Staying Connected to Seniors Despite Covid-19

A Year to Remember

As the year 2020 rang in, many people held the belief that this year would be special, and even memorable. Few people were aware that, in China, 2019 was ending in a very dramatic way. A new, highly contagious corona virus named Covid-19 was discovered which was rapidly spreading, leaving wide spread sickness and death in its wake. No one could have dreamed how the entire world would be turned upside down.

Within 3 weeks, on January 20, 2020, the first case of Covid-19 was reported in the United States and on February 6, 2020 it was reported that the first person in the United States had died from it.¹ At a time of the year when many people struggle to stay connected due to weather, colds and the flu being further isolated from family and loved ones served to bolster loneliness and depression, particularly among seniors.

Quarantines and Lockdowns

Amid the growing fear of the virus rapidly spreading across the nation, states began implementing 14-day quarantines, stay at home orders, and a variety of different forms of lockdowns; and so began a new way of life with people being isolated from one another.

The elderly, the sick, and anyone confined to a hospital, care facility, or nursing home found themselves suddenly isolated from the outside world.

Fear and Depression

For everyone, changing conditions and uncertainty about the future are catalysts that can lead to fear and depression. Add in forced isolation and the outlook becomes even more grim; especially for the elderly, children, and those living with disabilities.

Equally affected are those whose lives revolve around the seniors who are under lockdown, whether in a facility or in their own home. Concerns about their loved one’s wellbeing, frustration, and guilt takes a toll on even the most serene and long-suffering.

Although most areas of the country are not currently under stay at home orders, most care facilities and nursing homes still are relatively locked down to outsiders. In hospitals, visitor policy is largely determined by local conditions of the number new Covid-19 cases and how overwhelmed is the hospital.

Through the summer months, it looked as though the number of new cases was steadily decreasing; the hope was that things would soon return to normal. However, at the end of summer with people returning to work and children returning to school the number of new Covid-19 cases has been on the rise.

Looking Ahead Toward the Holidays and Winter

According to forecasting done by the Centers for Disease Control (CDC), the number of new cases is predicted to rise through December 5^th. The forecasting models used by the CDC utilize a variety of factors to predict trends of the pandemic over a four week period.²

Given the current state of limited contact with loved ones and the projected increase in new Covid-19 cases, it appears unlikely that visitation restrictions will be eased over the coming holidays. Caregivers are particularly feeling overwhelmed. With so many people feeling that they are at their breaking point, making extra efforts to stay connected can help ease those emotions.

Facility Guidelines

On September 17, 2020, the Centers for Medicare and Medicaid Services (CMS) updated a document which provides guidance to nursing homes concerning visitation during the Covid-19 pandemic. This document, labeled QSO-20-39-NH, contains core principles of Covid-19 infection prevention which are consistent with guidance set forth by the CDC for nursing homes, and directs “visitation should be person-centered, consider the residents’ physical, mental, and psychosocial well-being, and support their quality of life.” Situations of compassionate care are also discussed and recommendations given.³

Each state has established guidelines for care facilities to manage visitation during the current Covid-19 pandemic consistent with QSO-20-39-NH. Each state has also developed various stages of opening for care facilities based on the current number of new Covid-19 cases.

Since nursing homes and care facilities have been locked down for most of the year, many have found ways that their residents can be somewhat connected to the outside world. If you haven’t already, call the facility and ask them what are their current policies on visitation. The staff inside these facilities love their residents and want their lives to be as enriched as possible. Ask what they suggest for ways to engage your loved one, and give them your ideas to see if they would fit within the guidelines of safety. If your loved one is living at home, in a retirement community, or independent living facility I’ll talk about that a little later.

Get Creative About Staying Connected

Once you have talked to the facility in which your loved one resides, you will know all the conditions they have set for visitation. For in-person visits, be prepared to be screened, wear a face mask, remain socially distant, and mandatory hand washing or use of hand sanitizer.³ Some facilities only allow visiting outside of the building in designated areas. As we head into cold weather, this option may not be available in all parts of the country.

Indoor visitation may consist of designated areas that have seating arranged 6 feet apart, and/or have plexiglass dividers. Some facilities may allow visitation in the resident’s room. Also, remember that as the number of new cases of Covid-19 waxes and wanes, policies may also change.

If your loved one is in a memory care facility, the isolation has been particularly hard on them. This type of stress often accelerates the progression of dementia. Don’t lose heart if they no longer recognize you or are acting out due to frustration. Do not let these things keep you from trying to connect with them. The pandemic and shutdowns are not your fault. Make the most of the time you can interact with them.

No matter where your loved one is living, it is the connection you make with them that matters the most. So, let’s look at some ways you can do that.

If you can have in-person visits, take with you things that you can show them and talk about. Pictures make great conversation starters. Take pictures of everything in your world to show them what is going on in your life. Not only can you show them pictures of people and pets, you can take pictures of things that you are doing like gardening, art and décor projects, home renovations, vehicle projects, new things that you bought, the list is endless. If you have digital photos that you can show them with a tablet or computer, it will be easier for them to see from 6 feet away.

Sometimes you will want to show them old pictures, so it would be helpful if you had digital copies of them made, as well. Old photos are especially important if your loved one has dementia and has lost their recent memory. Pictures from their past will enable them to engage and talk passionately about what or who is in the photo. Take advantage of finding out who are all those people in old photos; you could learn a lot about their family (and yours if related).

Most facilities will accept care packages for their residents. Ask if you can drop things off or if they need to be mailed. Also ask if they need to be packaged a certain way. There are lots of possibilities for connecting with them this way. You can send them things that they can use, or things to make them smile (ask the staff if you can include small food items), clothing, etc. If your loved one enjoys crafts, coloring or drawing you can send them things ahead of time before your visit that you can do together when you visit; take your own things to work with. If there are songs that they like to sing, you can send them the words to help them remember so they can sing along while you play the music during your visit. Use your imagination for the types of things that you can do together.

If you cannot have in-person visits there are still ways you can connect with your loved one. Of course, talking on the telephone is the most obvious. Having their own phone would be easier than having to arrange phone calls with the staff. Connecting via video has become easier since the pandemic started. There are apps on your smart phone like Facebook Messenger, WhatsApp, Skype (also on tablets and computers), Google Hangouts, and Google Duo.⁴ And of course there is Zoom for phones, tablets and computers. Your loved one will need to have their own smart phone, tablet or computer. If they do not know how to use them, talk to the staff to see if you can arrange for someone to help them establish the call at a prearranged time.

If connecting with video is not possible, depending on the facility, you may be able to arrange talking to them on the phone while seeing each other through a window. While it is not the same as being in the room with them, you be able to make eye contact and share emotions, which is an important part of being connected.

Retirement communities and independent living facilities still have to follow the guidance of the CDC but are allowed to make adjustments which fit the needs of the community. The CDC recommends “Implementation should be guided by what is feasible, practical, acceptable, and tailored to the needs of each community.”⁵ Open communication with the facility will ensure that you can make the most of your visit. Be as creative as you can but just showing up in whatever capacity that you can is the most important part.

If your loved one is being cared for at home, it is up to the caregiver to ensure that they are taking the appropriate precautions and following the guidelines of the CDC. This puts a great strain on the caregiver so be willing to follow their guidance. Upsetting the caregiver upsets the one for whom they are caring, which is never a good thing. If you are the caregiver, be firm in what you are doing to keep them safe but also be willing to consider other people’s suggestions for how they can interact with their loved one. Also, check out this older adult resource guide from Front Porch Center for Innovation and Wellbeing for recommendations on ways to engage and stay connected to the outside world. http://fpciw.org/wp-content/uploads/sites/15/2020/04/FPCIW-COVID-19-AN-OLDER-ADULTS-RESOURCE-GUIDE4.3.pdf ⁶

Holidays are an especially hard time to be separated from friends and family. It has been a long year of isolation. Let’s be intentional about finding joy. Joy will lift us from despair and hopelessness. It is especially effective when we share it with others. Make it a goal to bring a smile to someone’s face every day. In this time of distancing and isolation, you may be surprised how easy it is to let someone know that they are valued and loved just by taking the time to make a connection with them; eye contact and a kind word could make someone’s day, or even save their life.

Cards and letters, a handwritten note would mean so much to so many just to know that they are being thought of. If your loved one has a roommate, send them a card, too. Everyone loves to receive happy mail! They will treasure it more than you know and it will be a physical reminder that they have not been forgotten.

For further recommendations on ways to stay positive and stay connected, take a look at this guide put out by the California Department of Aging at https://aging.ca.gov/download.ashx?lE0rcNUV0zYlqz5kxLW8bA%3d%3d ⁷

 

References

1. Neilson, S., Aylin Woodward, A., & & Mosher, D. (2020, September 29). A comprehensive timeline of the coronavirus pandemic at 9 months, from China’s first case to the present. Retrieved from Business Insider: https://www.businessinsider.com/coronavirus-pandemic-timeline-history-major-events-2020-3

2. COVID-19 Forecasts: Cases. (2020, November 12). Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/forecasts-cases.html

3. Nursing Home Visitation – COVID-19. (2020, September 17). Retrieved from Department of Health and Human Services – CMS: https://www.cms.gov/files/document/qso-20-39-nh.pdf

4. NURSING HOME LOCKDOWN: 6 WAYS TO STAY CONNECTED WITH SENIORS DURING A CORONAVIRUS SCARE. (n.d.). Retrieved from Daily Caring: https://dailycaring.com/nursing-home-lockdown-6-ways-to-stay-connected-with-seniors-during-a-coronavirus-scare/

5. Considerations for Retirement Communities and Independent Living Facilities. (2020, October 30). Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019-ncov/community/retirement/considerations.html

6. Feeling Good and Staying Connected An Activity Guide. (n.d.). Retrieved from California Department of Aging: https://aging.ca.gov/download.ashx?lE0rcNUV0zYlqz5kxLW8bA%3d%3d

7. Staying Home, Staying Connected. (2020, April 3). Retrieved from Front Porch Center for Innovation and Wellbeing: http://fpciw.org/wp-content/uploads/sites/15/2020/04/FPCIW-COVID-19-AN-OLDER-ADULTS-RESOURCE-GUIDE4.3.pdf