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Out of Sight, but Always On Our Minds

by Ira Chilton


During the COVID-19 crisis, and particularly in the United States, it has become obvious that COVID-19 preys on older people, in settings like nursing homes and assisted-living facilities. The virus is highly contagious and spreads quickly. Even as the pandemic advances and facts become revealed, we find little leadership consensus or even constructive debate on even the simplest of issues.


The lockdown of senior living and care residences has left families in a worried state wondering if their senior feels abandoned. Soon after, fear rises for the psychological health of the senior, not to mention physical deterioration concerns that might develop. Industry officials say the lockdowns have been unforgiving in many facilities, with communal dining and group activities restricted. The impact on residents surfaces in the condition of emotional well-being, and for the families who were regularly interfacing with their senior, a question of why is this happening.


Facilities are stuck with a decentralized political approach to following the Center for Disease Control policy. This has increased the stress and confusion for the public who are living in the environment between family integrity and senior care. There continues to be a hope that visitation will open, or someone in political leadership will definitively give a structure that can be observed and understood. As it stands, today one case on the first floor can mean no visitation for those on the third floor for another fourteen days in best case scenarios and for an unending time period in many scenarios exemplified regularly. Or consider, a clean facility in Texas may be closed in one county and open in the next. Or a family member tested and confirmed negative cannot be admitted into the facility but a staff member with a normal temperature can. Where is the common rationale in this decentralized approach?


It is true that many facilities are trying desperately to connect senior residents to the greater world. Window visitations are apparently opening in many places. Phone assistance for phone communication with loved ones is often cited. Virtual visitations are also listed as available to many. Many of these approaches are ineffective for those having memory issues. In these cases, the activities for these seniors is low hanging fruit to be reconceptualized. It is possible to increase exterior (outdoor) visitation zones. Can the residents have access to socially arranged virtual media rooms where virtual travel to places showing art, music, cuisine, or simple life and entertainment features can be displayed and made available? Is there even a mobility circuit within the facility allowing regular ambulation?


No one knows what the new reality will be, but we certainly have the opportunity to research and explore what may be needed in the future without preconceived opinions of the past interfering in our explorations. There is large room for improvement for addressing the pandemic situations of the future: not only for the political leaders, but also for caregivers, medical providers, residential facility owners, insurers, architects, and engineers alike.

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