If you keep up with current events, your newsfeed may include articles talking about the negative effects of the COVID-19 pandemic on older adults living in nursing homes. If you just scan the headlines, you might think that exposure to the coronavirus leading to a COVID-19 diagnosis would be the biggest risk.
While it’s true that a COVID-19 diagnosis can prove fatal for a frail elderly person, we’re seeing that the actions nursing homes are taking to protect their residents end up being a double-edged sword. Chronic isolation is creating an even bigger problem for people living in nursing homes: an outbreak of lockdown fueled loneliness, depression, and atrophy.
The problem is starting to get some attention. Recent articles in the New York Times and NextAvenue detail the horrifying emotional toll that COVID-19 is taking on nursing home residents and their family caregivers. What’s it like closer to home, here in Middle Tennessee?
In this article, the first of a series of four, the elder care coordinators on the Takacs McGinnis team will attempt to answer these questions. Debra King, a licensed clinical social worker who has been with Takacs McGinnis for more than a decade, and Pati Bedwell, who has spent most of her career working in and around long-term care facilities like nursing homes, have watched their clients deal with the effects of isolation. In the third article in the series, we will hear from the family caregivers of two Takacs McGinnis clients, and in the final installment, we will look at how one long-term care facility has attempted to strike a balance between resident safety and family access.
During normal times, Pati and Debra are frequently visiting elderly clients in long-term care facilities. COVID-19 lockdowns brought those visits to an end. “We’re not seeing our clients now because we can’t get in the facilities,” Debra said. “Neither can their family members, and that’s creating a huge problem.”
Debra said that while residents may be getting basic care, they aren’t getting those loving emotional touches, eye contact, and social visits from loved ones like they were before COVID. “Some nursing home residents may have bonded to their caregivers in the nursing home,” she explained, “but it’s rare because nursing homes are notoriously short-staffed. As a result, we’re seeing a condition called Failure to Thrive where older adults who were once active become socially withdrawn, lonely, bored, and depressed. Being locked in your room with no contact with anyone, not even your family, creates incredible loneliness. People have no reason to go on living, so they just give up.”
Memory problems compound the situation. “The new visitation guidelines allow very limited visits, often behind plexiglass, and it can be very confusing for elders,” Pati explained. “If the older adult has cognitive issues, they don’t understand why you can’t come in their room. They’ll say things like, ‘Why aren’t you in here? Why don’t you come in my room? Why can’t I hug you? Why don’t you like me anymore? Why don’t you want to see me?’”
Long lockdowns can make it hard for residents with memory problems to recognize family members. “I had one son tell me, ‘I don’t think mom knew who I was because it has been so long since I’d seen her in person,” Debra said. “Though many people believe that virtual visits using Zoom or Facetime are the answer, they don’t always work. “People with memory issues don’t always understand the concept of a video call. It creates big challenges, and some families find it easier to limit visits because it’s less confusing to their loved one.”
In some facilities, the lockdown was so complete that residents weren’t even allowed to leave their rooms. “I had one client where the husband and the wife were in the same facility for different reasons,” Pati said. “They weren’t allowed to leave their rooms and they couldn’t see each other.”
The restrictions can seem draconian, like solitary confinement in a prison. “One facility staff member told me that it’s just like what you see on television,” Debra said. “You have the glass barrier and the machine that you use to talk to the other person, but the older person often can’t tell who’s at the other end of the table. And they usually can’t hear, which makes things worse.”
Both Debra and Pati believe that if the official COVID-19 death toll were recalculated to include seniors who simply gave up due to the isolation, the number of fatalities would probably be much higher. “We walk alongside our clients during every step of the long-term care journey, and to see older adults and their families suffer so much is just tragic,” Pati added. “It’s the saddest thing.”