National Guard brings critical geriatric care to Pennsylvania nursing homes

When coronavirus lockdowns began across the nation, those most vulnerable were also seemingly those whom the military were least qualified to care for.

Defense Secretary Mark Esper warned that soldiers were trained for trauma injuries and battlefield wounds. Domestic deployments were a new challenge. Meanwhile, nursing home infections were raging, and some caretakers were sickened or refused to go to work.

In Pennsylvania, that changed when two geriatric doctors shed their civilian coats for a National Guard uniform.

“It's really reinforced my feeling of being a civilian soldier,” said Lt. Col. Rick Fogle, 67, a geriatric doctor in Pittsburgh who, along with Lt. Col. John Peacock, 50, helped train young soldiers to assist thousands of Pennsylvania nursing home residents.

Sending 20-something-year-old National Guard soldiers into nursing homes is not the mission one weekend a month prepared them to do.

“The average run of the mill young soldier — 20, 22, 24 — is not familiar with a geriatric patient who is a dementia patient, and they need special handling,” Fogle told the Washington Examiner, describing some of the most challenging guidance he provided.

“I told them that [for] a dementia patient, you may see them, and they may not recognize you, or they may call you their granddaughter,” he said of a conversation he had with a young soldier at a nursing home in western Pennsylvania Tuesday.

“If they do, just work with it, just go ahead. Be kind. Be gentle. Say, ‘Yes, grandma,’” he continued. “It better prepared them if they had to take care of a geriatric patient or test the geriatric patient for COVID.”

Peacock, a geriatric doctor in suburban Philadelphia who served for more than 20 years in the Navy, helped create a training program for soldiers to learn the fundamentals of caring for the elderly.

“Things like activities of daily living, how to feed a patient, how to bathe a patient, how to lift a patient, all of these types of things that these guys would never have dealt with before, but they did it,” he told the Washington Examiner.

Peacock and Fogle assessed the needs at 23 nursing homes across the state, filling staffing shortages at 11 residences and training caretakers on the proper use of personal protective equipment.

Fogle said he recently passed a crowd of family members waiting outside one facility, unable to see their loved ones. He knew that the Guard soldiers he was training might represent the only human contact for those family members.

He told the family that soldiers would be coming in to assist with daily upkeep, sanitation, and teaching caretakers how to use PPE.

“The family was just overwhelmed,” he recalled. “They had so much anxiety about what's going on because they can't see their family anymore. And then to know that the National Guard was sending troops in to supplement and take care of their family members. I mean, they had tears in their eyes.”

The uniforms mattered.

“They see a young soldier coming, and, really, they were impressed, and they're like, ‘We can't thank you enough,’” Fogle said.

Peacock added that nursing home caretakers also relaxed after the Guard’s PPE training and tests.

“You could visibly see the staff almost relax more after they had this testing after the troops were there,” he said.

Fogle, who had deployed to Forward Operating Base Camp Phoenix in Afghanistan, said working in a COVID environment sometimes requires greater attentiveness than deployment to a war zone.

“Every second of every day they were exposed,” he said to the Guard members on the front lines of the COVID response.

“Over there, if you get a round come in, you know if somebody gets hurt, but if you make a slip with your PPE, it's not going to show up for days or a week,” he added.

Fogle and Peacock’s civilian employers have allowed them to remain activated in the Guard for an additional federal deployment that the White House scheduled to end June 24.

President Trump said Thursday he would extend federal Guard deployments until mid-August, quelling criticism about the date that many said left some Guard members just short of qualifying for federal benefits and coronavirus response missions incomplete.

“There's a whole lot left to do,” said Peacock. “There are over 700 skilled nursing facilities in Pennsylvania, and we've been able to affect good change in a little over 20.”

Added Fogle: “We're moving into a new phase.”

That phase includes instructing soldiers on how to conduct COVID tests and sending out “medical strike teams” to nursing homes.

“We've hardly scratched the surface on that,” said Fogle. “Dr. Peacock and I have both have a soft spot in our hearts for our elderly populations. And so, if they need our help, they need our help. That's what we've always been here for as physicians.”

Fogle said the young soldiers who are sacrificing their lives, living in hotels away from their families, exemplify the Guard as “citizen soldier.”

“We are civilian soldiers, and we give up our civilian life when needed to serve, and these young people have been heroic battling this invisible enemy,” said Fogle, noting that the young soldiers have learned about humanity on this unique mission.

“When the soldiers first went in, they were just doing a job,” he said of a conversation with one young officer in charge who developed a relationship with an elderly woman who told her to call her “Granny.”

“They found that these people are in there, but they are people,” he continued. “They have personalities, and they want to be loved, and they want to know that they are being loved back.”