Interview by Jan Osborn. Photos Courtesy of Juliette Fowler Communities.
When COVID19 became an international pandemic in 2020, many of us had no idea what to expect. To some it meant that their upcoming travel plans would be canceled. To others it was rearranging their lives to accommodate homeschooling their children or bringing home their college students for the rest of the semester. But to some it was the tough decision of whether to bring their loved ones into their homes to care for them or leave them in their assisted living facilities where the chances of testing positive for COVID-19 might be greater. We visited with Nicole Gann, president and chief executive officer of Juliette Fowler Communities, to help us better understand what is involved in maintaining the safety and well-being of residents during a pandemic and how to make decisions that are right for your family.
How would you describe Juliette Fowler Communities?
Founded in 1892, Juliette Fowler Communities is a unique faith-based, intergenerational community of residents at various life-stages. Located on 25 picturesque acres in the Lakewood area, Juliette Fowler Communities provides independent and assisted living, skilled nursing and rehabilitation center, affordable senior housing, and memory care. As the only certified I’m Still Here® Center for Excellence in Dementia Care in Dallas and one of only three in Texas, Fowler’s program employs evidence-based techniques to adapt daily experiences to an individual’s cognitive abilities and strengths. Also, a part of our campus is The Ebby House, a residence for women, ages 18-24, at risk for homelessness due to neglect, abuse, and aging out of the foster care system. The Ebby House program instills life skills and provides mentoring, health care, education, career guidance and job training. Additional services of Juliette Fowler Communities include foster and adoption services.
What does it look like to care for a community while you mitigate risk among your residents?
At Fowler, we restricted visitor access and resident departures on March 12 before we received local and state executive orders. Since we proactively took that action, several CEOs in our industry have called us Fort Fowler. I will happily wear that label because it means we are doing all we can to protect our residents during this pandemic.
We immediately asked our staff to start practicing the highest level of social isolation for the benefit of our residents and themselves. They were asked to stay home and stop going to church, kids’ activities, concerts, and shopping malls – basically anywhere there could be a large gathering of people. We also asked them to implement infection control in their homes, sanitizing surfaces and handling their mail differently – all while we were developing those same protocols at Fowler to limit risk. We know it is not possible to mitigate every potential exposure, but we all must be able depend on each other to do what we can. For our staff, this is not a job, it is a vocation. They are following their life’s mission to come to work and care for others, prioritizing our residents over their own fears. Taking every precaution, we are utilizing all personal protection equipment – including masks, gloves, and hand sanitizer. We have isolated deliveries to one area for administrative personnel to distribute. To minimize cross contamination, resident access is limited to their respective areas.
As you look across the care industry, how does Fowler’s pandemic response compare to other organizations?
While I cannot speak to what other facilities are doing, I do know that we were early adopters and put many protocols in place before local and state directives. Our team has focused on keeping our community safe. As all of us have learned, things will continue to change as new information is provided by the CDC, national, state, and local governments daily. Just as our state and local leaders have the weight of the protection of our city and state on their shoulders, making changes as needed, we carry that same weight to protect our residents and staff at Fowler Communities. We are all working to reduce exposure, save lives, and keep our residents comfortable and safe.
What does it look like to help your community understand COVID-19 protocols and the need for compliance?
For this question, it is necessary to answer from the perspective of different stakeholders. If a resident or their family member is unable to comply with our protocols or feels as if there is going to be a conflict, this is addressed on a case-by-case basis. Regarding the Fowler team, they have gone above and beyond to make and execute protocol changes for our residents’ safety.
From a resident perspective, originally, we had minimal pushback from some independent living residents who felt they should be able to come and go as before the pandemic. That was handled in the first few days, and soon we had little to no non-compliance. Now our residents are notifying me if they see anything inconsistent with our policies! Residents who go out for essential medical care have a protocol to follow for their return. If a resident goes out for something non-essential, they are quarantined in their apartments for 14 days. And lastly, while we are prepared to do this, we hope we never have to take the last step of barring someone from the campus. Our first and foremost job is to protect our team and our residents, and that cannot be sacrificed for the desires and choices of one individual.
Families have been told that access to residents is restricted during this time. Our staff is committed to keeping them informed through communication opportunities throughout the day including website content, daily talking points, social media, videos, and emails.
How are you responding to questions from families about bringing a loved one into their home?
Families struggle with the question of “What is the best thing to do for the safety and comfort of my loved one?” With all the restrictions in place, they wonder, “Would my family member be better at my home?”
There are many factors to think about when considering these questions.
When a family member asks me if they should consider taking their loved one to live with them, I tell them I really can’t say what would best for their family. I can, however, walk them through important questions to consider. What are your home’s logistics? Are you dedicated to practicing social distancing, remembering that seniors are in a high-risk group? What is your infection control process for each person in your household? How often do you go out in the community? Are you doing anything that would be considered an exposure risk? You must honestly answer these questions before considering moving a loved one. Can you provide care for their needs? If your loved one is living in one of our licensed care areas such as assisted living, skilled nursing, or memory care, are you prepared to provide that care 24 hours a day? Can you do that physically, and do you have the supplies in place? Have you thought about the implications of doing that for the duration of the pandemic? We will not be able to accept them back into the community until our regulations are amended, and they will likely need to be tested prior to returning.
You must honestly answer these questions objectively before considering moving a loved one. This is an emotionally charged decision but always know that we are committed to providing exceptional care while loving them during this time of uncertainties.
Individual mental health is so important during this time. How are you keeping spirits up among your staff and residents?
I often describe the benefits of living in a senior environment as a community of peers with purpose and people who care about you and your well-being. Isolation can contribute significantly to a decline in health. During a pandemic when we need each other the most, we look for community in new and unique ways. At Fowler, we are keeping spirits high by creating as many touch points as we can and paying attention to the little things.
We started shelter-in-place and restricted access to all visitors on March 12 and immediately launched our Daily Briefings. In the Daily Briefing, I speak directly to our residents from our chapel to their living rooms through our internal broadcast system. They trust I will give them accurate information – the good and the bad of the virus and how that impacts them. By simply providing information and the comfort of a familiar face and place, we lessen anxiety and manage fear. We have encouraged our residents and team to contribute, and creativity is flowing! Our residents provide jokes and encouraging notes, and we infuse those into the briefings. We started Teammate Tuesday and Fun Friday and do segments to highlight successes, birthdays, and anniversaries. We have “Godwink Day” focusing on where we see God at work, and we now have “joy hunters” reporting the good things they observe. Virtual singalongs, games, dancing, exercise, and our Bible study and worship services are broadcast as well. One of our residents created a Scavenger Hunt of the trees and flowers along our walking paths. Another bakes surprise treats for neighbors and staff. Recently, we celebrated Cinco de Mayo with a door-to-door beverage cart and dancing. One of our managers created a video series of the history of Cinco de Mayo, featuring a female mariachi band and music from different regions throughout Latin America. We all learned together. Through our Amazon Sunshine List, residents received Snack Packs for National Pretzel Day, National Animal Cracker Day as well as coloring and puzzle books in Sunshine Bags. We launched a coloring contest with our own Fowler coloring book. Family members are connecting through zoom calls, and volunteers are making sunshine calls to those without family. Like I said, it’s the simple things. It’s being willing to sing when you can’t carry a tune or dance when you can’t keep a beat – it’s laughter therapy at its best. Purpose and levity are necessary, and no one needs this more than our seniors.
As different communities and companies begin to reopen, how is Fowler planning for the next phase of social isolation?
The reopening plan for Fowler is a big topic of conversation, and it will be a plan that will be developed with two fundamental things in mind: one, what does the data tell us, and two, what is the risk? Limiting risk and protecting our residents and our team have been our goal since the onset of this pandemic and continue to be our primary focus throughout all the phases and adjustments. As we’ve said from the beginning, the data changes rapidly and calls for us to adjust. Our extensive multi-phase plan is implemented cautiously and judiciously. We hope to offer a glimmer of “normal” to give a respite from the weight of the pandemic and the isolation felt by so many.
What kind of good are you hoping to see, or already seeing, as a result of COVID-19?
Although it’s hard to imagine anything good coming out of a pandemic, finding the good in the face of tragedy is the Fowler way, a lesson we learned from our founder, Juliette. She experienced great personal loss and turned her grief to good. She inspires us to look for the good in hard times.
My faith and reliance on God have sustained me through this pandemic. I believe all things work out for His good.
At Fowler, what resonates with me is our ability to eliminate noise, distraction and delays. In many ways, we will be better at focusing on what is important allowing us to move through decisions and execute with a greater level of efficiency. I think we have reached a new level of personal connection and a desire for simplicity. We have a granddaughter and grandmother who are now writing paper letters to each other. We are connecting in conversation, presence and belonging.
This pandemic will be the sentinel event of my life. Much like my grandparents remembering the great depression and experiencing a ripple throughout their lives, I know this will ripple through the “adapted me” for the rest of my life and in the choices I make.
Who are the heroes you are seeing in your community and across the city?
Without question, there are many heroes of the pandemic! At Fowler, the heroes are the team members who overcome fear as well as resistance from family members to answer the call to come to work each day to serve the residents that we all love. The heroes are our residents who accept the limitations and restrictions on their freedoms and the rearrangements to their daily activities. The heroes are our external community who send donations and volunteer to buy supplies helping us to continue doing what we are doing. In any tragedy, you can see the worst and the best of humanity. At Fowler, many beautiful aspects of humanity are evident every day. It’s important for us to all to take note of this beauty all around us – reminders that God is with us even through this hardship.
Have you seen any silver linings or the pandemic wins?
The pandemic has focused our attention on what is important and allowed us to reconnect with one another. As it relates our industry, it has highlighted the dedicated caregivers who work hard each day to do the right things for the right reasons. Additionally, it has revealed the importance of a senior care community – especially as an environment where caregivers are focused on the risks for our older citizens and the measures to prevent such risks. Our families believe their loved ones are safer here.
Another pandemic win or silver lining can be seen in the wisdom of our elders in sharing their life experiences. Even in our separateness, we have grown closer. I can hardly wait to hug the necks of the many residents who have been sources of encouragement and inspiration. We have members of our community who have survived wars, tuberculosis, and polio, and who recall multiple world pandemics. Their willingness to share their stories and wisdom have been invaluable to us all helping us to have perspective and realize there is nothing new under the sun—it is just a new name and experience for our world today.
How is Fowler a symbol of hope to other nonprofits?
Fowler has served as a symbol of hope throughout its 127-year existence, changing and evolving to meet the needs of society. Our visionary namesake Juliette, Dallas’ first female philanthropist, dreamed of a home for widows and orphans, and upon her death, her land in East Dallas was developed according to her wishes. Her sister, Sarah, fulfilled Juliette’s vision in 1892 and founded The Juliette Fowler Homes for Children and the Aged, where thousands have lived and served.
Throughout of all the storms we have weathered at Fowler – the flu pandemic of 1918, two World Wars, the Great Depression, and more, coupled with changing socioeconomics, politics and healthcare – our leadership over the years has remained focused on our mission and flexed to move with the times. Orphanages gave way to foster care, and the ‘old-folks home’ is now a community. Ours is a story of perseverance and hope. We still rise to answer the call of our community’s most vulnerable citizens, our seniors and at-risk youth. For anyone who needs to rebuild or find a new direction, Fowler continues to reflect what is possible with an unwavering passion and mission. Hope springs eternal at Fowler!
How can people help the Juliette Fowler Community during this time?
Donations to our One Heart Fund fulfill Juliette’s vision of providing a safe and loving home for older adults and at-risk youth. With or without a pandemic, those needs remain. The vulnerabilities of aging will always exist. Children will always need our protection. Each dollar contributed to Fowler supports our mission and values to love people, pursue excellence, and make a difference. Our COVID Relief Fund will help cover the unexpected and exorbitant cost of PPE (Personal Protection Equipment) and staffing. Donors are big heroes in our story as they do extraordinary things to impact the everyday life all those who call Fowler home. To make a donation to protect vulnerable youth and older adults, go to www.fowlercommunities.org or call 214.515.1342. To learn more about living at Fowler, call 214.827.0813.
If you or someone you know is experiencing a mental health crisis or suicidal thoughts, please dial 1-800-273-8255 for the National Suicide Prevention Lifeline. For help finding a mental health resource, call the Here for Texas Mental Health Navigation Line at 972-525-8181.