Nursing home lockdowns are forcing families to say goodbye

“If he passes, I don’t even know how I’ll get through that.”

Two weeks ago, during her daily visit to her dad’s nursing home on Staten Island, New York, a nurse notified Jan McDonnell that they were setting up stricter restrictions in response to the growing coronavirus threat. Visitors won’t be allowed after today, the nurse said.

While McDonnell digested the information, she thought it was best to go about the routine she has kept with her 94-year-old father for the past two-and-a-half years. She shared his favorite chocolates with him as they watched classic movies together. She took out her packed lunch while he ate his meal served by the nursing home.

Toward the end of her visit, she informed him about the facility’s lockdown that would begin the next day and explained that he may not see her for a while. Then she kissed him and left. It still seems surreal, she said: “I never really thought that would be it.”

Courtesy of Jan McDonnell

McDonnell said she knows the lockdown is a necessary measure that needs to be taken to protect her dad because, as a person with an obstructive lung disease, he is at a particularly higher risk of catching Covid-19.

But “he misses me, and I miss him,” she said. “I’m an only child. We’ve always been close. And this is like a living hell for me.”

As the Covid-19 pandemic sweeps the country, many are in the same predicament as McDonnell, worrying that the goodbyes they shared at the beginning of a nursing home lockdown will be their last.

Nursing homes have become hotspots for Covid-19 breakouts. Not only do elderly people have a high risk of catching the disease caused by the coronavirus, but in nursing homes they live in close proximity to each other, making spread easier. Thirty-five people died in a Kirkland, Washington, nursing home. Five died in a Mount Airy, Maryland, facility. And nearly 15 percent of New York’s death toll comes from nursing home residents. As a result, many nursing homes have been closing their doors to visitors indefinitely. If families are lucky, they get to say their final goodbyes in person. If not, they have to bid their farewells over the phone.

“If he passes, I don’t even know how I’ll get through that,” McDonnell said. “So I’m just praying that they’re taking good care of him.”

Families are worried that their loved ones will live — and die — alone in nursing homes during the pandemic

Nursing home lockdowns have altered the lives of families used to regularly visiting their relatives, riddling them with uncertainty and taking an emotional toll on both parties.

Kat, a 20-year-old Rutgers University student who asked to remain anonymous, said she was heartbroken to hear that she could no longer see her mom — especially because she wasn’t able to say one last goodbye before the lockdown.

“I’m a full-time college student, I’m pre-medicine, I’m studying for my MCAT. I have a full-time internship, and I teach at the university I go to. So my schedule is very busy,” she said. “So the small times that I’ve gotten to see my mom since she’s been in the nursing home have meant the world to me.”

While Kat said she’s been able to call her mom over the phone, it doesn’t help her feel safer, nor can it replace their ritual of them lying in bed together as Kat talks about her school life. And Kat remains worried about the possibility of her 52-year-old mom getting ill since her underlying health conditions make her more vulnerable to the virus.

It’s not just the comfort of rituals that have been disrupted by the pandemic, either. Celebrations that should be joyous have now ceased, as was the case for Janel Forte’s grandmother. Forte, who drives between Houston to Dallas at least every three weeks to visit her grandma, said she was unable to be there for her 96th birthday. If the pandemic hadn’t hit, Forte said her entire family would have thrown a big party for her grandma like they always do — complete with a birthday outfit and sweets. This time around, however, Forte said the nursing home wouldn’t even let her family drop off her grandma’s special outfit in fear of the package being infected.

Courtesy of Janel Forte

Although Forte’s been trying to explain to her grandmother over the phone why she can’t visit, she knows it’s a lost cause because of her grandmother’s dementia. She’ll have to explain again during the next call, when her grandmother will still understand very little. It’s a scary situation, she said, especially considering her grandmother is at high risk of contracting the virus and dying from it.

“You hear the horror stories about people who have gotten this, and then have been isolated because they had the virus and then ended up passing by themselves,” Forte said. “So it’s just a lot of uncertainty. And a lot of it is very scary.”

Although Kat hopes to see her mom in the near future, there’s no telling when nursing homes will open up their doors again — and it’s not helping that people are ignoring social distancing rules that could flatten the curve and help her reunite with her mom sooner. She said she was frustrated with her peers who went on their spring break trips without considering the consequences of their actions.

“[They’ll say,] ‘I’m not going to let this ruin my trip.’ You’re not gonna let it ruin your trip, but when you come home and you kill grandma, then it’s going to be an issue,” she said. “But until it affects them, they don’t care. This has affected me long before it got worse.”

While many of Kat’s friends can return home to their parents during the pandemic, that’s something Kat cannot do. All she can do is look forward to the day she can hopefully see her mom again.

“I am going to probably sit in her bed and just hold her and tell her how much I love her because I just miss her hugs,” she said.

Coping and coming to terms with the inevitability of the situation

For Kat and others, thinking about their loved ones, seemingly alone, while they also wait out the uncertainty of the pandemic can be doubly distressing.

Rev. Marie Siroky, a hospital chaplain in Indiana, said a lot of emotional stress comes from not only worrying about losing precious time with the loved ones but also being unable to practice the rituals of death if they do pass. During the pandemic, families can’t hold a funeral, read out prayers, or even see their relatives draw their last breath. And they’re often afraid this lack of witnessing or ritual is perceived as them not caring, or that they haven’t done their best for their loved ones, even during a pandemic.

But for these people, Siroky has one message: It’s not your fault, and there’s nothing you could have done differently.

“It’s easiest to accept it,” she said. “You’re not going to be able to get out there to say goodbye. You’re not going to be with them when they’ve died. … It’s sad, but [right now] you have to protect yourself and we have to protect others.”

The best way to get through these times is to create rituals that allow family members to honor and remember their loved ones while they are still alive, Siroky said. Families can set up small areas in their house where they can cherish their loved ones through prayers, pictures, and anything else that brings up good memories. And as silly or as uncomfortable as it may seem, she also recommends that, from home, people address their family members out loud, saying what they wish they could say to them in person.

“If you’re not used to talking out loud, it’s going to be strange, but say, ‘Mom, Dad, I really want to be there,’” she said. “And then you may start crying, but you’re getting it out because it was in your head. At least you’re putting it out there.”

But even Siroky, who as a hospital chaplain has years of experience with death, acknowledges the difficulty of following her own advice during times like this. It’s been hard for her to do her job because she’s barred from entering the rooms of patients due to the lack of protective gear for her to wear. On Monday, she said she found herself screaming prayers for a dying patient from the doorway — and deep down she found herself wondering, “Where’s the holiness in this?”

Nevertheless, Siroky encourages people to celebrate the lives of their loved ones in whatever way they can: Think about them daily, write down the important memories, practice whatever rituals you’d have wanted for their death once the pandemic passes.

“Be creative and if you can find a way to do the ritual now, [do it],” she said. “This is your life and the person you loved’s life and their death. They need to be honored in whatever way you want to do it.”

For many with loved ones in nursing homes, death is a possibility that’s always in the back of their minds. But that doesn’t mean it’s easy to come to terms with. McDonnell said she wishes for her dad to make it to his 95th birthday in August. She still holds out hope that the lockdown will be lifted sooner rather than later.

“Maybe in eight weeks or something, I’ll be able to see him again,” she said. “I’m trying to have faith and be strong.”