The last time Alexandra Gunnison saw her father, in early March, the coronavirus was in the early, smoldering stages of its wildfire spread across the country.
Soon afterward, his nursing home in the suburbs of Washington, D.C., was closed to visitors. Not long after that, her father, Dana Gunnison, 75, was confined to his room, along with all other residents.
“He sleeps probably 18 hours a day. I call every day when I’m able,” she said, “but he doesn’t always pick up.” Since he has Parkinson’s disease— and now no access to physical or speech therapy — it’s increasingly difficult to understand him. And Gunnison, of West Philly, worries that ongoing isolation could accelerate his decline.
She’s now one of many who are wondering when, or whether, they will see their elderly loved ones again, as recommendations of social distancing and temporary retirement-home visitor bans are stretching into indefinite periods of separation.
A complicating factor is: For the elderly, lengthy periods of isolation to protect them from the virus could be a cure worse than the disease.
“The risks of loneliness and isolation are so great that we don’t know if we’re causing a lot of harm by totally socially isolating people,” said Carla Perissinotto, a geriatrician and associate professor at University of California-San Francisco School of Medicine, who has studied the health effects of loneliness in older adults, and found links to dementia, loss of mobility, cardiovascular decline, and death.
“The hard thing is, we don’t have any idea as to when these health risks take effect. Is it after a week? A month?” she said. “We need to proactively think about how we are supporting people, or we’re going to see a lot of complications.”
Some families are getting creative, driving by parents’ and grandparents’ homes with signs, or visiting through windows and screen doors. Nursing homes are, in some cases, leaning on such services as FaceTime and Zoom to maintain connections (an unproven intervention, said Perissinotto, but “probably better than nothing”). And local senior centers are stepping up by conducting frequent phone check-ins, and delivering crossword puzzles along with frozen meals.
But for many, coronavirus precautions have erected a barrier that’s starting to take on the look of permanency.
Beth Croker of Haddon Heights said her mother, Sandra, who is 76 and still recovering from a stroke, has not left her home in three weeks. They’ve fallen into a bleak quarantine routine: Croker drops off groceries, then goes around to the back of the senior housing complex and calls her mother, so she can wave from the window.
On Saturday, she decided to decorate the parking lot with handmade signs, blast some Bob Seger and “act like an idiot” — by throwing herself a dance party for her mother’s amusement.
“I want to make her smile every day,” she said, “but I don’t have much to talk about, because I’m just isolating myself, too."
Margate resident Kathy Tabasso and her family have also been hunting for loopholes.
Tabasso, 63, now visits her 88-year-old mother only peering in from the porch for a wave and a quick chat by phone. And last weekend, Tabasso’s son, a first responder, piled into his car with his wife and their four children for what Tabasso called a “love drive-by," holding hand-drawn signs out their car windows, while Tabasso waved from the porch.
“I wanted, of course, to go grab them out of the car,” she said. “It was such a joyous event.”
For those who don’t have children and grandchildren nearby, local organizations are rushing to fill the gaps. One is KleinLife, which runs four community centers in Philadelphia and Montgomery County that normally serve hundreds of seniors with classes, exercise programs, support groups and lunch service. The centers closed in March, but administrators pivoted quickly to support the seniors in exile.
They’re delivering a week’s worth of meals every Tuesday, along with booklets of crossword puzzles and, for Passover, haggadahs. The staff also divided up the list of clients from the last six months, and committed to calling every single one of them two or three times a week.
Still, Sue Aistrop, the organization’s vice president for active adult life, said she’s deeply concerned about the clients, including Holocaust survivors from Northeast Philadelphia’s Russian community still recovering from long-ago traumas through such programs as art and dance therapy.
More immediately, she said, “The Northeast is pretty low income for the seniors, and the congregate meal we were serving was for many their biggest nutritional and caloric meal of the day. So we’re really worried about their food intake."
Adele Knopman, who stopped counting after she turned 89, said she’s grateful those phone calls keep coming, even as her children and grandchildren are social-distancing for her safety.
The isolation wasn’t getting to her yet, though. She’s lived through a lot: World War II, Vietnam. Life will continue after this, too — and she’s looking forward to it. “I’m a crazy optimist,” she said, her shrug audible by phone. “You want me to tell you everything is terrible?”
It’s the grandchildren who are panicking.
Ryan Hancock of South Philadelphia received news that his 96-year-old grandmother, who raised him in Albany, Ga., was running a high fever and might not pull through. Given that the town is a coronavirus hot spot, the emergency room was not an option — and neither was visiting for Hancock, who is a cancer survivor.
“If she dies or she gets sicker, there is no opportunity for me to get down there,” he said.
Matt Roberts, whose parents recently moved from Philadelphia to Florida, checked in helplessly by phone as his father drove himself six hours to a hospital in Jacksonville for emergency surgery on a brain aneurysm. Under other circumstances, he would have been there. Now, he said, “There’s this fear of being close to each other to help, and certainly traveling to help introduces this risk that a lot of people are uncomfortable with."
Perissinotto, the geriatrician, confessed that, as she spoke with a reporter, she was on her way to pick up her own 76-year-old mother, to bring her to shelter in place with her family. Given her mother’s sturdy health and the recent death of Perissinotto’s father, they decided that, for them, the safest choice was to be together — with precautions to minimize the risk.
“How I phrase this for my own patients is, you have to have these conversations with your family: What are the risks I’m willing to have, and how do I balance our wishes with the greater public-health goals?" she said. “Is there a calculated risk I need to take, in that I will mask and clean my hands, but still have contact, if that’s going to be the last time potentially I see someone?”
For those who make the opposite decision, it’s hard not to second-guess.
Anthony Monte Carlo, 20, a Deptford resident and a student at Rutgers-Camden, had planned to visit his 94-year-old great-grandmother in South Carolina in March — but succumbed to his parents’ pleas that he stay home.
“I hope I get to see her again because I don’t know when all of this is going to be over, and I don’t know how much time I might have left to see her,” said Monte Carlo, who believes he’s only just begun to realize how much he and his great-grandmother have in common.
“Part of me really just wants to go down there," he said. "A greater part of me wants to protect her.”