Mary Louise Aims stares at the ceiling from a nest of wire attached to thermometers, blood pressure gauges and heart rate monitors. The only instrument in her Penn State Heart and Vascular Institute hospital room that tracks her emotions is the expression on her face, and the current reading says she’s had better days.
Several floors up in the Telehealth Resources Center at Penn State Health Milton S. Hershey Medical Center, Darlene Miller Cooley, one of the hospital’s chaplains, aches for Aims. If only she could reach into her computer screen where she’s watching a camera view of the heart patient and hug her. She wants to hold her hand and give her arm the reassuring squeeze she’s sure Aims needs.
Photos illustrate spiritual and physical changes made to treat patients.
“For most of us human touch is very, very healing,” Miller Cooley explained. The axiom is just as true for Miller Cooley as it is for Aims. Empathy is basic equipment for the job of a spiritual counselor.
Instead, both women must connect with microphones and two-dimensional images on screens. To talk, they use a program called Caregility. Penn State Health purchased Caregility several years ago for its growing telehealth service. Recent events have increased its importance.
To slow the spread of COVID-19, therapists at the Milton S. Hershey Medical Center, to whom touch and close contact have become second nature, are staying clear of patients’ rooms and finding new ways to heal body, speech and spirit. Some use Caregility. Some use paper signs. Others work directly with health care workers in personal protective equipment (PPE) who act as the therapists’ hands. The systems they’re perfecting could enhance their jobs beyond COVID-19, they say.
But can they replace physical contact?
Virtual hugs
Before Miller Cooley fires up her camera, she removes the surgical mask she’s wearing and applies lipstick. She wants Aims to see her smile.
She presses a button. Inside Aims’ room, a bell rings, letting Aims know someone wants to talk with her online.
An overhead view of Aims’ room flashes on Miller Cooley’s screen. A nurse is hovering by the bed.
“Good morning Mary Louise,” Miller Cooley said. “How are you this morning? I’m wonderful!”
The two talk for a few minutes. Miller Cooley asks about Aims’ husband and children. They discuss religious faith and how Aims is feeling.
Miller Cooley has been using Caregility for a little over a week. “It’s just wonderful,” she said. “It gives me that face-to-face contact … and I can offer them a virtual hug.”
The old-fashioned way
Some therapy sessions for COVID-19 patients at Hershey Medical Center are still completed in person. Therapists don mountains of PPE. Just after Miller Cooley ministers to Aims, Physical Therapist Heather Hahn puts on a face shield, surgical mask, protective smock and rubber gloves. She slides back the door to a negative-pressure room and ducks inside for a session with a COVID-19 patient. This patient doesn’t speak, which complicates her ability to share what hurts with Hahn, who already has to raise her voice to be heard through all her gear and the noise of the room.
Gently, Hahn and a nurse help the woman bend her knees and flex her ankles. The woman grimaces as she flexes her right foot. Hahn and her partner coax the woman to stand up from her hospital bed and sit in a chair. They applaud each minor movement like it’s a Super Bowl victory.
When Hahn, who usually works in the Medical Intensive Care Unit, treats people with COVID-19 on a given day, she either works with them exclusively or stacks her coronavirus caseload at the end of her shift to prevent spreading the disease. She sees between two and five COVID-19 patients per day.
Other than the garb, Hahn says, and all the essential-but-intractable rules governing sterilization, COVID-19 patients are just like any other. “They’re weak. They’re deconditioned,” she said. “They just need care and therapy and recovery and rehab.”
Going virtual
As patients’ symptoms worsen and the virus withers their ability to speak or move on their own, they usually meet with someone like Hahn. When a patient is first admitted, if they can still communicate and move without assistance, they are more likely to meet with members of the telehealth therapy team via Caregility.