For those in senior housing, coronavirus provokes both bonding and fear
Places built to foster interaction are now enforcing isolation.
The coronavirus has been hard on Meadowood Senior Living, a Montgomery County retirement community.
Five residents — all of them in Meadowood’s nursing home — have contracted the virus. One has died. A staff member also got it.
The invisible invader has changed life for everyone on the 137-acre campus in Worcester.
COVID-19 is especially deadly for seniors, so Meadowood’s 500 residents have not been able to see their family members in person since mid-March. They’re strongly discouraged from shopping off campus. Dining rooms are closed, and food is delivered to their doors. Activities have been canceled and everyone — staff and residents — wears masks, a constant reminder that danger lurks.
That all sounds dark, but Paul Nordeman, Meadowood’s president and CEO, and two leaders of the community’s resident council said the coronavirus has also done something unexpected.
Lorraine Lee, president of the resident council, said the “sense of community” is much greater than it was before the virus. Residents, she said, are grateful for the risks that staff members have taken to keep them safe and well-fed. A hundred residents have volunteered to take on low-risk jobs such as delivering mail and newspapers. Phones are a lifeline now as friends check on each other. Residents can still exercise together from their patios, and they play socially distant bingo in the halls. There are trivia games and in-house grocery shopping.
“It’s brought the community alive in a very different way,” Nordeman said. “What I’m seeing just inspires me so much. It put the fuel in my tank.”
Nordeman now lives at Meadowood on weekdays and some of his staff members are there all the time. He does frequent televised updates for residents and their families and says he’s been completely open about cases and safety. Anything less than that kind of transparency, he said, leaves residents “wondering and making up their own stories.”
People who’ve had a taste of a more secretive approach describe much different atmospheres.
John Beaty, 74, who lives in a North Philadelphia nursing home, said he has heard through the grapevine that multiple people in his facility have tested positive for COVID-19. He watched as a special off-limits unit was created and asked repeatedly what was going on. There have been no official announcements, he said. “I feel like I’m on death row.”
A man who identified himself as the administrator of Beaty’s center would not comment.
James Maloney, 72, went to a well-regarded nursing facility in Montgomery County in late March after knee surgery. He was alarmed that he sometimes had to demand that staffers wear masks in his room. Then safety procedures abruptly got more stringent, and he heard, unofficially, that two people had tested positive. He told his doctor he wanted to leave as soon as possible. “Get me the hell out of here,” he said. He has just finished a two-week quarantine back home in Manayunk.
His rehab facility did not return a call for comment.
Once inside a nursing home, where most people have roommates and require close, hands-on care from nurses and aides, COVID-19 can spread quickly. Like younger people, even the elderly can be infected without having any symptoms, or without the symptoms that initially got all the attention: fever, dry cough and difficulty breathing.
Testing got off to a slow start and industry leaders say many facilities still cannot do all the needed testing. Some are still struggling to procure enough protective gear for staff. Some facilities entered the pandemic with bare-bones staffing and are now dealing with high absenteeism. The physical design of some buildings works against separating patients known to have the virus, those who’ve been exposed, and those who still seem healthy.
Such factors make containment hard, and that shows in the statistics. In Pennsylvania, 60% of coronavirus cases that led to death originated in long-term care facilities, the state health department said. The percentage is 29% in New Jersey, but that doesn’t include nearly 1,000 deaths in nursing homes and assisted-living facilities where COVID-19 was the suspected cause.
Dee Pekruhn, director of life plan communities for Leading Age, which represents nonprofit senior housing providers, said communities for older adults will likely be among the last to relax restrictions because their residents are so vulnerable. She hasn’t seen her mother, who lives in a community in the Oxford area, since March. “I don’t believe I’ll be able to visit my mom again till June,” she said.
Older people move to places such as Meadowood because they make socializing easy and offer help and medical care as health declines. Most modern nursing homes also are designed to foster interaction. Now, the virus is forcing them to keep residents apart, while experts warn that isolation can further damage the already fragile health of some older people.
Jennifer Olszewski, a geriatric psychiatric nurse who heads Drexel University’s accelerated nursing program, works in three nursing homes in Montgomery County. One, which she won’t identify, is having a “fulminant” outbreak. Last she heard, there were about 20 cases and 10 deaths there. The two others have one case or none.
In most ways, life at the three centers is similar, with temperature checks before anyone can enter the building and universal masking requirements. Patients can no longer congregate at nurses stations, something that used to help some feel less alone. As much as possible, they’re confined to their rooms. That can be very difficult for people with dementia.
The “really great” staff at the center with the outbreak is feeling “overwhelmed,” Olszewski said. At a recent webinar, she outlined a disaster response that would allow nursing homes to quickly group residents at different risk levels. “You have a moment to figure it out once it’s there,” she said. “That’s all you get.”
In all the facilities, Olszewski has seen staffers who are worried about residents and residents who seem more worried about their friends, family and staff than themselves. Cognition and behavior have declined in some with dementia, who are anxious and alone. Others are increasingly irritated with roommates. People are eating less, and they’re missing appointments with their specialists. In multilevel retirement centers, some couples who need different types of care can’t visit each other. Everywhere, residents are absorbing the gravity of what they’re facing.
“I’m feeling this,” one of her patients said heavily.
“That will that some of them have is falling aside,” Olszewski said. As many of us chafe at sheltering in place, she said, we should keep in mind that isolated seniors are “feeling what we feel times 100. … We have our most vulnerable population that has lost contact with the outside world right now.”
Caroline Wroblewski, 76, who lives at Normandy Farms Estates in Blue Bell, had to stop volunteer hospice work in the community’s nursing home. “My patient is very hard of hearing, so I can’t use the phone,” she said. “She can’t see so well, so there’s no point in writing a note. I think she will have forgotten me by the time I get the opportunity to revisit her.”
She is getting so many texts from family members that she sometimes silences her phone. She’s working on a 1,000-piece jigsaw puzzle she brought in from the hall. She walks around the property for exercise. She helped make a banner to thank the culinary staff. She’s taking longer showers and foot baths. Wroblewski, a former nun who later ran a counseling service, is reading “prayerful literature” and novels.
» READ MORE: How do seniors live with loss?
She’s also doing a lot of “inner work” as coronavirus has made death an even more salient presence than usual at Normandy Farms, where she said three residents and two staffers in the nursing home were sickened. “I don’t think I need to make peace anywhere,” she said. “I’ve not left anything unresolved.”
Back at Meadowood, Lee and her vice president, Hugh Trumbull, 85, are having no trouble keeping themselves busy.
Lee has been reading and watching TV. Her Unitarian fellowship meets on Zoom. She feels confident that she will get good care if she catches COVID-19, but sometimes has to stop herself from worrying. “We do worry about people here who are frail,” she said. “I have a brother who has cancer, and I worry about him."
Trumbull misses concerts, lectures and other activities he enjoyed pre-coronavirus. The resident council had 60 committees for activities that have now stopped.
He’s now keeping very well-informed and is spending more time talking with people who are not as good as he is at entertaining themselves. “There’s a lot of sense of neighbors looking out for neighbors,” he said.
“We’re all in this together,” Lee added. “If one of us falls down, the other ones have to pull them back up.”