One of my duties as a Geriatrician is to check on folks living in Senior Housing. Some are independent settings and others have various forms of assistance available such as help with medication. What they all have in common is many elders living here are alone. They may have family that visit, but most rely on the community aspect of this living to provide healthy social interaction.
Before the Pandemic my welcoming committee would greet me with a circle of mostly older ladies (Men are rare as we just don’t live as long). Some of the ladies will smile (the ones that are awake), some are singing the Bob Seeger or Willie Nelson or trying to join in on an Elvis tune. Others are babbling at who knows what. They all share the fact that this gathering is after a Communal Breakfast, and gathering with others. Next on the schedule may be some seated upper body routines led by one of the staff, moving as best they can to more music. The smiles, the laughter, and yes the sometimes drooling folks are being cared-for.
Enter COVID: Very early on during this Pandemic I urged the corporate side of my facilities to be on guard, but it wasn’t until State and Local “Health” Authorities stepped in did they begin to recognize the danger to this age group. One memory care building lost many to the disease before they recognized that sending them to the hospital and returning them was NOT the right thing to do. My urging to set up quarantine areas in the facilities fell on deaf ears.
So lock them in. No visitors. No guests. No gatherings for these folks at Meals. Some are wearing masks. Remember, these residents no longer can have family (if they have any that care) visit. No one to check on their care, make sure they are eating, drinking, bathing properly except for the understaffed and overworked, underpaid workers at the care centers.
No more welcoming committee of babbling, singing, laughing and drooling seniors. No Elvis. No gatherings for meals. No hair salon. No exercise. Wear a mask; try that if you are 90 years old and have lung disease. Stay isolated in your room. We will deliver your meal to you in a box. You can eat out of a box can’t you? Really? I can barely hold a fork to my mouth.
Result: More depression. More Isolation. More loss of cognitive awareness (worsening dementia). The lack of socialization gives way to an increase of less than favorable behaviors such as yelling, crying, poor hygiene and potential for suicidal thoughts and gestures. Imagine being in a prison with a private cell in solitary confinement. I am one of the few allowed to enter and visit with my Patients. I see the pain and the changes in their mental acuity. I smell the fact that they are not bathing often enough. I see the mostly half-eaten meals they have been delivered. I see the rooms disheveled and lacking for housekeeping. (How often is the bedding changed now?) Anyone’s guess.
The result: You guessed it. We are killing our elderly with protection. Not truly understanding other ways to reduce infection from COVID, we are isolating them into their graves even sooner than what one would expect. The family has no input. The Patient has no choice. Compassion? Get back to your room, Mrs. Smith! As I depart the Senior Housing after rounds My thoughts are of my own future and would I be isolated? “Where are you going?” Mrs. Smith asks me as I pass her door on my way out. The desperation I see in her eyes says it all. She’s being isolated to death.