By Mike De Felice
Kitsap News Group
PORT ORCHARD – Grace Hofer, a wheelchair-bound veteran who resides at Washington Veterans Home in Retsil, considers the state-run facility to be “home.”
But for the 78-year-old former Army cook and seven-year resident, the facility most recently has felt less homey and a lot more uncomfortable. That’s because she believes caregivers’ ability to tend to basic patient hygiene and other needs has taken a back seat due to staff shortages caused by the COVID-19 pandemic.
The veteran, who served three years in the service in North Carolina and at Fort Lewis, near Tacoma, said she recently has had to endure waits of up to an hour for nursing staff members to respond to her calls for bathroom help. She also had to hang on for nine days before a staff member could break free and help her take a shower.
Like so many others among the community of 190 residents at the veterans’ home, the assistance they receive from staff members is essential to their living a comfortable life. And that’s especially true for Hofer, who has been in a wheelchair for the past seven years following a car accident and surgery.
Since the start of the pandemic, the veterans’ home, like many other operations, has wrestled with staffing issues. But unlike a restaurant where having fewer employees might lead to reduced operating hours or increased wait times for service, when a nursing home has insufficient staffing, the impact on residents is immediate and personal.
“We have been so terribly short on staff, it is getting critical,” Hofer said. “There is one person to take care of 20 people, all needing special care and special help, and it just can’t be done by one person.”
Invariably, though, reduced staffing levels result in service responsibilities that are spread too thin among remaining caregivers.
Toileting and bathing issues
Hofer outlined to the Kitsap News Group a number of instances where the workforce shortage has impacted her care.
“And it’s not only my care but others too,” she said. “In January, there were two times in one day [where] I had to wait over an hour to go the bathroom.”
In order to get help for that chore, Hofer turns on her call light, signaling staff members that their assistance is needed. An employee then arrives and assists in getting her to the restroom. In pre-pandemic times when staffing levels were normal, she said the response time was five to 10 minutes. Now, she reports having to routinely wait for an hour before a staff member arrives.
“This is scary because you have accidents,” she said. “We are all seniors, you know. We don’t have control anymore.”
Having fewer caregivers has also disrupted her usual Wednesday and Sunday bathing schedule, she said. Hofer reported being unable to shower for nine days in January. On consecutive shower days, she was told she would not be able to bathe because there was not enough staff available to assist her, forcing her to delay her basic hygiene needs for a full week.
Meal service has also been impacted, forcing residents to wait longer to eat, she said. “This morning they were an hour late [with breakfast]. Yesterday, they were about 45 minutes late.”
Hofer said it’s difficult for the home’s administration to attract more employees, even in the best of times.
“Nobody wants to take care of old people that are sick and cranky. It takes a dedicated sort of person to want to care for people,” she said.
Despite the hardships created by the staff shortage, Hofer holds the regular employees at the veterans’ home in high regard.
“The few regular staff we have left are doing their best. They want to serve and be pleasant under all the pressure. They do the best they can to take care of each one of us the way we want to be cared for. [Residents] have their idiosyncrasies and [the staff] puts up with them.”
The Army veteran does tend to view regular staff differently than many of the temporary hires brought in from employment agencies to cover shifts. “They don’t want to work if they don’t have to,” she said of the “temps.”
“Sometimes they get put on the schedule and don’t show up,” Hofer said. And it irks her that the temporary employees often get paid more than regular staff.
The complaints Hofer made about the reduced standard of care are regularly voiced at the resident council meetings, where residents gather to discuss issues and concerns. Hofer has been a member of the council on and off for years.
“We talk about staffing shortages at every council meeting,” she said.
But the complaints aren’t new to the veterans’ home administration. Notes from the meetings are forwarded to administrators, she explained. Hofer said when the administration is asked about problems associated with too few employees, the usual response is: “We are doing everything we can.”
The main points Hofer raised with Kitsap News Group were shared with officials from the state Department of Veteran Affairs.
“Due to privacy laws, we are unable to share information or comment on individual residents,” Jennifer Montgomery, a spokeswoman for the department, said in an email response to a reporter.
Montgomery did, however, provide information about a number of general issues that Hofer raised.
“The State Veteran Homes have struggled with staffing since the pandemic begin in March of 2020,” the department stated in a Feb. 2 letter sent to residents and family members. The department has experienced an “unusually high number of vacant positions” and unplanned call-outs due to COVID-19 inflections in staff or family, the correspondence stated.
To combat the impacts of fewer employees and ensure the best possible care, the Retsil facility has reduced the number of residents from a full capacity of 240 to 190 residents, Montgomery said.
“If we were at full capacity of 240 residents, we would have 70 vacant positions, 54 of those are in the NAC [certified nursing assistant], LPN [licensed practical nurse] and RN [registered nurse] job classes,” the spokeswoman said.
Faced with staffing shortfalls, the veteran’s home is taking action to ensure patient care is maintained, she noted. “If we experience less than ideal direct care staffing, we provide additional support staff,” Montgomery said.
The facility is taking steps to increase staffing levels by changing employee shifts and staffing patterns, and closing units, she added.
Meanwhile, the veterans’ affairs department is “aggressively recruiting” for direct care staff, Montgomery said.
To attract job applicants, certified nursing assistant candidates will soon be offered incentive pay. Steps are being taken to recruit more registered nursing assistants.
Regarding complaints about reduced bathing schedules, Montgomery said: “We have shared with residents … that under the current staffing shortage, there may be a decrease in the care provided.” For example, bathing may take place only weekly, but personal hygiene needs may be met using other methods such as bed baths, she added.