Every day the response to the COVID-19 outbreak has gained urgency, so Beth and Jeff Paul made a spreadsheet and turned their downtown Vancouver work office into a supply room.
Soap bottles, facial tissue, latex gloves and cloth masks were gathered on the conference room table. Twenty-two jumbo toilet paper boxes, and three boxes of paper towels were stacked on the ground in the waiting room.
On a normal day at In It Together RN things would look different, but as Clark County, and the rest of the world, has become more and more disrupted by the coronavirus pandemic, so have the Pauls’ lives and office.
“Times are crazy,” Jeff Paul said Friday.
Their main duties running a nurse delegation business for nearly 200 adult family homes in Clark County have begun to morph. Instead of helping clients structure care for residents, they are now helping any of the 368 adult family homes in the county search for basic necessities and protective equipment for staff and the more than 2,000 adult family home residents.
As grocery stores across the state place restrictions on products, such as toilet paper and disinfecting wipes, adult family homes are “really struggling with the basics,” said Patti Gray, a registered nurse who runs Angelbrook Senior Living in Salmon Creek, which has six residents between the ages of 86 and 96.
Some caregivers are having to shop at three to four grocery stores a day to find supplies. Yet, it’s critical that caregivers don’t spend too much time in public, because they could catch COVID-19 and spread it to residents, Beth Paul said. One of the first COVID-19 deaths in Clark County happened at an adult family home.
“If I don’t have anybody to care for these residents, what do we do?” asked Jamie Myers, the owner of Sequoia Heights Adult Family Home.
Those worries are permeating adult family homes in Clark County, so the Pauls are trying to take on some of the burden.
“We’ve been jumping around to figure out what the supply shortages are,” Beth Paul said.
One home was folding paper towels to use for residents’ toiletry needs, so the Pauls dropped off toilet paper for them. Another home needed thermometers, so the Pauls dropped those off, too. Some homes were cutting slits in trash bags and using them as makeshift gowns. Others were re-using face masks until they became too droopy to stay on.
“This is a bigger problem than we realized,” Beth Paul said.
The Department of Health recently sent out forms to adult family homes seeking information on their stock of personal protective equipment. But adult family homes are still trying to figure out the forms, which were structured for larger long-term care facilities.
Help might come from the state soon, but right now “amazing” gestures like those from the Pauls are helping to fill the gaps, said John Ficker, executive director of Adult Family Home Council.
When the state’s first death happened at a long-term care facility last month, there was a sprint to figure out the best response, Ficker said. Now that homes are struggling to find necessities and personal protective equipment, a marathon has begun.
“We’ve really just got to the beginning of the hard part,” Ficker said.”We’re just starting to see the sickness arriving.”
Each day, cracks emerge throughout the United States health care system, and there’s worry over what might splinter next. Will hospitals run out of beds and ventilators? Will health care workers and first responders have the protection they need?
And there’s another layer of worry. How are long-term care facilities making sure they aren’t the next Life Care Center? With nearly 40 people dead from a COVID-19 outbreak at the nursing home in Kirkland, there’s been plenty of focus on larger assisted living facilities and nursing homes, but what about adult family homes?
In Washington, the homes are more residence than facility. Adult family homes are only licensed for two to six beds and have a limited staff to care for the residents. But there are 3,200 adult family homes throughout the state, with 18,000 beds.
“In these moments, it’s easy to be forgotten,” Ficker said.
On Friday, the Pauls lined up empty boxes and bags against a wall in their waiting room, and began filling them with supplies. Jeff Paul made hand sanitizer in a back room and brought the bottles to his wife so she could label them. Beth Paul stuffed latex gloves into zip-close bags.
“The people who needed gloves were out, which terrifies me,” Beth Paul said.
The Pauls had been doing donations piecemeal, but as requests grew, they created a spreadsheet for each home’s need.
Disinfectant, toilet paper, cloth masks, gloves and facial tissue were headed to a home in Salmon Creek. Paper towels, toilet paper and a gallon of disinfectant were headed to a home in Washougal. Another home in Vancouver just needed hand sanitizer.
Jeff Paul created a route to hit 15 homes throughout Clark County in four hours, dropping off packages at each stop.
As the boxes and bags filled with supplies, they moved them into another corner, ready to be packed into a trailer the Pauls borrowed from Caring Closet. Each box had a sheet with the recommended donation for each supply, so the Pauls could continue to afford their program.
Jeff Paul started carrying the boxes out to the trailer. He loaded them in one by one, and then with the help of his wife and a co-worker.
There will be at least another 15 trips to be made over the weekend, and who knows how many requests they will get in the coming weeks. But this was it for now. Jeff Paul stepped out of the trailer, and sealed it shut, ready to make the deliveries.
“Time to pay it forward,” he said.