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COVID-19 and Elder Care: A family struggles to cope with isolation amid the pandemic

It was to be only a 30-day respite trial period when Vittorio C., a proud, strong, 84-year-old New Yorker, went to a memory-care facility in South Florida during March of this year.

Five years ago, dementia had begun to intrude into the life of Vittorio, his wife Elizabeth, and their family, limiting the travel and Florida retirement he so enjoyed. As the disease progressed, he frequently became agitated, confrontational and began to wander, at times putting himself at risk.

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Caregiving responsibilities were so heavy that his wife Elizabeth’s health buckled under the strain in early 2020, putting her in the hospital suffering from exhaustion. The family decided that Vittorio should try living in a brand-new memory-care facility in Florida.

Then the coronavirus put all Florida elder-care facilities on lockdown. “When we brought him there, they took him upstairs from the lobby doorway, and that’s the last time I saw my father,” says his daughter, Victoria.

Family members say the isolation is taking a heavy toll on Vittorio: Increased agitation, confusion, disorientation, depression, some weight loss and overall mental and physical decline.

Vittorio’s family is not alone. AARP members nationwide are reporting concerns that their loved ones are suffering in the social isolation that officials have ordered to reduce the risk to residents of elder-care facilities.

A recent review of state policy and implementation by AARP staff in each state turned up widespread concerns about flawed policies on testing of staff and residents, inaccurate information being provided to families, inconsistency in testing requirements, and widespread concerns that even when states establish sound policies, implementation may be inconsistent.

For example, AARP staff in many states reported hearing that frontline nursing staff in facilities still lack adequate personal protective equipment, despite claims from some officials that adequate supplies are on hand.

Victoria C. shares many of those concerns, particularly regarding delays in getting testing results for frontline staff. In her father’s facility, administrators were posting statements on social media thinking the facility was free of COVID-19, while days later, state reports showed two staff members had tested positive but were symptom-free.

AARP believes that delays in getting testing results can cause gaps in protections for both residents and staff – a situation that could be prevented if rapid-turnaround tests could be made available to facilities.

Like others AARP Florida have heard from, Victoria is also concerned about staff shortages and staff burnout because of the extra load on elder-care staff caused by the pandemic. Meanwhile, industry representatives have been pressing state lawmakers to relax state standards for the hours of daily hands-on care that facilities must provide to residents.

Victoria is also concerned that family members can no longer visit her father, to help him with some grooming needs, oversee his care and serve as his advocate. Most of all, she mourns the lost opportunities to connect.

“We’re losing precious time with him,” says Victoria, a Manhattan attorney and entrepreneur. “We’re missing all the milestones, his 58thh wedding anniversary in May, Father’s Day in June, and his 85th birthday in July.”

AARP Florida continues to advocate for these principles:

- Test all elder-care facility staff frequently: AARP Florida believes this is key to protecting elders living in facilities. Ideally, staff should be tested daily before reporting to work, using quick-turn testing methods that allow results to be known quickly.

- Tough infection control: AARP Florida is calling for adequate supplies of personal protective equipment, rigorous training in infection control and tough oversight to ensure policies are followed.]

- No blanket immunity for facilities: Some industry representatives are asking lawmakers to provide blanket immunity from lawsuits for elder-care facility. AARP does not support taking away the right of families to hold facilities accountable for lapses in care in court.

- Effective visitation policies: Families play a critical role in the care of elders living in facilities. If families cannot visit in person because quick-turn testing is not available, then virtual visitation should be mandatory.

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