KIRKLAND, Washington – After months of near isolation at his senior care facility, Charlie has not recognized his wife for almost 50 years. In another nursing home, Susan’s toenails got so long that she couldn’t fit into her shoes. Ida lost 37 pounds and stopped talking. Minnie cried and asked God to take her.
They are among the thousands of seniors stricken by another epidemic ravaging America’s nursing homes – an epidemic of loneliness, depression and atrophy fueled by the same lockdowns that were imposed to protect them from the coronavirus.
“A slow killer,” said Esther Sarachene, who said she had seen her 82-year-old mother, Ida Pasik, wither and fall mute during the months she was confined to her nursing room in Maryland. “She didn’t know who I was.”
Covid-19 continues to creep through the halls of long-term care facilities despite a series of security measures and visitor bans put in place months ago to slow the devastation.
More than 87,000 residents and workers have died from the virus, which has infected more than half a million people linked to the facilities, and new clusters continue to erupt with numbing regularity: 16 people were pronounced dead this month in a retirement home in Chesterfield, Virginia. ; all 62 residents of a Kansas nursing home infected.
At the same time, the damage of loneliness is being overlooked, say families and advocacy groups. They say widespread lockdowns are still needed to protect people from the virus, but also that facilities now face a growing physical and mental toll of social isolation as the pandemic shows no signs of slowing down.
One of the most serious deprivations of the pandemic is separation from family and friends. Experts say absence can inflict particularly severe damage on people with dementia and Alzheimer’s disease, thousands of whom have been confined to their buildings since March.
Long-term care facility operators say they are faced with an impossible choice between depriving residents of vital human contact and inviting the virus inside.
“We have to walk a very fine line,” said Robin Dale, president of the Washington Health Care Association, a business group that has noted a recent increase in cases of the virus at state facilities amid new news. national outbreak. “We need to work on more in-person visits, but it’s difficult at the moment.”
In more than two dozen interviews across the country, long-term care workers described increased confusion, anger and anxiety among residents. Family members said their loved ones are deteriorating in understaffed facilities that have cut back on physiotherapy, exercise classes and community visits.
A worker described how a resident told her one evening that she was the first person she had seen all day.
“Mum just isn’t here,” Deanna Williams said, as she and her two siblings traveled to Life Care Center in Kirkland, Wash., To visit their 89-year-old mother. year-old Peggy Walsh, who loved to cycle across the country before developing. dementia.
Life Care, on the outskirts of Seattle, was the country’s first hotspot for Covid-19 in February, a location that provided a first glimpse of how the virus could tear homes apart. Forty-six residents of Life Care have died.
Since the outbreak, as the deaths of residents of long-term care facilities have risen to nearly 40% of the 229,600 coronavirus deaths in the country, Ms Walsh has spent every day sitting quietly in her wheelchair, facing to the fence and to the bushes outside his room. .
She used to say “I love you” when her children visited and kissed her, but it has now been eight months since they could touch her. Some days she doesn’t seem to notice when they wave her bedroom window or dance with decorative fall scarecrows to get her attention.
“If we could just give her a hug or a kiss on the cheek,” said another girl, Colleen Mallory. “It’s like losing her over and over and over again.”
Life Care has continued to operate throughout the pandemic, although families say its population of 200 patients has declined. The initial outbreak that killed dozens of residents and sickened many of the staff is now gone, but families say they are still receiving sporadic notifications of a new infection inside.
As Ms Walsh’s children chatted at a Starbucks before a morning’s visit, their phones suddenly rang in unison – it was a text message from Life Care reporting that a patient and three staff had been tested positive.
Life Care Centers of America, which has more than 200 facilities, faces wrongful death lawsuits from the families of two former Kirkland residents, and federal and state regulators have cited loopholes in its response to the outbreak .
Life Care has challenged the lawsuits and appealed the findings of regulators. In September, a Washington state administrative judge broadly sided with Life Care, saying the facility had violated certain regulations, but the evidence did not show that the care or health of residents had been threat.
Nancy Butner, vice president of the Northwest Division for Life Care, said the Kirkland facility is doing well and is a top notch facility. “They provide a high level of service in a safe environment that ensures peace of mind for our residents and their families,” she said.
In total, the virus has infected more than 581,000 people in some 23,000 long-term care facilities, including nursing homes, assisted living facilities, memory care centers, retirement and retirement communities. other care facilities for the elderly.
In the first few months of the pandemic, most senior facilities banned family and friends from entering their buildings. State and federal regulators have issued guidelines, restricting visitors and non-essential healthcare personnel and canceling communal activities in buildings. In the months that followed, even as illness and deaths continued in some facilities, government restrictions were relaxed in many places.
Research groups recently reported that thousands of nursing homes still face severe shortages of masks, gowns and other equipment. Adding to the risks, nursing home workers continue a long-standing practice of working across multiple facilities, which increases the chances of carrying the virus from one location to another, especially if the virus is more easily spread. this winter.
Mark Parkinson, president of the American Health Care Association and the National Center for Assisted Living, a business group, said that despite the institutions’ efforts to protect residents, they are largely at the mercy of their surrounding communities.
For now, a patchwork of state and federal guidelines govern the way long-term care facilities handle visits from family and friends of residents. Some leave families indoors while many only allow outdoor visits, an option that decreases in colder weather.
Previously, relatives could visit to make sure residents finished lunch and brushed their teeth. A family member’s face and touch can be anchors, experts said, and such a presence helps spark people’s long-term memories.
“These familiar faces are what our residents rely on to determine whether they are in a safe place or not,” said Dr. Jim Wright, medical director of a nursing home in Richmond, Va., Who criticized the security conditions in an establishment where he worked after the death of 51 inhabitants in the spring.
At the start of the pandemic, Charlie Cape could still recognize his 50-year-old wife, Linda.
Mr Cape learned he had Alzheimer’s disease ten years ago and had spent the past two years in an elderly care facility in Sarasota, Fla. Where Ms Cape was returning to him. visit almost every day. A nurse, she sometimes helped him feed him, shower him, shave him and periodically give him a pedicure.
Her weight was stable, she said, around 180 pounds. He could string together a few words. He went to rallies that stood on his floor, even dancing with his wife on “My Girl” before the pandemic.
Then the installation stopped allowing visitors.
Ms Cape said she had tried speaking with her husband using video chats, but the technology was intimidating. He didn’t understand how the iPad worked and was going to look elsewhere or get up and walk away. On such calls between March and August, she could see that he was losing weight and retiring. He no longer participates in group activities, she says. She hadn’t understood anything he was saying for months.
Ms Cape said she did not blame the establishment for banning visitors, adding that she had been impressed with its staff and communication during the pandemic. The facility, HarborChase, did not respond to interview requests.
“Charlie doesn’t know us anymore,” she said in October after seeing him as the tours resumed. She and her son go every Sunday with a cookie and a diet coke, unless Mr. Cape is sleeping. Sometimes during these visits Mr. Cape sits down and cries.
Part of her decline may be attributable to Alzheimer’s disease, Ms. Cape said, but she believes the family’s long period of isolation has accelerated her progress. If nothing else, she feels that she has missed a crucial period in her life when he still knew who she was.
“I wish I had spent a little more time with him, a little more quality time,” she said. “It‘s my regret.”
A survey of 365 people living in nursing homes across the country found that most no longer leave their rooms to socialize. Three in four residents said they felt lonely.
Susan Hailey, 77, is trying to recover from five months of isolation. She moved to Life Care Center in Kirkland to recover from knee surgery, but contracted the coronavirus and saw her roommate and closest friend at the facility die from the virus. She fell twice and began to hallucinate that the dead were visiting her.
“I missed talking to my family and touching them, kissing them on the cheek,” she says.
In August, she moved to a small adult care home where she started learning to walk again. She still has cognitive problems and can no longer read detective novels because she forgets what happened from paragraph to paragraph.
But she says she’s happy now and full of hope, and when her two daughters visited her one evening, Mrs. Hailey smiled and asked, “Touch me, okay?”
Jack healy reported from Kirkland, and Danielle Ivory and Serge F. Kovaleski from New York. Susan C. Beachy contributed to the research.