Gov. Andrew Cuomo is facing increasing pressure to relax a ban on nursing home visits. The ban is intended to protect residents of long-term care facilities from coronavirus infections, but many feel the policy endangers senior citizens in another way.
On March 12, just as the coronavirus starting showing up in local communities, the governor signed an executive order to keep visitors out of nursing homes. It was clear, even at that early stage, that senior citizens were at the greatest risk of serious illness and death if they contracted the virus.
The vast majority of deaths has been people age 65 and older. But the measure intended to protect them is taking its own toll.
"With prolonged isolation, people not only get anxiety and depression, they eat less, they lose strength, they may fall more, and all of these things are life threatening as well to them and certainly impact their quality of life," said Dr. Joseph Nicholas, medical director of The Highlands at Brighton, a nursing home operated by the University of Rochester Medical Center.
Those possible affects he listed? They weigh heavily on the minds of my siblings and me.
My 91-year old mother, Dorothy Pack, lives at The Greenfields, an assisted living community in Lancaster. My three sisters, my brother and I haven't seen her in three months.
"It just doesn't seem right," my mother lamented. "You can't see your own kids."
We know the staff at The Greenfields takes great care of our mom. The campus, which includes a nursing home and memory care facility, has not had any outbreaks of COVID-19. An employee in my mother's building tested positive for the virus around June 9 and was immediately placed in quarantine. My mother's test came back negative.
As far as we know, she hasn't had any physical decline since the pandemic started, but this separation is hard on her. Even my typically stoic mother, not one to complain, will admit it.
"It's a lonely feeling," she said.
For a while, we could go to her apartment window and talk on the phone, where she could at least see us through a pane of glass, but that option was taken away weeks ago.
"We had some issues with some folks coming, knocking on windows, looking in the windows of the wrong residents when the patients were getting hygiene performed by staff and really violating their privacy," said Christopher Koenig, the CEO of Niagara Lutheran Health System, the nonprofit that runs The Greenfields Continuing Care Community.
He said they have spent thousands of dollars on technology to help residents connect with their families on Zoom or Face Time, but that doesn't work for everyone. My mother, for instance, is hard of hearing and she especially has trouble hearing voices on electronic devices.
She goes to the dining room for breakfast, lunch and dinner, but residents are seated one person to a table to maximize social distancing -- another effort to shield people from the coronavirus that takes away connections.
Koenig is sympathetic to the pleas from my family and others about the suffering of our loved ones, but says they must comply with the state mandates.
"A lot of this is looked at as black and white, but sometimes the human component, which is very important, is missed by a lot of the people who make these decisions, unfortunately," he said.
Cuomo has been asked repeatedly about when the state will relax the ban on visitations. He said that won't happen until the state Department of Health determines that the reward of looser restrictions outweighs the risk of COVID-19 infection.
"I'm not going to let people endanger people, because you could walk into a nursing home to visit your mother and bring in the virus that could infect my mother who's in the next room," Cuomo said on June 11. "So, it's not just your responsibility and your parent and your loved one, it's all the other people how are in that nursing home also and your right to endanger their lives."
Nicholas thinks a shift in the thinking around this decision may be coming. Early in the pandemic, he said there was intense scrutiny and criticism of nursing homes from both the public and government regulators, so the initial reaction was extreme vigilance with infection control practices.
"I think, as you see in the rest of society, we realize we're going to have to live with COVID for some time," Nicholas said. "I think the pendulum is gonna begin swinging a little bit back the other way, where we try to find some reasonable balance of risk and benefit."
Federal guidelines are in place for the reopening of long term care facilities. At The Greenfields, Koenig said his staff is already creating plans for when the state begins allowing visitors again. He said they will likely face the same kinds of restrictions that staff currently do: temperature checks, face coverings and visits by appointment.
"It takes one hug," Koenig said. "I hate to say it, and I know that sounds harsh, but we're gonna have to take baby steps with this until there is a vaccine or there's something to make sure somebody's not going to get infected," he said.
The last thing any of us want to do is expose our older loved ones to this unpredictable disease. On the other hand, we don't want to think we'll never be in the same room with them again.
My sister, Mary, says what I and all of our siblings are thinking about our mother.
"She's 91 years old and I think every day, the time we have with her is so limited," she said. "We don't know what tomorrow is going to bring."