When Betty Rutt remembers life before the pandemic, what she misses most is her family.
“That’s the hardest thing for all adults this age, if you don’t see your family,” Rutt said. “Because that’s almost what you live for.”
Rutt, who is 92 and a resident at Brethren Villages’ Village Manor home, is limited in her ability to see her family, which consists of five children, 13 grandchildren, and 28 great grandchildren, due to COVID-19.
She can call them on the phone, or video chat, or meet them in groups of four, 6 feet apart. But it’s not the same as before, Rutt said, when she could hug them, and eat with them, and see them all at once.
“I can’t hold them; I can’t touch them,” Rutt said. “It’s strange.”
Lancaster County nursing and personal-care homes have been hit hard by the pandemic. Of the 440 people in the county who have died from COVID-19, 360, or 82%, were residents of these homes, according to the county coroner’s office.
A total of eight residents at Brethren Village have died from the virus, which infected a total of 19 residents and 18 staff.
But while nursing and personal-care homes follow state Department of Health guidelines to prevent the spread of the coronavirus, some experts worry that the isolation resulting from safety measures is taking its toll.
Douglas Ockrymiek, a psychiatrist at Behavioral Healthcare Corp. in Lancaster, said he has noticed an increase in depression and loneliness among older adults during the pandemic.
“The elderly are missing relationships with family, friends, and that has a big impact on them,” Ockrymiek said. “There’s no doubt that loneliness can lead to an increase in what I call morbidity and mortality.”
Loneliness can exacerbate physical decline if a person lacks the motivation to take medication, or develops anxiety-induced shortness of breath, chest pain or lightheadedness, Ockrymiek said.
“It’s this balancing act,” said Tara Ober, vice president of communications and resident life at Brethren Village, which shut down all visitation from March until June as ordered by the state. “We want to keep (our residents) safe; we don’t want them to die of loneliness.”
During the shutdown, only staff, residents and essential personnel could enter Brethren Village, Ober said. They experienced a COVID-19 outbreak in their dementia unit during those months.
Lori Schoener, director for skilled living admissions and therapeutic recreation, described the March to June atmosphere as dark.
“If COVID numbers continue to go up, I’m not sure that they’ll ever have us go back into full lockdown,” Schoener said. “It took so much pressure from families and providers that said, ‘this can’t keep happening; we can’t have our residents this isolated.’ ”
That was part of the retirement community’s motivation for prioritizing visitation in its recent reopening plan that took effect Oct. 2. Now, residents may accept face-to-face visitors in three ways: indoor groups of four, with everyone wearing masks and spaced 6 feet apart; outdoor groups with the same limitations; or window visits, where residents speak to guests through a plastic screen inside a coat closet.
“It was fun,” Rutt said of the times she’s seen family members. “At least I saw ‘em.”
Other nursing homes and senior living facilities in the county also are promoting socialization among their residents.
Luther Acres in Lititz and ManorCare Health Services in Lancaster Township have yet to resume in-person visitation but are prioritizing virtual communication.
Both were hit hard early on in the pandemic, with 29 Luther Acres residents and 22 ManorCare residents having died of COVID-19.
Luther Acres reported 60 positive cases among residents and 54 among staff. ManorCare reported 104 positive cases among its residents and 34 among staff.
Luther Acres is offering virtual support and outdoor window visits, and hopes to reopen more visitation soon, following required safety measures, according to health care administrator Mark Kessler.
ManorCare spokeswoman Julie Beckert said nearly 600 iPads were ordered for residents to make video calls over the past six months.
All Pennsylvania nursing homes offer compassionate care visits, which allow in-room visitors for residents showing two or more documented signs of declining health. This does not apply to residents with COVID-19.
‘I try to stay busy’
Concern about isolation’s impact on mental health stretches beyond nursing homes.
Lancaster County Office of Aging’s eight senior centers, which temporarily closed March 14, reopened in September after an influx of calls from members expressing depression, said Lisa Paulson, the office’s program director.
“We’re one of the few counties in the surrounding areas that has our centers open,” Paulson said. “But we chose to do that because we were hearing from people about their level of depression and loneliness.”
The centers allow for about one third as many guests as before the pandemic but are expanding virtual programming to make up for the loss.
For some residents, staying up-to-date on COVID-19 can give them peace of mind. But for others, like Rutt, staying sane amid this year’s news cycle means avoiding it. She keeps herself occupied by solving Rubik’s Cubes, assembling puzzle books and embroidering.
“I stay away from it,” Rutt said. “There’s nothing I can do about it anyhow.
“That’s why I try to stay busy,” she said.“If I sit in my room and think about myself, my head goes crazy. It almost gives you a headache.”