Assisted Living, A Living Hell; How COVID turned assisted living facilities into virtual prisons

By: Laurie McInstosh

As overreaching politicians have continued their nearly unfettered march in curtailing many of our fundamental freedoms, nearly all of us are feeling the stress and the strain of these restrictions. For some it is as trivial as limiting where we can shop or having to wear a mask to enter a restaurant, for others it is far more serious infringements from having one’s business shut down to being forced to wear a mask all day. However, for our elderly family and friends living in nursing homes and assisted living facilities, it is unimaginably unbearable.

Priorities for ensuring quality of life for the elderly

Ensuring physical safety, providing appropriate medical treatments, and delivering nutritious food are some of the obvious functions of nursing homes and assisted living facilities. Love, compassion, and engagement with loved ones are even more important factors in ensuring high quality of life for nursing home residents. Considering that, according to the Journal of the American Geriatrics Society (JAGS), the median length of stay in a nursing home before death is about 5 months, it becomes clear that our highest priority for nursing home and assisted living residents is to bring them love, kindness, and joy in as abundant a measure as possible, which in the vast majority of cases can best be provided by interaction with children, grandchildren, and close friends.

State guidelines for Vermont Long Term Care Facilities

According to www.healthvermont.gov, the Department of Disabilities, Aging, & Independent Living issued COVID related guidelines to Vermont’s long term care facilities on June 12th of this year. These guidelines, as manifested in the policies of the majority of Vermont’s assisted living facilities, provide only outdoor visitation while maintaining distances from 6-8’ or more between residents and their loved ones. Visitors are required to be masked and the residents are encouraged to be masked, visits are limited to one per resident per day, physical contact is strictly forbidden, and must be overseen by a staff member to ensure compliance with guidelines. Aside from the practical aspects of visitors and their elderly loved ones having to sit outside in heat, damp, or cold, and the difficulty in speaking and being understood at that distance through masks, there are the less tangible and more important aspects to consider. The forbidding of any physical contact means no hugs from children, no sweet sticky kisses from grandchildren, and not even handholding with a lifelong friend; and these are the cornerstones of mental well being among the human species.

The COVID curve in Vermont

The guidelines described above, as well as a host of other “guidelines”, which, incidentally, many choose to interpret as mandates or worse still laws, were implemented in Vermont with the willing compliance of a populace who were assured repeatedly that they were temporary measures to “flatten the curve”. According to data from Johns Hopkins University CSSE, the curve, which in Vermont was barely a blip, became flat in late April and has remained flat ever since with no COVID related deaths in over a month. Please note that the guidelines described above were issued in mid-June, almost two months after the blip, and the guidelines have not been relaxed since then, but in fact have become more strict in some facilities.

COVID-19 Deaths Per Day

This Travesty Has A Face

While facts and figures tell part of the story, the story is not complete without a human face. While I cannot share the name of the resident or the facility I am about to describe, I can attest to the fact that this description is true in every detail. Let’s call this resident Jane Doe. Jane is in her late 70s and lives in an assisted living facility in Chittenden County. She is not thrilled about living in assisted living, but recognizes that due to an underlying health condition and failing short term memory, she needs the daily help provided there. Up until COVID, Jane had a robust social life with frequent visits and outings with friends and family, and that made the situation tolerable. Fast forward, Jane has been on forced lockdown for about 6 months, her mental state is in sharp decline with deep depression and suicidal thoughts. The family and staff are unable to find mental healthcare providers with the bandwidth to work with Jane on a regular basis, and the situation goes from bad to worse. During this time, the only comfort available to Jane was the type of visit described above and for someone accustomed to frequent interactions with her loved ones, this was intolerable. After a week of negotiating between Jane’s family and the facility, she was allowed to leave the facility to spend a few days to visit one of her children. Upon returning to the facility, she had no symptoms and tested negative for COVID, but was nonetheless quarantined to her room for 10 days, not even allowed out for a shower during that entire period. Ten days of isolation drove Jane to even deeper depths of depression and the feeling of having no options left to her except to idle away her days alternating between sleep and some reading or tv. That is the current and ongoing life of Jane.

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