooted, and if they're manifest in different ways, and so if you take an increase in mental health challenges and a decrease in support systems, that's that's a bad combination. And so that's why I'm absolutely tickled to speak today and to speak on this platform, because I have a saying it's, instead of focusing on what we can't do, I want us to focus on what we can do. And so that's what I'd like to speak with you more about today.JoLynne Lyon:
I am so with you. I feel like, you know, for the last seven months, we've been hearing a lot about the things we can't do. So yeah, I'm really happy to move on to a different conversation. And you had mentioned that you were doing these zoom meetings with the two support groups that you're with. How's that gone?Unknown:
Well, I'm going to give you a minute, give you a little bit of my own personal opinion, then a clinical observation and administrative observation. I believe that there's other ways that we can still reach people. Now, I don't want to rule out telehealth, please don't take me that way. Because right now 40% of what physicians are doing is probably that and I would guess that close to 30 to 40% of what I do is still telehealth, that we zoom platform, FaceTime, Skype, whatever that might be, telehealth, there's still a need for that, JoLynne, and I think that's so important that we let the public hear that. However, just like I articulated on our groups, the other group that we're still going live with is once a month, we meet with all the Parkinson's patients and all the Parkinson's loved ones. That is absolutely in person. Now, there's times where we need to have that platform that we need to have Zoom's we need to have telemedicine, I believe, and that's part of what I'm trying to encourage not just our agency, but other agencies, that there's other ways that we can still meet their needs. I think there's other ways that we can think of those things. And so just off the top of my head, we, as you can see from the groups it's, it's a two thirds live and one third zoom. And that's kind of similar to the clinical interventions. But there's times where I meet with a client outside in our garden, there's times where I meet with clients or families in a bigger like a gym area, or boardroom or those kinds of setting. there's times where we meet with the hospital officials, and we meet in larger areas or outside on patio areas. I jokingly called it kind of curbside counseling this year for the last seven months. ButJoLynne Lyon:
I like that!Unknown:
There's ways, JoLynne, that we can still meet needs and still make people safe.JoLynne Lyon:
You had mentioned that there's sceening, that there are all these procedures in place, when you have your group meet. What are some of the things that you do to make sure that that's going to work?Unknown:
Yeah. So I just think it's really important for us as a foundation to follow CDC guidelines. And that is social distancing, and mask and sanitization. Those are the basics that we, as American public can do in general. So we encourage that first and foremost, we also strategize the seating so that you can't sit that close to somebody that certain chairs are maneuvered. So you have to be separated. But that screening, when you enter our building would be just like you enter a hospital, or an outpatient clinic, which we are here, isn't it, you come through, we do a temperature check, we asked if you've had any contact with the COVID, or at any kind of a COVID situation and you or your family's life, you have a cough, do you have a temperature? Do you have any of those other criteria, we what we want you really important is when someone comes into their screen, they wait there and then we bring them up as you know, individuals up to the upstairs boardroom where we meet with these. And that's important for them to know that they're being protected. And it's also important for us to know that we want to be very careful and cautious and systematic and strategic when we bring people into our buildings, because I believe that some of our there are some agencies out there that just said because of COVID we're not going to do anything. We're going to just do zoom. I struggled with that because the billing sources the same and I hope that people are making that decision because people are at risk not because it's more faster way to be able to faster way to see people.JoLynne Lyon:
Yeah. What are some things that people are doing to make sure they're not feeling isolated?Unknown:
Yeah, so I have an acronym JoLynne that I utilize with our clients and it's a complete Dennis-ism, but NVV. So normalize, validate and vulnerability by trying to start the conversations with that acronym that we want to normalize that you feel this way. We want to validate that these are your feelings and it's connected to just your own diagnoses, your own psyche, your own mental health, your own physical well being or just your personality. But we also don't want people to feel vulnerable. And so just as I tried to articulate why we might go above and beyond to screen people in is that both protects the client but also to remind patients and staff and family when they do come in. We want to make sure that they're not vulnerable. So we we do those things up front I think there's another part that we're seeing a lot of success with right now. And I'll just turn this as body, mind and spirit that we can kind of look at this triangle, that we're actually empowering people a little bit more to explore the body, the mind and the spirit. So again, let's just take an anxiety or OCD or depression or schizophrenia patient, and then you add COVID on top of that, that's pretty complex. And so we want to make sure that we take body, mind and spirit to help them. We have some very specific tools that I've developed over the years just have some analysis to help them balance their life. So really, it's just an analysis of what their weekly hourly compilation looks like, but we try to help them. How much time are you spending worried? How much time are you spending, trying to look for solutions? How much time are you spending reaching out to somebody? How much time are you actually seeing the clinician? How much time are you doing screen time or social media? So that's a pretty big umbrella. But that body, mind, and spirit really helps us drill that down a little bit for them. It's important for the public to hear that. We want to always be guided by appropriate assessments. Our assessments drive what we do, we just don't say, JoLynne's this way. And so we're gonna do this and Dennis's this way. We're gonna do it this way. What we try to look at is what are the specific needs of JoLynne? What are the specific needs of Dennis? What are the specific needs of Grandma Gladys or Billy Bob? Right? We want to make sure we do an assessment to find out what their needs are. And then we address that direction. JoLynne there's a, there's a concept called strengths perspective, that I found very effective. As a clinician, I found it extremely effective as a healthcare administrator. And I've seen this extraordinarily effective during the COVID. Because if you take a look at that strengths perspective, is that you focus on the things you can do not the things that you can you don't you look less at your limitations, and you look at what strengths you have, or what tools you have or interventions you have. So we're seeing an awful lot of that right now.JoLynne Lyon:
And what are some strengths that you are seeing? Are there some that maybe you might not have noticed before March 2020, that are becoming evident now?Unknown:
Yeah, I think if we look at life management, or just behavioral management, that's something that we've looked at for lots and lots of years. But what we're seeing more of right now, is when people are feeling isolated when they are having to stay home when they're needing to stay home, or they have a loved one in the facility, heaven forbid, that they can't see. We're looking at ways that they can still social network, how can you still speak to that person? Can you still go visit out a window? Could you still reach out to a loved one? Can you write to them? Can you do Skype with them? Can you do FaceTime with them. But what I think is a really, really important is that we're doing a good job right now and asking people to connect or reconnect during this time with people. But JoLynne, what we've also seen pretty special is that we're seeing how people are able to re energize or harvest some new ideas in their life. And so sometimes in our group, we'll start off with what new what new things have you done this week? Is there a goal or project that you're working on that you would like to reconnect with sometimes, and so we try to encourage them to look at those things. It's been kind of fun to watch some of our seniors, you know, the people that took care of us, JoLynne, as we were growing up as that's what's special about this. But what's been pretty unique is to see these individuals reconnect with family, children, grandchildren, reconnect with classmates, to reconnect with other people, and how much joy that brings them where sometimes we got in a rut of just doing certain things. And this is a way for us to reconnect with those or end or find new projects or new skills in our life.JoLynne Lyon:
Yeah, I'm just remembering at the early part of the pandemic, I tried some painting, which I hadn't done in years, and it showed. But you know, it's kind of fun to try.Unknown:
I'll give you two different examples. One's a personal, one's our foundation. A personal one is I really like to weld, I really like to do those things. That's a connection with me and my brother who's really good at that stuff. And so I actually, I've had a goal to build a trailer, a little utility traded for my my kayaks and my bikes and my camping gear. And it's been a goal for a long time. And, you know, I finally took this opportunity to, to build a trailer and to paint a trailer and to weld it and to set it all up. And we've taken it to Yellowstone this year, we took it to St. George two weeks ago, it's just been really fun to reconnect with that. And then I'll give you one that's really tender to us today. We had a we have a patient here who's been involved with St. George marathon, I think for 22 years, he's a paraplegic at this point, he's been in that state for quite most of his life, he's in a wheelchair on a day to day basis, we take care of his everyday needs. But for 22 years, he's been involved with this with the St. George marathon. And they actually, you might even see this on the TV, it's called Team brenchley. He's actually been involved with the St. George marathon. And he was so sad this year, because obviously, that's not something we can do. So tomorrow, I'm super excited about this. But tomorrow, we're gonna have our first annual sunshine tears foundation marathon. Instead of 26.1 miles, we're going to have 2.6 blocks. And we're going to be able to have every resident come out individually and go around the block. And I've arranged with my dear friend Troy Oldham, we've arranged for all of the materials from the Logan Marathon. So our residents will leave in a wheelchair and they'll go around, they'll actually come through the arts or go through the tape, and they'll actually get a time. And we're super excited about this. This is a good example of what we can do instead of what we can do. That's awesome.JoLynne Lyon:
Yeah, it's awesome. How was he involved in the marathon in St. George?Unknown:
He was, it turns out, he was where he lived before us. There was a college student 22 ish years ago that started to push him. And this individual has pushed him every year. So when he was a student, now he's married and has kids, he still comes and does that. And that's how they were first engaged. And then Brian moved up here to Logan, Utah, and that individual followed. So once a year, he would come and get him and take him to events. But you know, a great example of that easiest thing to say, we can't do that because of COVID. And I kept saying, let's not let COVID win. Let's have Brian win. And so amazingly, our loving staff just created this magical thing that will occur tomorrow, timed it out. So every one of our residents in our skilled nursing facility, though, they all leave 10 minutes apart, so we keep them separated. And what's really fun, JoLynne, is we actually have our staff who are going to be pushing them and each of us have to be tested for covid before we could push, and then we'll all be dressed in PPE. But what a great opportunity for our residents to get an enjoyable moment for our staff to have an enjoyable moment. But also let that let the community see hey, sunshine terrace is still doing what we can.JoLynne Lyon:
So another thing that I I'm not gonna lie, I've been bracing myself a little bit. It's been a nice long summer, we've had great weather. It's ending, you know. So I am bracing myself a little bit for the winter. Are there some indoor ideas indoor things?Unknown:
Yeah. So let's take a 30,000 look at that, a real 30,000 foot look at that real quick, scuse me. But when we look at our flu symptoms, when we look at our strep throat, we look at our common cold symptoms, they're going to go right in line with our covered entry or beginning symptomology. So the diagnostic part of this is going to be that much more complicated as we go forward. So that's a complex portion to this. But also, when I just referenced that I lovingly put on my name tag, curbside counseling sometimes in the middle of winter, you can't go outside and do this. So we're actively strategically looking for ways that we can still do some of these things and do them inside. So Case in point, you know, was we could still do some activities in our gym area or in our family areas or in our hallways, but we have to be very strategic to risk out to weigh out that risk versus benefit. So we're exploring those things to still keep them connected with each other, keep them connected with their families and keep them connected with some physician and or psychosocial support.JoLynne Lyon:
You have mentioned that anxiety has been such a big part of this or just mental health, managing your own anxiety and your own worrying your own stress. You have mentioned also that focusing on what you can do is really helpful. Are there other things?Unknown:
Well, I think, again, we start with that nbv is that we have to normalize and validate why people feel that way. And then we need to strategize things, because with an increase in domestic violence and substance abuse and drug related crimes, and even suicidal ideation is extremely high right now. We need to take those things into consideration. So how can we still get these people to get the support. And so I think if we narrow this down to individual family, and group, we can still do some of those things, we just have to follow the CDC guidelines, we could still meet with somebody in their home, we could still meet with someone in our offices, we can still meet with someone places, we just have to keep eight feet distance, right with both of us wear masks and sanitizing. So that's part of it. I think we can still try to mobilize people to things as well, just like our group, when we say you can either zoom in for this group, or you can come meet with us what's best for you. That's important. I think that it's it's important for us to look at that social networking and social mapping pieces. What are your deficits in your life? And how can we reconnect you to somethingJoLynne Lyon:
Nancy (a colleague in Brigham City) had mentioned that they were doing some exercise classes over zoom. And I just thought that was so intriguing. I know for myself, I've been doing a lot of YouTube yoga, and it's, I can't say a bad thing about it.Unknown:
Yeah. I think, let's look at that, right. There's a great example. So if I take the individual family and group modalities we just talked about people, some people can still get together at a gym, you know, one of the local gyms, they can still get together and go to aerobics. Some people feel more comfortable zooming in. And some people have decided, Hey, you know what, me and my family might enjoy that alone. So we're going to actually learn this. And we're going to do this together as a family. So just taking that one modality you talked about, we could break that out into group, family and individual. So if we take that same thought we can do that with a counseling session, we can do that with other events. You know, I think we want the cash value box or people that we live in a beautiful area. Why can't we get out just a little bit more sometimes? And why can't we spend more time outside? Why can't we spend more time, and with the winter coming available? You know, I don't know if you follow outdoor sports but men, that's one of the highest retail sells of anything right now anything outdoors. So it certainly tells us that people want and need to get out more and I think snowshoeing is coming up. We have, you know, outdoor skiing, we have snowmobiling, we have other things in Cache Valley that we can get out and do more. So we encourage that. And there's times where we might have a loved one who's there caring for someone that's sick and not well, that's where we really say contact us. Let one of the agencies come in and provide some respite care for you. And you go to a group, you go to the temple, you go get your hair done, or you can go out and go for a walk or go for a jogger, go do something outside of the house. And I think that's where you have to look community instead of just inside your own house. Right.JoLynne Lyon:
I think there's been a little bit of a tendency, at least with some people to do these back to back zoom meetings to feel more connected. It it's not my favorite thing to do. to be honest. So and we've talked a little bit about some other things that we can do to feel connected, but but also I are there things that we should be doing when we're not connecting?Unknown:
Yeah. So I think it's important that we validate, JoLynne, you and I talked before but I'm exhausted after I do three or four of those during the day. And as a clinician, it's really hard for me to read people's non verbal skills. It's hard for me to read anything but what I hear. And actually, when I ran a administrative type of meeting or a coalition or something, it's very complex, because you've missed a fair amount. So that's important for us to acknowledge that it's more difficult. I think there's, that's, I think we can easily get into a rut, JoLynne with our society. And again, from a clinical standpoint, a physician or provider could provide more visits because of zoom. And so you could bill for more, and you could be more efficient, because you're producing more, but are you more effective? And that's where I go back to is that I asked us to work backwards, instead of start with zoom. What can we do besides that? And if we need to, let's have telemedicine be our last or second choice. But what can we do before that, with that fine balance of still addressing the risks and the benefits? And following CDC guidelines following you know, local mandates? What can we do first, and I think, having people contact their loved ones, can you still stand outside and visit with somebody? Can you still call someone and say, having us stand on an under bottom of your stairs and visit with you on your porch? That's something that some people are scared of, if you really understand this, this COVID issue, you can be six to eight feet apart and still be safe. And I'm going to tell something that will will be a little shocking to people, but PPE works. Bottom line is our personal protection equipment that we put on we know works. We had a husband and wife on our hospice, and we still provided care for them in their home. We just had to wear PPE, we have physicians who are operating on people who are positive. We have, we have providers in ERs and in clinics, who are still providing care for people who have covid positive. So we need to realize that PP works. And so there's times where I still go visit a patient I'm dressed from toe to head with with protection, but I can still let them know I love them. I still care for them. I'm just also letting them know that I'm protecting them as well as myself in this process.JoLynne Lyon:
Great. Yeah, I've pretty much run through my list of questions. Is there anything else that you would like to tell me?Unknown:
I think it's I think, JoLynne, I'd love I'd love to give a shout out to our providers. Never before in 32 years, have I seen more what I would consider is compassion fatigue, it's when a health care worker starts to run into what we used to call burnout. Compassion fatigue is a real issue right now. And we're seeing more and more that our providers are, are staying indoors more and they're not... We're having more locked doors. We're having more testing. We're having, you know, some of our skilled nursing facilities based upon the community percentages. We're testing our staff twice a week. And that's, that's a lot of COVID testing. Yeah, so that's a big piece to this. If you just take a look at what I said, we're seeing the increase in domestic violence, substance abuse, drug related crimes, suicidal ideation, we're seeing increased with compassion, fatigue, or healthcare burnout. Hats off to our providers, we want to give them a shout out, let them know we love and care for them. We appreciate that they're in the trenches caring for these people. When you see these signs around Logan that says, We love our health care workers. Thank you. I can't say that enough. I mean, I think about that nurse, I'll even say her name is Priscilla. She went inside that home twice a week, for six weeks while the husband and wife were diagnosed with COVID and passed away. That takes a lot of courage when you have three children at home. And you know, that just shows an awful lot of courage. Most of us in our health care worker, we've all had scares we've all you know, we've had staff that have been positive throughout, not just in our foundation in our health care industry, but we're right there on the lines sometimes. And you know, we all we're all doing the very best we can so hats off and shout out to the health care workers out there. We love them. We appreciate them.