Crisis communication: PT pen pals ease shut-ins' isolation

Published on Sunday, November 1, 2020

By: Bruce Coleman

Physical therapy faculty and students at the University of Mississippi Medical Center are embracing an “old school” communications tool to engage community members who have been among the most severely impacted by COVID-19 pandemic restrictions.

Dr. Sherry T. Colson, associate professor of physical therapy in the School of Health Related Professions, has partnered with Sheila Wells, activities director at the Manhattan Nursing and Rehabilitation Center in Jackson, on a voluntary “pen pal” program that has helped residents at the facility cope with uncertainty, isolation and seclusion.

Colson, who served as director of rehabilitation at a skilled nursing facility before joining the UMMC faculty and whose area of practice was geriatrics, said nursing homes have been “tragically impacted” by COVID-19 restrictions because of health precautions. Older adults and people with underlying medical conditions are at greatest risk for severe illness and death from COVID-19, according to the Centers for Disease Control. These restrictions have resulted in loneliness, boredom and an overall decline in health status.

“In my conversations with therapists in other facilities around the state, once the pandemic hit, basically everyone was sheltering in place,” Colson said. “What was happening in the nursing homes, they could not have visitors, they could not leave the facilities and they stopped all group activities. Some people were pretty much isolated to their rooms and doorways.

“All these measures are for their safety, but the precautions have left our seniors feeling isolated and unhappy. What therapists were reporting was a decline in cognition and a decline in physical mobility because these residents weren’t getting about.”

Colson recognized for many elderly people, going to the mailbox was a highlight of their day. So she sought to establish a “pen pal” program with a local nursing home facility that could reinvigorate elderly participants. She contacted Wells, who immediately perceived the value of the arrangement for Manhattan residents.

“When the pandemic hit, it hit some facilities pretty hard - our facility was one that was hit very hard,” Wells said. “It’s something I never thought we would go through. It was tough on our residents, keeping everyone in their rooms, staying safe.

“I have some residents who really enjoy visiting with others. This was a big adjustment for them. I’d known Sherry for years, and when she reached out to me, it was like, ‘Oh my gosh, we’re on the same page!’” 

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Dylan Raines, a third-year PT student from Little Rock, connected with his pen pal over a simple message of wisdom: “experience is your best teacher.”

“As a student for 20 years of my life, I have had amazing and phenomenal teachers that have helped shape my life, but nothing can compete with hands-on experience in regards to developing skills,” Raines said.

While he couldn’t remember the last time he had used a pen and paper to keep in touch with someone, he said actually writing a handwritten note made the pen pal experience more personable.

“At first, I did not really know what to write in the letter,” he said. “I decided I would write as if introducing myself to a stranger that I would like to get to know better, and that’s exactly what I did.

“The best part of the program is visualizing the smile on a stranger’s face when he opens up the card that I sent. I have learned that it’s the little things in life that help get us through tough times. The fact that a card that doesn’t cost any more than a dollar but can improve someone’s day is worth the time to send. Life is about sharing experiences with others.”   

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SHRP’s physical therapy program normally requires students to devote a certain number of hours to community service activities each semester. Because of the COVID-19 pandemic, however, that requirement had been relaxed. Although they would not receive course credit for participating in the program, about 35 students signed up to be pen pals.

“That says volumes about where their heart and allegiances lie,” Colson said. “They do have a heart for service. That’s what health care is. To be successful at it, you really do have to want to help others and to serve others. It’s an issue that goes right along with what we expect from them, not only in the clinic, but in their personal lives as well.

“What surprised me even though many students are working a 50-hour week in the clinic, they were still interested in participating. They’ve got practicals, exams and projects and they’re not required to volunteer for community service, but they’re still willing to give of themselves. I think that means we’ve got a good group of students.”

The students either mail letters directly to Manhattan or place them in a basket in SHRP’s PT lab. Colson hand-delivers the letters each week.

“The first resident who got a letter pretty much spends her leisure time in her room, only attends BINGO, does crossword puzzles by herself and only comes out to eat,” Wells said. “This pen pal program brought something back to her.

“After I delivered the first letter, I left her room. Shortly after, she was walking down the hallway, saying, ‘I got a letter from my pen pal. I need an envelope and some paper (to write back).’ I’d never seen that from her in two years. She loves receiving letters and writing her weekly letters.”

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Bailey Turbville, a second-year PT student from Madison, was in the middle of an eight-week clinical rotation in a swing bed program when she decided to participate in the pen pal program.

“Our patients were also unable to have visitors and I saw firsthand how depressing that could be,” Turbville said.

She discovered her pen pal shared some of her interests.

“My pen pal’s favorite foods are steak and candy bars, and her favorite song is Play That Funky Music,” she said. “With a bio like that, she seemed like my kind of gal!”

Turbville was comfortable with written communication, having grown up writing thank you notes to anyone who ever sent her a gift. Despite her experience with written communication, she found her initial pen pal letter a bit difficult to write.

“I wanted her to know I was so excited about this opportunity to be her pen pal. I told her some important events happening in my life, such as my clinical rotation and that I was getting married and planning a wedding.

“I quickly realized it wasn’t what I said in my letter, it was more about the gesture of just sending them anything.”   

When she learned how excited her pen pal had been to receive her letter, Turbville considered her participation well worth the effort.

“This made me realize that small amounts of time I spent writing a seemingly simple letter made this sweet lady’s week. Hearing her story made me feel like I was helping to make a difference.”

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The pen pal arrangement is truly reciprocal: Colson said the students love to hear back from their pen pals.

“In our physical therapy program, we have such good one-on-one opportunities with our patients,” she said. “We teach our students to meet patients where they are. This is what they’re doing with their pen pals. The residents may not be technologically savvy - they are a paper generation, so we’re trying to meet them where they are.

“I try to keep the students informed about the responses from the nursing home residents and let them know that their small gesture of reaching out is making a real impact on somebody’s day.”

Wells said the program made a significant difference in the life of one Manhattan resident who had recently died.

“Her pen pal had sent her a picture of her with a llama,” Wells recalled. “The resident made me put that picture where she could see it every night - right by her bedside. I don’t think the students really know the impact their letters have had on our residents.

“About 40 residents here are constantly writing. Even when they’re not writing, they’re talking about their pen pals. Those who can’t even write, they’re sending pictures. It brings tears to my eyes. It’s sad it took a pandemic for something like this one-on-one, basically pen-to-paper interaction to happen.”

Colson said the program has been such a success that four faculty members have signed up to participate as well. In addition to personalized letters, other items PT faculty and students have sent their pen pals include photos, drawings and even puzzle books.

“The nursing home has really embraced the project, and it is benefitting the patients,” Colson said. “Members of the rehabilitation department in the nursing home said the letters have caused residents to want to get up and move more. Speech therapists, because they deal with cognition, work with patients who have pen pals, helping them to organize their thoughts and about what to write back and helping them get letters out.”

“Manhattan is honored to be a part of such a wonderful program where both parties benefit greatly,” Wells said. “This is such a wonderful opportunity for our residents to communicate and socialize with others.

“Our residents aren’t just writing letters, they’re engaging with physical therapy, speech therapy and occupational therapy. When they write their letters, they have to come deliver them to me. Some require assistance from physical therapy. They talk to and engage other residents, saying ‘My pen pal is named this and she can do this. Now I need to make a mailbox so they can have a place to go ‘mail’ their letters.”

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Emily York, a first-year PT student from Madison, keeps in contact with her closest group of friends from college through “snail mail,” so participating in a pen pal program seemed only natural. Until the time came to write that first letter.

“As much as I already loved doing it, this was my first time to write to someone I had never met before, which was a completely new experience,” York said. “Getting to know a person and what makes them unique through a piece of paper is so different than what I’m used to, but it has been so eye-opening and fun to get to do.”

She found her pen pal to be quite responsive, sending her numerous letters. “Often before I can even get the chance to write one back, there’s another one waiting for me in the mailbox.”

She shared with him the “craziness” of adopting two puppies during quarantine and how spoiled they are with her at home all of the time. Among his frequent notes, the resident told of his excitement for an upcoming birthday celebration and the annual Halloween party at the nursing home. With her most recent letter, York sent along a honeybun as a “birthday cake.”

“He wrote on his information sheet that it was his favorite snack, so of course, I had to get him one!”

York said the best part of being a pen pal is cultivating a friendship that she might not ordinarily have had.

“It’s definitely a silver lining during the pandemic,” she said. “The most difficult part for me is condensing all that I want to say and ask in such a short letter. It requires prioritizing what you want to know and ask about the most.”

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Although she hopes the program will continue throughout the duration of the pandemic, Wells said she and Colson have discussed an ideal conclusion.

“When this pandemic is over, I want the students to come in here and get to actually meet their pen pals, to have a pen pal party,” Wells said. “For some of these residents, they don’t have any family members and this is the only mail they receive. And even for those that do, they’re so excited to get mail, they say ‘thank you so much.’ It’s a great program.

“To see a resident open mail for the first time when they haven’t received anything in a long time, read it and take the time to write about themselves and about their day, is amazing. This hit us hard. Some of these residents have been in their rooms for months. We’ve made the best of a bad situation, and I can’t thank them enough.”

Colson said the program fits well within the Medical Center’s mission.

“Dr. Woodward (UMMC vice chancellor for health affairs) has said what we’re reaching for is a healthier Mississippi,” Colson said. “With this pen pal project, we’re looking out for these residents’ mental health, their social well-being and their ability to just make it through this very trying time.”

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