Ombudswoman stands up for Sonoma County care home residents during pandemic
For ombudswoman Kathy Baldassari, entering a long-term care home where every elderly resident and staff member tested positive for COVID-19 was not the most difficult thing she has ever had to do on the job.
Rather, Baldassari’s greatest challenge in 13 years as a senior advocate was being prevented from visiting Sonoma County’s long-term care homes for an agonizing six months at the outset of the pandemic.
“Unless you walk in that building, you can’t really see what’s going on,” she said. “You can’t figure it out with a phone call. A lot of these residents can’t talk on the phone. They can’t see you. They can’t hear you. They don’t remember you.”
Baldassari, 61, works for Senior Advocacy Services, a regional agency that runs the Sonoma County Long-Term Care Ombudsman program, a key watchdog and representative for residents of care homes. She and her colleagues are tasked with the safety and welfare of some of society’s most vulnerable people — a job that is difficult and draining on the best of days but in a pandemic can feel overwhelming.
“It is absolutely the most challenging, indescribable time,” said Crista Barnett Nelson, executive director of Senior Advocacy Services.
The elderly are at particular risk of suffering severe or fatal complications from the novel coronavirus, which has run rampant in Sonoma County’s wide network of skilled nursing and residential care facilities. Since the pandemic started in mid-March, those living in these facilities represent more than three quarters of the 149 county residents who have died from COVID-19 as of Nov. 16.
Barnett Nelson said other challenges include wildfires that forced the evacuations of some care homes in Sonoma County, staffing shortages and perennial challenges providing quality care.
The county has 5,500 senior care home beds. The ombudsman program typically investigates about 1,000 complaints annually. So far this year, however, the number of complaints is dramatically lower, for reasons that are not yet clear, according to Paul Dunaway, director of the Adult and Aging division of the county Human Services Department.
One factor could be the restricted access to facilities because of the pandemic. An ombudsman normally makes unannounced visits to facilities or can be dispatched to check on a resident, often at the request of staff or a concerned loved one.
Baldassari and her colleagues were finally granted access to care homes in late September, six months after the start of the pandemic. But these visits come with risks.
In early October, Baldassari visited St. Francis Assisted Living in southwest Santa Rosa, where all 20 residents and the entire staff of eight tested positive for the virus. To many, that sounds like brazen risk-taking. Dunaway, however, said he understands why Baldassari says it’s harder for her to not go inside.
“When you don’t know, and you’re drawn to do that work, that answer makes total sense to me,” he said. “It makes you worry that much more.”
Many residents live in stark isolation, with little to no visitation from anyone other than staff. As a result of the pandemic, visitors are not allowed inside care homes except for very specific reasons, including end-of-life situations.
Baldassari said residents are “really isolated, not just from families but in a lot of ways from other residents. People make friendships in a building. If you’re told you have to stay in your room, you can’t see that face. People lose track of time.”
As a result, she continued, “We’ve seen a big shift in people with dementia. They start going downhill after three months. You can’t remember your loved one’s face.”
Baldassari carries her own burdens. As a mother of three and grandmother who cares for her own 87-year-old mother at the Rincon Valley home she shares with her husband, she lives with the daily worry her work could expose her and her loved ones to a potentially fatal disease.
She takes precautions on the job, wearing a full-body protective suit, mask and face shield. Nevertheless, she had to take a day off in early November after feeling ill, leading to a COVID test to be sure she could safely go back to work. She also had to keep her distance from her grandchildren as a precaution.
Baldassari, who has worked as an ombudswoman since 2007, holds a certificate in gerontology from Sonoma State University. But none of that training or experience fully prepared her for working during a pandemic.
“You have to be ultra-careful, but this is the work we do,” she said.
Barnett Nelson called Baldassari a “master” in the role.
“Her sweet nature is not to be confused with weakness,” Barnett Nelson said. “She is a powerful force to be reckoned with when someone abuses an elder. She is a fierce advocate who has a complete understanding of the rules and regulations that govern the care for seniors and she will go to great lengths to ensure our seniors are well cared for.”
Case in point from a Christmas past: Years ago, firefighters asked Baldassari to come to a care home on Dec. 23 because the caregivers had all gone home for the night. She stayed until help arrived to take care of residents.
She also has assisted in a number of elder abuse cases, including the successful prosecution of an attorney who was stealing money from a client.
Barnett Nelson, her boss, is a fierce advocate in her own right, and on Nov. 17 was presented with the Carroll L. Estes Older Adults Advocacy Award by the Sonoma County Board of Supervisors. The award is given to a “community champion who has demonstrated exemplary advocacy on aging issues.”
Dunaway nominated Barnett Nelson for the honor, saying she has gone above and beyond to help residents and work with care home providers during the pandemic.
Barnett Nelson and Baldassari say their greatest reward is getting to know their clients and advocate for their welfare. Pandemic or no, staying away is not an option. They have too many people counting on them.
“The magic is when we can develop a relationship with that resident,” Baldassari said. “I can tell, because I’ve been doing this for awhile, how a building feels when we have a regular presence there, versus when we don’t. It’s really apparent.”