Nursing home residents at Oak Park in Auburn and East Alabama Medical Center-Lanier look forward to playing bingo, but the game hasn’t looked the same since both enacted strict measures March 12 to prevent coronavirus.
Instead of gathering in a meeting room, players sit in the hallway. Each person must wear a mask and remain at least six feet away from other people. Otherwise the game remains the same, one of few things that hasn’t changed since coronavirus arrived in Alabama.
Even though business across the state have reopened to the public after lockdowns in spring, restrictions remain in place for nursing homes ravaged by coronavirus. At Oak Park and EAMC-Lanier, residents no longer eat together or socialize in each other’s rooms. Outings to grocery stories, nail salons and fishing holes have all been suspended. Residents spend much of the day in their rooms.
“It’s been really hard,” said Robyn Olive, executive director of senior services for East Alabama Medical Center. “It’s very difficult for the residents. You can tell the isolation is wearing on them. We’ve seen some depression in some.”
Their vigilance has paid off. No residents of Oak Park or EAMC-Lanier Nursing Home have tested positive for coronavirus. Most Alabama nursing homes have had at least one case, and some have had dozens. More than 40 percent of deaths in Alabama have occurred in residents of long-term care, which includes nursing homes and assisted living.
But it’s come at a cost. All Alabama nursing homes ended visitation in March, with exceptions for end-of-life. Families have gone without in-person contact ever since, leaving some residents lonely and confused.
“They are missing their friendships with other residents,” said Eve Milner, vice president of senior services for East Alabama Medical Center. “You have residents with dementia who think their families have abandoned them because they haven’t seen them in months.”
The situation shows no signs of changing. Nursing homes were the first facilities to lock down in Alabama and will be the last to reopen, according to the state’s phased reopening plan. Meanwhile cases have spiked in July, and the virus shows little sign of retreat.
The lockdown has forced staff members to get creative. They help residents connect to family members using tablets. Olive said small, scheduled meetings have been arranged outside the nursing homes, with residents on one side of the fence and family members on the other. Still, they cannot touch, and the distance required for safety can make it difficult to communicate, especially when someone suffers from hearing loss.
Staff members have stepped up to spend extra time with residents, Milner said. The homes created buddy systems to pair workers with residents.
“We’re doing everything we can,” Milner said. “But you can’t replace family. You really can’t.”
Not all of the residents suffer dementia. Many only have physical disabilities and understand everything that’s happening. Milner said those residents have been worried about the virus and concerned they may never see their families again.
The lack of contact has also caused stress for relatives. Jamie Harding, spokeswoman for the AARP of Alabama, said the organization often hears from family members concerned about a loved one they haven’t seen for weeks.
“Many people in nursing homes have dementia,” Harding said. “I think those are the toughest cases to deal with. If you have an older person who is in cognitively pretty good shape, you can have a good visit with them over video. But some people really can’t communicate that way.”
If the lockdown continues, Milner said nursing homes will need extra assistance to address depression and anxiety in residents. Many residents already suffered the negative effects of isolation, which can increase cognitive decline, according to the American Psychological Association.
“If we’re going to continue like this, there’s going to be a lot of need for mental health support,” Milner said. “Our residents have not had a hug in months. That would make you sad too.”
Nursing homes cannot reopen to visitors until they meet several benchmarks, most importantly a decline in cases in the surrounding community. Lee and Chambers Counties emerged as early hotspots for coronavirus. The number of cases fell for a while, then surged back. East Alabama Medical Center, which also operates hospitals in the counties, reported an all-time high number of coronavirus patients this week.
Milner and Oliver said it’s critical to keep patients safe from the virus. Long-term care facilities are especially vulnerable to large, deadly outbreaks. Even when they can reopen, it’s unclear what visitation may look like. Precautions such as temperature screens and masks may remain even after the virus is gone.
“I wish I could just open the doors and let everybody in,” Olive said. “I don’t foresee it ever even looking like that ever again.”
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Still in lockdown: Nursing home residents in Alabama face depression, fear as pandemic drags on - AL.com
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