A plate of glass separated Mary Smith from her family when she celebrated her 100th birthday last April.
“We had to talk through the window,” Smith remembers.
The window of Smith’s nursing home stayed closed to prevent the spread of COVID-19, so the family used cell phones to communicate.
“It was hard,” says Smith’s granddaughter, Anna Pollard. “I planned this big party to celebrate her 100th birthday. And I had to, you know, cancel the whole thing and just have it be me and my husband and my kids looking at her through a window.”
Before the pandemic, Pollard visited Smith at her nursing home in West Bridgewater every week. She’d bring food, do the laundry, chat. Then, the nursing home locked down for several months last spring. By summer, Pollard was able to visit her grandmother outdoors, but it wasn’t until vaccines became available that she could go inside the facility.
Pollard is quick to praise the staff for finding ways to keep the residents engaged, even though they couldn’t gather. But the separation from her grandmother was hard.
“Until I don't even know, not long ago, we couldn't touch,” Pollard says. “I couldn't hold her hand. I couldn't give her a hug.”
Not touching, not hugging — this was the price nursing home residents paid to try to stop the spread of the coronavirus. COVID has killed at least one in seven people who live in the state’s long-term care facilities. (The state originally reported that one in four long-term care residents had died of COVID, but recently amended its method for counting deaths, causing the number to drop.)
Now, vaccines mean that families can finally visit their loved ones again in-person, and many activities inside long-term care facilities can resume. But some relatives and doctors are finding that isolation has taken a lingering toll on the mental and physical health of older adults in long-term care.
“With social isolation, there’s increased risk of things like depression, anxiety,” says Dr. Rossana Lau-Ng, an assistant professor at Boston University School of Medicine and a geriatrician at Boston Medical Center.
It's hard to know exactly how much sicker nursing home residents became as a result of quarantine, and what declines might have happened anyway, but research shows isolation increases the risk of heart attacks and strokes. Dr. Lau-Ng says isolation made cognitive problems worse for her patients with memory loss and dementia.
“It's one of those things like, you don't use it, you lose it,” Dr. Lau-Ng says. It's as though your brain stops exercising when you stop socializing. “Your brain isn’t stimulated anymore, and any preexisting cognitive problem kind of gets exacerbated,” she explains.
Some residents also struggle to readjust when facilities reopen. Dr. Lisa Caruso, a geriatrician at Boston Medical Center, noticed that one of her patients didn’t join in when activities at her nursing home resumed, even though the patient used to love to play bingo with her friends.
“I asked her about that,” Dr. Caruso says. “And she said, ‘Well, a lot of my friends that I did those activities with passed away.’”
Her patient is re-entering a changed world, Dr. Caruso explains: "It’s just not the same. And I think she expressed to me this kind of ongoing feeling of sadness, too, about that, and about how things have changed.”
Susan Farrell, of Newton, says her family faced an impossible dilemma when her mother's assisted living facility locked down last year.
“We didn't want her to get sick and die in the hospital,” Farrell says. “And yet we see that she's lost, you know, maybe 10 months of interaction with other human beings on a regular basis. And I think that that has had a lasting effect for her.”
Farrell’s mother, Carolyn, had just moved into a facility in Newton when the pandemic shut everything down, and she was confined to her small apartment for months.
“I can't think of anything less dignified than being locked in two rooms,” Farrell says. “It kind of feels like when you were in trouble as a small child and you had to stay in your room for a time-out.”
Farrell says her mother became more frail during lockdown. The isolation, combined with her mother's severe hearing loss, made it difficult for her to form new friendships and keep in touch with family.
“I think that the entire experience has made her more isolated and alone,” Farrell says.
Her mother has started to improve now that indoor visits are once again possible. Farrell taught herself to knit, so she can join her mom in one of her favorite pastimes.
“This past weekend, she was knitting this bright salmon hat that's probably going to be for one of the workers there at the facility,” Farrell says. “And that's a sign to me that she is brightening up, taking a little bit of an interest.”
With coronavirus infection rates falling statewide and roughly 80% of nursing home residents now vaccinated, life at these facilities is returning to normal. Mary Smith was able to plan her 101st birthday, one year after her centennial bash behind a closed window. This year, she can celebrate with her granddaughter, Anna Pollard, in person.
“I'm looking forward to it,” Smith says. “And seeing Anna's husband and the kids together, too. It would be nice on my birthday to see them all together.”
The family reunited at Smith’s nursing home on a Saturday earlier this month to sing happy birthday and eat cake — all together, in one room. Pollard, for her part, is impressed with how well her grandmother weathered the months of isolation.
"That's one of the things I've learned about her this year," Pollard says, "is how resilient and adaptable she is."
This segment aired on May 13, 2021.