COVID’s deadly side-effect on nursing homes

MARY REICHARD, HOST: Coming up next on The World and Everything in It: lockdowns in nursing homes.

NICK EICHER, HOST: Of the nearly 300,000 Americans who’ve died from COVID-related illness, 40 percent of those deaths occurred in long-term care facilities, housing the most vulnerable. To try to contain the virus, most nursing homes have now been in lockdown for nine months.

REICHARD: That’s a long time to go without visits from loved ones or even get together with people living in the nursing home. WORLD’s Sarah Schweinsberg reports.

SARAH SCHWEINSBERG, REPORTER: 19-year-old Mackenzie Olson is a certified nursing assistant. She works in a nursing home in Macomb, Illinois. 

OLSON: My shift consists of getting all the towels and linens passed out to each of the rooms, making the beds, cleaning the beds, helping people with showers, getting them ready for bed at night after supper… 

It’s hard work, but Olson likes helping the elderly residents.

OLSON: You would want this care done for your grandparents or your parents.

But Olson says this year with COVID-19 lockdowns, residents need more than physical care. They need friendship. For much of this year, Olson’s nursing home hasn’t allowed outside visits. 

OLSON: Unless they’re on hospice or end of life care. There’s no family members allowed in the building.

The home does allow window visits—where a resident and family member can see each other through a closed window. 

OLSON: And then you can talk through the phone or FaceTime. 

Mackenzie Olson says while that’s a nice option, talking on the phone just isn’t the same as a hug from a grandchild or a child holding their hand. Many residents haven’t gotten that physical contact in months. 

OLSON: Some of them it’s really, really, really hard because they have a lot of kids, or a lot of grandkids, and they’re so used to them calling and visiting like, multiple times a week. Some of them don’t understand, or they can’t remember why. So it does get really hard, especially when they get emotional. 

Nursing home residents are also engaging with others in the facility less. 

In an October survey of nursing homes in more than 30 states, half of residents reported not participating in any organized activities. Things like exercise, art classes, or church services. 

That loneliness is taking a toll on their physical and mental health. 

Dr. Jim Avery is a professor of medicine at the University of Virginia and a member of the Christian Medical and Dental Associations. He also works in hospice care and nursing homes. 

AVERY: We’re seeing increased anxiety, we’re seeing loneliness. We’ve had an increase in pain medications, an increase in sleepers, so we’re seeing more insomnia. We’ve seen an increase in antidepressants. I remember seeing one patient and he basically said this, if the virus doesn’t kill me, the loneliness will. 

Dr. Avery says poor mental health leads to physical ailments. Issues like weight loss, muscle weakness, and pressure sores.  

AVERY: When you see more falls, more weight loss, more rehospitalizations and increase in pressure ulcers, and you see people on more pain medications, you are definitely going to see other related deaths.

An Associated Press study found that long term care facilities have had a 15 percent increase in non-COVID related deaths compared to last year. That’s about 40,000 excess fatalities. 

Elderly care advocates also worry the isolation has left nursing home residents vulnerable. 

Daniel Musto is long-term care ombudsman for the state of Utah. His job is to investigate reports of abuse and neglect. 

MUSTO: We’ve seen a drastic reduction in our case numbers. 

Last year, his team handled 700 cases. This year, the caseload has dropped to 450. 

Musto says that’s because when visitors are kept out of a facility, fewer people can observe what’s going on. 

MUSTO:  In a normal situation, you would have family members, friends, church. You know, the Ombudsman, many people out there with eyes on the situation and concerns over their loved ones. So, I think the caseload primarily went down because of decreased visitation, honestly.

Musto says, at the same time, nursing home staff are stretched thin. That means there’s more chances for neglect. 

MUSTO: They’re running on short staff, and they’re just trying to make ends meet and get the residents’ needs met. But sometimes it’s a lot more difficult when you don’t have the manpower you need.

This fall, the federal government encouraged nursing homes without COVID cases to resume visits and scheduled activities. But now as infections in nursing homes rise, many facilities are once again restricting in-person contact.

But not from everyone. 

John Schneider heads Nursing Home Ministries, an organization that sends chaplains into long-term care facilities. He says during lockdowns, his team has reached residents online. 

SCHNEIDER: We have chaplains that live stream services from their homes. They’ll play music, we have some chaplains that have created just some beautiful photography videos…

This fall, as lockdowns relaxed, Schneider got to resume in-person visits. Now as many facilities are going back into shutdown…Scheider says more nursing homes aren’t ending chaplain visits. Instead, they’re recognizing spiritual care is just as important as physical care. 

SCHNEIDER: They said we see that you are part of the essential care of these people, and we definitely want you to keep coming. So I think that’s that’s happening and we’re hearing that elsewhere as well.

Reporting for WORLD, I’m Sarah Schweinsberg.

(Ben Garver/The Berkshire Eagle via AP) The pre-kindergarten group from the Boys and Girls Club visit through the window with members of the supportive daycare program at the Froio Senior Center in Pittsfield, Mass., Tuesday, Nov. 24, 2020. 

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