When the announcement came down that visitors would no longer be allowed in the Rock Hill, South Carolina, assisted living facility where Fannie Mae Faile lived, her sons Dean and Garry knew she was in trouble.
Fannie Mae, known as “Tillie,” was struggling with worsening dementia. Although she’d be fine at times and loved outings with her sons, some days the fog would descend. Only the comforting presence of family could calm her down.
So when COVID-19 hit and visitors were banned from her assisted living, there was no one around who had just the right touch to redirect her attention and settle her nerves.
She became more lethargic and less active. About four weeks into the quarantine, Faile became so weak she was transferred to Piedmont Medical Center in Rock Hill. She died on April 19 at the age of 84.
“I really think her will to live was kind of taken away by no fault of anyone,” Dean Faile said by phone last week. “My mom somewhat died of isolation.”
The Risks
For seniors, isolating themselves from the general population is critical to staying safe from the deadly coronavirus, which affects older people at an alarming rate. Some 87% of those who have died of COVID-19 — the disease caused by the coronavirus — in North Carolina were 65 or older, and more than half of the state’s COVID-19 deaths stem from elder-care facilities, according to state data.
But that isolation also leads to catastrophic health risks, because staying connected to loved ones and support systems is critical to both physical and mental wellbeing, experts say. Without enough social contact, risks grow for things like cognitive decline, depression and heart disease.
Of North Carolina seniors, 27% live alone, and 55% have two or more chronic health conditions.
“The isolation is coming to seniors in so many different, unique ways,” said Allison Costanzo, executive director of the N.C. Coalition on Aging.
Among them:
- Confinement: Patients in residential care facilities are largely forced to stay in their rooms in order to prevent or curb the spread of the coronavirus. But without a change of scenery or much human contact, they’re at risk for suffering from depression and intense loneliness.
- Decreased social services: Many social service providers for seniors, like Meals on Wheels or senior daycare centers, are operating on less-frequent schedules, if at all. Volunteers who normally visit seniors on a schedule to provide companionship are no longer making those visits because of COVID-19.
- Elder abuse:Social isolation is a big risk factor for elder abuse, and seniors are more prone to being abused by family members or caregivers who are also isolated and stressed.
- Self-neglect:Without contact from others or their normal routine, seniors are at a risk for self-neglect — not taking medications, eating properly, maintaining a sleep schedule or keeping up with house maintenance.
- Scammers:Seniors are already more likely to fall victim to scammers, and being isolated only heightens that risk. There have been reports of scammers trying to sell fake coronavirus test kits and asking seniors for their Social Security numbers under the guise of needing it to send a stimulus check.
The N.C. Coalition on Aging has recommended that the General Assembly provide support and funding for things like more protective gear for nursing homes, an increase in the investigation of elder abuse and iPads and other tech devices to help nursing homes connect residents with family who can’t visit.
Costanzo said she’s been heartened to see churches, agencies and individual volunteers stepping up to try to keep seniors connected.
Huge Obstacle For Nursing Homes
For long-term care facilities, the challenge almost seems impossible: Be hyper stringent about maintaining quarantine to prevent the spread of illness, while keeping residents emotionally healthy.
At Pineville Rehabilitation & Living Center, staff has had to get creative to try to keep residents’ minds sharp and keep them connected with their families.
Activities director Julie Carter throws “virtual birthday parties” for residents, decorating their rooms with balloons, streamers and tablecloths and letting residents celebrate with cake during either an iPad visit with family or sometimes, a visit at the window.
She also travels from room to room daily, guiding residents in special activities like planting seeds in pots of soil and coloring signs Carter sends to their loved ones.
AdministratorJohn Ficker negotiated with their cable provider to get 20 more channels in the cable package, including ones featuring old movies the residents would enjoy. Roughly two-thirds of Pineville’s 80 residents are there long-term; the other third is there for just 20 to 30 days of rehab.
For Some Families, Workarounds
Ruby Douglas’ mom, 95-year-old Virginia Ford, has lived at Pineville Rehabilitation & Living Center for almost seven years.
Before the quarantine, Douglas made sure that either she or her sister visited every day. When the doors closed to visitors “I thought I was going to worry myself to death,” Douglas said.
But Carter and the other staff have lessened her worry.
“I’ll call mama on the telephone, and they’ll put her on. I’ll say, ‘Sing, mama,’ and she’ll sing hymns like ‘On the Cross’ or ‘Amazing Grace.’”
Carter arranged a family singalong recently, with Douglas and her sister at Ford’s window, her brother on an iPad and Ford in her room.
It’s not the same as being an arm's length away, but for now, it’s all they have.
“I called her a little while ago and I said I’d be at the window tomorrow or Saturday,” Douglas said on a recent weekday afternoon. “And then I told her, ‘We’re going to have lot of hugs to make up for all this.’”
‘No Way To Explain’
Dean Faile and his family are grieving the loss of Tillie, an avid gardener and sports fan who kept copious stats during her sons’ basketball games while they were growing up and loved playing on the floor with her grandchildren.
Tillie Faile grew up on a farm, and while dementia ran in her family, healthy bodies that lasted well into old age did, too. Dean Faile, who is president of the Lancaster County, South Carolina, Chamber of Commerce, said before COVID-19, he expected that his mom could live another five years.
It had only been one year since she moved out of her home on a one-acre lot in Rock Hill, where she had lived alone for years and mowed her own grass. Her dementia was progressing steadily, but with the exception of a course of radiation treatments she’d just finished for a skin tumor, she was healthy.
“The assisted living facility was doing all the possible right things they could do. But when you have a mother that’s having some dementia issues, there’s no way you can explain why one day your two sons can come see you anytime,” he said, “and now they can’t come see you at all.”
Reach managing editor Cristina Bolling at cristina@cltledger.com.
This article originally appeared in the Charlotte Ledger Business Newsletter and was republished with permission.