Families fear isolation taking toll
For three months and counting, nursing homes have remained shuttered to residents’ loved ones
With no end in sight to the coronavirus lockdown at Florida’s senior-care facilities, family members and their advocates are pleading with Gov. Ron DeSantis to find a safe way to allow limited, in-person visits with loved ones — as 17 other states have already announced plans to do.
The move is critical to keep the emotional well-being of elderly, frail residents from deteriorating further, supporters claim.
“This has been hell. Pure hell,” said Jeanine Pomeroy of Oviedo, who wrote to the governor’s office recently after the memorycare center housing her 86-year-old husband, Earl, was ordered closed to visitors March 13. “I’ve felt so guilty. I think, ‘Oh, God, why did I ever put him in there? What have I done?’ I’ve put him in [solitary] confinement.”
For three months and counting — as shopping centers and gyms and bars have begun to reemerge from coronavirus closures — Florida’s 3,800 nursing homes and assisted living facilities have remained shuttered to loved ones with rare exceptions, typically reserved for residents in their final days of life.
Six weeks ago, DeSantis had spoken hopefully about reopening in the summer, saying, “Having the isolation does come at a psychological and social cost. … We can’t just turn a blind eye.”
But that was before a surge in Florida’s coronavirus cases. The state reported its largest singleday increases this week, an escalation fueled mostly by infection among younger age groups but with some spikes at senior care facilities, too — and an all-time high of 2,637 for the number of long-term care workers who are
infected.
At Oakmonte Village of Lake Mary, for instance, the assisted living facility reported 10 staff members and 27 residents were infected as of Friday, and an additional infected resident had been transferred out.
Meanwhile, federal guidelines recommend that nursing homes remain on lockdown until they’ve gone 28 days without a new infection and their community enters Phase 3 of reopening — something DeSantis said Thursday he is in no hurry to order.
“I understand there is huge strain when you are told you can’t have visitors,” DeSantis said, but added he can’t risk a visitor triggering an outbreak. He said he has asked Mary Mayhew, secretary of the Florida Agency for Health Care Administration, to create a plan on how to reopen safely when the time is right.
No one disputes the vulnerability of elderly residents with chronic heart and lung ailments, diabetes and high blood pressure, who are at the greatest risk of dying from the coronavirus. This week, the COVID death toll in the state’s long-term care facilities reached 1,772 — 60 of them in Volusia, Orange, Osceola, Seminole and Lake — accounting for more than half of all COVID-19 deaths in Florida.
But advocates and loved ones say residents’ health is already declining as a result of separation and isolation.
“Three months without a lot of familiar faces is going to have an impact on a dementia patient,” said Lisa Warren, whose 64-year-old husband, Bill, moved into a Winter Springs memory care facility in September after being diagnosed with early-onset Alzheimer’s disease in his late 50s. “I have definitely noticed a difference in him. He used to be more verbal.”
Warren praises the facility’s aides, who she said have worked hard to comfort her husband and keep him connected to family by arranging FaceTime chats and Zoom meetings. Still, she said, technology can only go so far.
When the facility reported its first two positive cases last week, she said, it added a whole new layer of worry.
“There’s no reason that we can’t do the same thing that the staff is doing,” she said. “Let’s put on the gloves and the masks and the goggles and sanitize everything. That way, at least we could go in and be there with them, even if we can’t touch.”
Pomeroy agrees. After two months of getting little information on her husband, she said, he fell, breaking his hip, and had to be hospitalized for surgery. There, she was able to visit him.
“When he saw me, his eyes really lit up,” she said. “The hospital allowed one visitor every day, so I saw him every day. I was able to encourage him, and I made sure he ate. And they were trying to do physical therapy with him, which was painful, but, you know, he would do it for me. … I so treasure those days that we had together.”
As he improved, though, doctors deemed him well enough to go to a rehabilitation facility, where once again Pomeroy couldn’t visit.
“If hospitals can make it work,” she said, “why can’t nursing homes? It would make the staff’s job easier because the residents wouldn’t be so depressed.”
In May, the Florida Health Care Association — a trade-group representing nursing homes — enlisted infection-control experts, clinicians and facility owners to create a plan for reopening that was sent to the DeSantis administration. The recommendations included mandatory mask use by all staff and visitors, universal temperature checks, strict sanitation protocols, social distancing and frequent testing.
DeSantis has not formally responded to the recommendations, but on June 16 he announced an executive order requiring all longterm care employees to undergo COVID-19 testing every two weeks.
Some say that’s not enough.
“A lot can happen in two weeks,” said Jeff Johnson, state director of AARP Florida. “We need to figure out how we can test people as they’re coming in the door and make sure they’re not bringing the virus in with them.”
Brian Lee, executive director of the national nonprofit Families for Better Care, an advocacy and watchdog group, insists that’s the only way to ensure residents’ safety.
“As much as it pains me to say this — because I know that there are families out there hanging by a thread — it’s a very dangerous proposition to open nursing homes back to the public until we have a national testing strategy,” he said. “And, honestly, it cannot be a state solution because states are doing an extremely poor job when it comes to testing.”
Lee said the cost of rapid results testing could be covered by the millions of dollars in fines already collected from long-term care facilities for failing health inspections or other improprieties — an idea that has yet to gain traction.
Meanwhile, all but one of the 17 states that have announced reopening plans for their nursing homes have recommended allowing outdoor visitation only.
But that will only accommodate nursing home residents healthy enough to move or be wheeled outside. And in Florida’s extreme summer heat, even visits under an awning or carport would likely have to be short.
“It has been very difficult,” said Midge Ruff, a remarkably vibrant 109-year-old resident of The Mayflower at Winter Park. Since the lockdown started, employees have tried to provide extra attention — even setting up a Zoom meeting with her extended family for her birthday last week and arranging for cake and entertainment. But Ruff misses the camaraderie, bridge tournaments and group activities of her precoronavirus life there.
“We don’t go any place, and no one can come in,” she said. “Everybody has accepted that this is what we have to do, but it’s boring.”