For months, residents at the nation's long-term care facilities have been physically cut off from those they love, divided by a computer screen, a window or phones as the death toll of the novel coronavirus, especially among older adults, climbs.
Many residents are confined to their rooms, said Robyn Grant, director of public policy and advocacy for the National Consumer Voice for Quality Long-Term Care, a consumer advocacy group.
"We have families telling us that they can see their loved one is just really lonely and feels abandoned," Grant said. "That has been crushing, just crushing to many residents who don't understand why their loved ones aren't there."
In February, Life Care Center of Kirkland (Wash.), which has now been linked to at least 37 COVID-19-related deaths, recorded its first positive cases, and things began to rapidly change in long-term care facilities across the country. Visitation was restricted, and residents were quarantined in their rooms to protect against the virus that is disproportionately fatal for older adults and those with chronic conditions. But the mental health of residents suffered as those physical safety precautions were taken, Grant said.
A 12-person advisory group of residents in assisted-living facilities, nursing homes and home care have told Grant and her colleagues that the effects are extensive.
"They have been just really distressed by the impact this has had on them," Grant said. "They're really depressed. They're anxious. They're worried. They're frustrated."
Ninety-year-old Lucy Mason moved into Aegis Living Ravenna, an assisted-living and memory-care facility in Bellevue, Wash., in November. She had fallen a few times in her condo and felt increasingly isolated as her friends aged.
"I couldn't do normal things like go out for brunch and get a Bloody Mary," Mason said.
She hoped moving into an assisted-living facility would give her a community and bring her closer to her family that lives nearby. But she hadn't been able to see her family for months once the pandemic hit. Likewise, group activities were canceled for safety reasons.
"You really start going stir crazy after a while when you don't see people and interact with them," said Mason, a retired family physician who this year had to miss her youngest grandson's graduation—the only grandchild's graduation she has ever missed. "I'm a sociable person, and that's hard to take."
Across the country, post-acute care facilities have tried to create connections for residents while there are visitor restrictions. Some, like the WellSpring Group, a retirement community in Greensboro, N.C., have organized family drive-by parades; others have set up window visits; and many have used video calls and recordings. It's not perfect, Grant said, because some residents have trouble using technology or connecting virtually but "it's a major step forward."
Like other long-term care facilities, Aegis Living recently started experimenting with ways to connect residents and their families outdoors, where the risk of transmission of COVID-19 is lower. After consulting with doctors and public health officials, the company installed three-paneled seven-foot-tall Plexiglas walls in outdoor patios at its facilities to give families a way to interact while physically distanced.
"So much about life when you're older is maintaining your dignity and your respect. This allows residents and families to do that, to feel like there's a little bit of normality. Despite the physical barrier, they can still sit together," said Aegis Living President Kris Engskov.
One resident, Lori Melson, recently got to reconnect with her daughter and young granddaughter in one of what Aegis Living is calling outdoor living rooms. Melson had developed some cognitive impairments and moved to Aegis Living Ravenna in Seattle a year ago.