For Bettie Lynn Walden, 72, life during the pandemic has “really been horrible.” As a resident of Elk Run Assisted Living in Evergreen, Walden believes that the strict public health measures designed to protect Coloradans in long-term care facilities actually ended up causing physical, emotional, and possibly life-threatening problems for them.
“If you don’t see people, or interact with people,” she says, “your whole body breaks down.”
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The intense isolation Walden faced the past year—including virtually no physical contact with others and weeks where she barely left her room because of COVID-19 outbreaks at the facility—made her feel depressed, angry, and at times, hopeless. To Walden, the coronavirus crisis has felt far more challenging than what she endured in 2006 when she and her late husband lost their home to Hurricane Katrina. With a natural disaster, you at least know there’s an end in sight, Walden explains. But with a pandemic? “I didn’t think this year would pass at all,” she says. “It weighs heavily on the body. And the soul, too.”
In recent weeks, as restrictions at Elk Run have eased in light of the vaccine rollout, Walden has started to see “a little teeny tiny ray of light.” But normalcy, she feels, is still a long way off.
Walden is one of 120,900 Coloradans who either live or work in long-term care facilities, where pandemic-induced isolation and fear have defined much of the past year. Though research suggests older adults are notably resilient psychologically because they can tap into a lifetime of experience and perspective when navigating challenging times, “the stress of this last year was really especially compounded for people in the elderly population,” says Dr. Kristin Orlowski, a licensed psychologist with UCHealth Family Medicine in Littleton.
Many older people, Orlowski explains, have been more isolated than younger folks and have also had to grapple with the fact that they are at significantly higher risk for dying from the virus. Coloradans ages 70 and up have accounted for 77 percent of COVID-19 deaths even though they comprise just 10 percent of the state’s population. As of Monday, April 19, there have been 13,514 cases and 2,563 deaths among residents in residential healthcare facilities, which includes nursing facilities, assisted living residences, intermediate care facilities, and group homes. There have also been 11,787 cases and 15 deaths among staff.
When Elk Run closed to visitors in mid-March 2020, the staff did what they could to facilitate connections, arranging phone and Zoom calls. But it was difficult, says executive director Dan Kipp, especially since physical contact was not allowed per public health guidance. Instead of getting regular hugs from family members, many residents were touched only when caregivers helped them stand up, sit down, or change clothes.
In December 2020, as COVID-19 surged across Colorado, the facility confirmed its first positive case. The virus then slowly spread around the building, infecting about a half dozen people over the course of a month. Thankfully, the outbreak was much less severe compared to what occurred at other local facilities, and no one who contracted the virus died from it. One resident who got COVID-19 recovered and then died months later, says Kipp.
Still, “it was very stressful,” remembers Michelle Quihuiz, registered nurse and director of health services at Elk Run. “We were constantly sanitizing our hands; we had to wear N-95 masks all day long and protective goggles all day long.” The protective gear was so extensive that residents struggled to recognize staff members they had known for years, recalls Quihuiz.
During that period, group dining and activities were canceled, and residents were encouraged to stay in their rooms, where they ate their meals alone. “It was pretty horrible having to stay in your room and eat up there,” says Walden, who kept busy by writing letters, emailing, and scrolling Facebook.
But not everyone at Elk Run seems deeply impacted by the pandemic. George Faust, a World War II veteran and 95-year-old resident, was nonchalant about the experience. “You hope you don’t get” the virus, he says, “but you know, I’m not going to worry over it.” Faust, a great grandfather to nine, sums up his attitude about COVID by quoting a line from the 1956 Albert Hitchcook film The Man Who Knew Too Much: “Que sera, sera,” says Faust. “Whatever will be, will be.”
Steve Kurland, a 71-year-old resident, hasn’t fretted over the pandemic either. He admits he “didn’t really care” for quarantine, “but it’s better now because we can walk around, and I can do what I want to do here.” He enjoys playing games, doing puzzles, and watching TV.
Faust and Kurland may be outliers in their indifference; Quihuiz says she’s seen a number of residents notably decline, both physically and mentally, because of pandemic-induced isolation. “They’ve gotten weaker from sitting in their chairs so much and just being in their rooms,” Quihuiz explains. And the mental toll of prolonged lockdown has triggered anxiety and depression; several residents told Quihuiz that they would rather die of COVID-19 than loneliness. “It’s heartbreaking,” she says, “but I completely understand.”
Staff have also been profoundly impacted. Kipp, the executive director who has worked in senior living for a decade, says his stress levels have been “off the charts” the past year. “It was never an easy position or an easy industry to be in,” he says. But the pandemic “just added a very complex layer on top of what was already a strained industry.”
Kristen Fite, business office manager at Elk Run, is still so worried about bringing COVID-19 into the facility that she routinely sanitizes everything she buys at the grocery store, despite the fact that she is fully vaccinated and that the CDC recently confirmed that viral surface transmission is rare.
Fortunately, the vaccine rollout in January “completely changed the mood” at Elk Run, says Quihuiz. “We became very hopeful, very excited.” To date, more than 90 percent of the 43 residents and 36 staff have been vaccinated, according to Kipp. And the facility has not recorded any more COVID-19 cases since January.
In the past month, Elk Run loosened restrictions to allow visitors inside the building for the first time in a year. Group dining and activities have resumed, with some precautions. And vaccinated residents are now allowed to touch and hug visitors. As a result, residents’ functioning, moods, and even appetites have increased, says Quihuiz. Adds Kipp: “There’s a renewed spark of energy in people’s eyes.”
Still, about 20 percent of residents are “somewhat traumatized by COVID and still quite fearful of coming out of their rooms,” says Quihuiz. That parallels Orlowski’s prediction that the emotional toll of the past year will outlast the pandemic itself. “It’s gonna take time for people to feel repaired in their mental health,” she explains, adding that the more people can regain social connections and resume their pre-pandemic routines, the better they’ll fare.
Someday, hopefully soon, staff at Elk Run plan to host a large outdoor barbecue party to celebrate the facility’s re-opening. “I’m too nervous currently,” says Quihuiz, citing the recent rise in case numbers statewide, including in long-term care facilities. “But maybe by June.”