the Caregivers

COVID-19 Through the Eyes of Social Workers By Paul A. Miller

Q: You each work in different settings. How did COVID-19 alter your job and workplace? 

(Hunter) Nursing homes are some of the most regulated institutions in the state to begin with, and even more so with the current pandemic. We are not allowing visitors, staff are being tested on a weekly basis and required to wear PPE at all times, and residents are put on various precautions and restrictions. There was a period where residents could not leave their rooms because of the risk of getting COVID-19. This was challenging, because humans are social by nature, so that period was extremely isolating for residents. It is hard to communicate with someone when you have a mask on. Many residents are hard of hearing so they rely on lip reading to communicate. This experience has made me realize just how much I use my facial expressions to communicate with people – I squint my eyes harder than normal just so people can tell I’m smiling under my mask!

(Soto) The very nature of a senior center and the structures within it is to provide services, support and a safe space for seniors to engage with other members living in the community [and provide] the ability to remain active while they age in place [in their homes]. COVID-19 forced centers across NYC to close their doors. Currently, my focus as a social worker is to connect with seniors in the comfort of their homes via phone/Zoom to ensure they are safe. The goal is to assess safety in terms of overall well-being as it pertains to access to a steady food supply and medication, as well as access to tele-health and mental-health support systems. We also keep an open communication with our seniors and provide them with information and education about COVID-19, steps they can take to protect themselves. 

(O'Keeffe) When the crisis was at its height, the ICU I work on had 34 COVID patients daily who required ICU-level medical interventions. I would say a majority of them were on life support. My job responsibilities were not necessarily altered. I would do the same tasks and provide the same level of support to families making tough decisions; it was just at a much higher volume. We [needed] to get creative and use technology (iPads) to communicate with families. This was especially true for the patients from NYC we took to assist with the volume down there.

Q: What has been the biggest challenge for the clients/patients you serve?

(Hunter) Not allowing visitors has been the biggest challenge for our residents. Before the pandemic, we would have an average of 40-50 visitors a day. Some families and friends would visit every day, so you can imagine how difficult this period has been for some of our residents. In a way, staff have had to take on the responsibility that friends and families provided to residents [but] we simply cannot provide the same level of attention that our visitors provided. Many residents have felt disconnected from the world, which can lead to emotional and behavioral issues. I have gotten creative as a social worker to make sure psychosocial needs are still being met. I help facilitate FaceTime calls, phone calls, and window visits for our residents and families. It’s not the same, but it is definitely better than nothing.

(Soto) Many of my clients have never been isolated before, and they find themselves navigating complex emotions and thoughts. COVID-19 has had a huge impact in seniors’ mental well-being as their sense of self was very much tied to their independence and their self-direction. Much of that has changed since the pandemic began, therefore greatly impacting every aspect of their lives. It is not uncommon to find a senior experiencing one or two symptoms of anxiety, and/or depression. Particularly seniors living alone, and without access to online programming feel extremely isolated.

(O'Keeffe) The biggest challenge was assisting families and patients in making difficult medical decisions – oftentimes end-of-life decisions, without them being [physically] present in the hospital. Typically, we would have a day or two to build rapport with families and let them acclimate to the ICU/hospital environment. Due to visitor restrictions, that was no longer possible. In addition, due to the unknown nature of the virus, patients would become critically ill very quickly. I worked very closely with doctors to explain what interventions were available and the consequences of those interventions. For the patients who were awake and aware, I think it was difficult for them to be so removed from their families at such an uncertain time.

Q: A large part of your job is to provide support to others in times of crisis, but how have you, personally, coped with the stress?

(Hunter) I try to stay as mindful as possible and take one day at a time in order to cope with the stress. I continue to tell myself that this experience is only going to make me a better social worker – this is my first year and first job outside of graduate school. If I can handle this now, I can handle anything! I also prioritize self-care. Self-care, for me, is simple. I make sure to take my full hour for lunch, away from my desk, if I can. I read each day, as this helps me slow down and be in the moment. One of my favorite forms of self-care is to indulge in a bouquet of flowers every now and then. Flowers work wonders for stress!

(Soto) The beginning was truly a heart-wrenching time for me both as a social worker and as an individual. Thankfully, I have a great support system with family and friends. I constantly remind myself that I am doing the best I can during these unprecedented times. I have set realistic professional and personal goals since the pandemic began. If I can accomplish a few of those weekly, I take the time to recognize it and celebrate it. In the spare time I do have, I’ve begun doing things I loved to do pre-pandemic yet never seemed to have time to do (baking, reading, etc.).

(O'Keeffe) I will say it was very difficult for me to remain stress-free during the crisis. I am an active person, yoga, volleyball, exercise. With most of that shut down, I was forced to find other ways to cope. I have a supportive family at home. I did try to run as much as I could outside, weather and energy level permitting. I also utilized my co-workers and supervisors a lot during this. I felt as though talking to others on the front lines validated my feelings and [I] got energy from talking to them.

Q: This global health crisis has put a spotlight on social work and its essential role in our society. What do you think will change in your field as a result?

(Hunter) I think (and hope!) that there will be more interest in this field because we are in the spotlight right now. There are a lot of misconceptions about social work and what social workers actually do. My hope is that this period will highlight the diversity of social work, and show just how rich and rewarding this work truly is. I also think social-work education will change as a whole, as well; I think there will be more emphasis on crisis intervention, as this is a skill that is definitely needed during a pandemic, or any other unexpected life event.

(Soto) Social workers often don’t have power to change policies and/or big programs in their day-to-day work. But in the age of COVID-19, as well as in the face of numerous social movements, such as #BLM, I think social workers in the aging field have an opportunity to step up to bring awareness about our clients’ needs [and to] advocate proposed strategies to be inclusive to the 60+ community in NYC and across the country. If we can be an integral part of the biggest safety net used to address the biggest public-health crisis this country has ever faced, then we can and should be part of the conversations, planning teams, and policy-developing spaces to ensure our clients’ needs are met during a post-COVID-19 world. I am hopeful about the future of social work as a change-enabling profession.

(O'Keeffe) I always thought that the field of medical social work was very misunderstood. I think it is seen as a “discharge planner,” when in practice, it is so much more than that. There were times when I was empowering families to ask tough questions before the doctors. Being hospitalized can be traumatic, stressful, and emotional. Families and patients need someone on their side [to navigate] the complexities and supporting their decisions. I hope that [I and my colleagues] at the hospital have shown that social workers are essential workers and are valued members of a medical team. I think the future of social work, in general, is going to be much more respected.