Arguments for and against isolating the elderly.

As the COVID-19 pandemic has stretched on, we have gone to both ends of the spectrum in the case for and against isolating our loved ones in nursing homes and assisted living facilities. When the pandemic first began, the general consensus was to protect this generation from this often fatal disease, and keep our family members isolated in their respective living quarters.

As the pandemic stretched on for months, however, we started to hear reports of the negative effects this isolation was having on our loved ones. Many were not dying from COVID-19, but they were declining rapidly both physically and mentally because of the loss of contact with the outside world.

There have been a vast amount of studies in the past several years showing the negative effects of social isolation in the elderly population. Because the need for isolation has been so widespread these past several months, most of us have likely seen first-hand the effects of that on a loved one. I know I have. And it is hard to see someone you love decline at such a rapid pace.

This mass decline in the physical function and mental function of our elderly family members and friends has made most of us wonder if keeping them in this continued strict isolation is really what is best for those in our lives that are in the high-risk population. The purpose of this post is not to side with one group or the other. Rather, I want this post to help you think through both sides and decide what is best for you and your family.

The shut down leads to isolation of the elderly.

So, let’s speak from the side of the nursing home or assisted living facility that initially completely shut down all outside visitors to their facilities. I understand that. I am sure many of you saw the villainization of any nursing home that had positive COVID-19 cases with multiple deaths.

I guarantee you there is no nursing home administrator that wants to be in charge of that facility that is featured on the news. The nursing homes and assisted living facilities have a responsibility to keep your loved ones safe and healthy, especially from those diseases that are transferred throughout the community.

Once the infection was in the buildings, it became very difficult to prevent the spread of this awful illness. Most did the only thing they knew how to do, and that was shut the facility down to staff only. I understood the rationale of limiting the number of people into the buildings in order to limit the possibilities of this virus from infecting a person within the building. Despite these efforts approximately 40% of those killed by COVID-19 have been nursing home residents.

Now there were certainly facilities that handled the communication with family members regarding infections of loved ones better than others. Many building administrators did an excellent job of maintaining communication between loved ones in the buildings and those on the outside. 

From the beginning, we knew the higher death rates were occurring in the elderly population. The deaths that occur from COVID-19 are not the deaths anyone would want their loved one to experience. Most of these deaths are not peaceful, and we would not wish them on our worst of enemies. Because of this, we protected our loved ones by staying away. 

Negative effects of isolation.

As we moved into May and early June, we started to see the effects of the isolation on this population. Many in assisted living facilities were confined to their rooms, no longer able to walk to the dining room for their meals or to the activity room for social events. The lack of the usual built-in physical activity caused a significant decline in their strength and ability to mobilize safely and independently.

Those in nursing homes and short-term rehab could no longer go to the therapy gym where they had a community of people around them while they worked to regain function. Visits were being done by video calls and through the windows. For those with dementia and other cognitive deficits, this added to the confusion and, ultimately, more deaths.

People became depressed because they craved physical contact, which led to poor intake of food and fluids. With nowhere to go and no additional activities to do, people often slept or remained sedentary, leading to poor sleep at night time, which would then sometimes lead to hallucinations. It was a domino effect. It made most of us wonder, is this isolation worth it? 

Visitors begin to return.

As many facilities are loosening some visitor restrictions, our loved ones are starting to be able to get some face to face visits, but it still is not the same. We are starting to move forward, cautiously, into this new normal. Hopefully, our loved ones that have been isolated for so long will start to show some improvement in both their mental and physical health.

I think we need to be prepared for the possibility of the need for additional isolation as we move into the winter months. So what is the answer for how to handle this? Do we eliminate all visits with loved ones again or do we just keep on visiting them, albeit, cautiously? Quite frankly, I cannot answer that for you. It is an individual decision that you and your family must make based on the unique circumstances of your situation.

If you have a loved one that is not currently living in a nursing home (short-term or long-term) or assisted living facility but might end up needing placement during this time, it will be a tough decision. I think it is a decision that will need to be talked through among the family and trusted experts to weigh the pros and cons of whether or not isolating your elderly family member is the right one. 

Please contact me or leave a comment if you have a question about how to keep your loved one safe during the pandemic.

© 2020 Jessica Kluetz, DO