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Lucinda Tinsman used to go to a Menlo Park memory-care home every day to visit her mother, who has advanced Alzheimer’s. She’d sit next to her, spoon feed her water mixed with a thickening solution and attend to her needs.
The people there work hard, she said, but none could dedicate as much time as she did to her almost 84-year-old mother, Marilyn. And although Marilyn needs constant care — feeding, bathing and hydrating — “she’s not a vegetable” and still recognizes her familiar face, Tinsman said. “Every time she sees me, a big light breaks out on her face.”
So when Gov. Gavin Newsom on Sunday told California nursing and care homes to bar all visitors except those with loved ones close to death in a statewide effort to slow the exponential spread of coronavirus, Tinsman became alarmed.
She wasn’t alone.
“While advocates and residents understand that restrictions on visitation is an important part of infection control, for families this really feels like throwing loved ones down a well,” said Mike Dark, a staff attorney with California Advocates for Nursing Home Reform.
“Almost every hour, I’m getting calls from family members who are desperate,” he said.
That desperation is compounded by the steady stream of revelations that coronavirus is rapidly spreading into nursing homes — many of them understaffed and ill-equipped to handle a pandemic, Dark said — whose residents are especially vulnerable because of their age and medical ailments.
One of the nursing facilities the virus has invaded is Silver Oaks Memory Care, the home of Tinsman’s mother. In addition, five residents at Atria Senior Living in Burlingame have contracted COVID-19 and one at the Los Altos Sub-acute and Rehabilitation Center. A staff member at The Forum in Cupertino has also tested positive.
And a U.S. Centers for Disease Control and Prevention report issued this week confirmed that a Washington state outbreak of COVID-19 cases included 129 linked to the Life Care Center of Kirkland, a long-term care facility. Of those, 35 have died from the disease, mostly elderly residents.
Meanwhile, some like Tinsman are pulling their loved ones out of nursing homes — either because they’re worried the coronavirus pandemic is overwhelming the nurses, technicians and others who work there or simply because they’d rather be with them than abide by visitation restrictions.
Tinsman said she felt the employees of Silver Oaks Memory Care provide good care, but with face masks in short supply and everyone stressed, she feared an invasion of coronavirus was inevitable.
She was told a patient had already tested positive for COVID-19 — San Mateo County health officials have since confirmed that — so after much wrangling this week, she managed to get her mother out of there, had her tested, moved her into her own home in Menlo Park and hired a caregiver. They are currently isolating and awaiting the results.
Dark said the concerns he’s hearing from people about nursing homes’ ability to handle the spread of coronavirus are not unfounded.
“Historically, nursing homes have been terribly understaffed. Most of the care provided in those homes is given by people who are making minimum wage who are overworked and largely untrained,” he said. “What was already an understaffing crisis in California is (amplified) by the virus’ movement through skilled nursing homes.”
Nursing homes say they’re following the guidelines set by the CDC as health authorities. In addition to the ban on visitors, many say they are reducing or halting group activities and programs, doing extra sanitizing and regularly checking the temperatures of residents and staff.
It’s hard on residents, said KJ Page, administrator of a small nonprofit care home in Berkeley called Chaparral House.
“Some people are really agitated their families aren’t here,” Page said, and some residents are also annoyed at having to use hand sanitizers so frequently or being cooped up inside their rooms.
Page said concerns about staffing and equipment shortages loom large. While many nursing home employees work full-time, some are part-time and also work at hospitals.
To help residents and families stay in touch, Chaparral staff is helping to facilitate video chats and calls, Page said. Other nursing homes have done the same, urging families to FaceTime or Skype their loved ones.
That’s really important, said Lori Smetanka, executive director of the Consumer Voice, an organization that provides support and training for long-term care ombudsmen programs throughout the country.
“Not only do they want to have that contact with them to assure themselves and to help with the emotional and psychosocial needs of the resident,” Smetanka said, “but many family members provide additional support in ensuring residents get what they need.”
Mark Lockaby’s 92-year-old mother lives in an assisted living and senior living community in San Pablo run by Brookdale, a national chain of senior communities. While staffers there help her mother shower and get in and out of bed, Lockaby used to visit about twice a week to bring her supplies or her favorite snacks, take her to appointments and provide other help.
“She has three things she enjoys in life: family visits, watching sports on TV, reading,” Lockaby said. So losing family visits and without sports to watch, “she’s totally upset. She’s totally aware and communicative, but her hearing is very poor, so when I called to try and explain everything on the phone, she’s not getting it.
“It’s very, very hard on these residents,” he said. Add to that the fact Brookdale San Pablo residents have been facing the possibility of eviction since January, when the facility told them it was discontinuing the lease and no new operator would be taking it over as a senior living home. The eviction deadline has been extended to the end of April, though many have already left.
While Lockaby tries to reassure his mother that he and his siblings are taking care of any possible moves, the threat of coronavirus itself has ratcheted up the stress and the restriction on visitors — which he agrees is necessary — makes it so much harder.
“It’s horrifying,” he said.
Hospitals also have strictly restricted visits, particularly of elderly or medically vulnerable patients.
Mark Reid, 63, of Hollister, had been staying in the hospital room of his wife, Karin Reid, for more than two weeks as she underwent heart surgery at Stanford Hospital. She’s been medically fragile for years and on dialysis, said Reid, her caregiver and advocate.
Stanford gives great medical care, he said, but his job is to give her “comfort care” — washing her mouth out with a swab, spraying the back of her throat with softener, or just getting a piece of ice. She can’t hear very well, so communication is hard.
“But she can understand me and I understand her much better than all the nurses,” Reid said. “So they would come in and explain to her about what needed to be done. I had to re-explain it — that was what I was there for.”
But last weekend he was told he’d need to leave. No more visitors — even family — as restrictions to prevent the coronavirus spread tightened around them.
Reid understands why, but to think of his wife of 44 years “disoriented and surrounded by strangers” brings tears to his eyes.
“This is the collateral damage of this virus,” Reid said. “To get a handle on it, there is this collateral damage that is behind the scenes.”
