As pandemic-induced isolation extends into its ninth month, residents of local senior living communities are finally reconnecting with the outside world.
Residents in independent living at Palo Alto's Moldaw Senior Residences, Vi and Channing House, who were once strictly confined to their apartments with all meals delivered to their doors, may now leave their homes for shopping, recreation and walks in the community. Those at The Sequoias in Portola Valley also have been cleared for certain outside activities, including golf.
Vi recently reopened its in-house hair salon and library and, along with Channing House, has begun to reopen its indoor dining facilities. But strict precautions apply in every instance.
At the Vi, diners must sit so far apart that "it's a little like some of the old British mansions, where people were at opposite ends of a large table," said resident Birt Harvey, adding that most people are still taking meals in their own apartments.
Though seniors in Channing House's independent living are free to come and go, "We emphasize, as does (County Health Director) Dr. Sara Cody, that just because you can doesn't mean you should," Kim Krebs, director of marketing, said. "It's always about safety first."
Channing House has constructed an open-air hair salon and visiting area in its parking lot, and all the senior housing communities have launched programs such as remote fitness and music appreciation classes to engage residents while they stay inside.
Much tighter restrictions apply for residents in skilled nursing at the senior communities. According to the Santa Clara County Health Department, nursing home and assisted living residents accounted for more than 40% of the county's 400-plus COVID-19 deaths at the end of October, underscoring the need for strict rules, which often preclude even family members from coming inside.
Such prolonged isolation from loved ones exacts a heavy toll on patients' physical and mental health, say physicians who make the rounds of nursing homes.
"I've had patients who would only eat if their family member fed them, or would only respond to their family member," Stanford geriatrician Marina Martin said.
Geriatrician Mehrdad Ayati said over the past two to three months, he's seen people getting worse in their depressive symptoms, including crying and sleep issues.
"For people who have dementia and whose children cannot come and visit, their routine has been changed," Ayati said. "In those patients I'm seeing more agitation, more behavioral disturbances related to dementia that had absolutely been well-controlled before the pandemic. Isolation makes everything become worse, both mental and physical health."
Since the lockdowns in mid-March, many nursing homes have become more proactive in promoting family contact for patients, however limited, doctors said.
"Some of them are purchasing iPads, setting up FaceTime visits and making full-on schedules where you have people signing up for certain slots of time and a nurse or staff person will facilitate that," Albert Lam, geriatrician at Palo Alto Medical Foundation, said.
"Staff will actually set it up for the residents because not all of the residents can figure it out. Some people can go on site and do what's known as a window visit," where patients and family members can see one another and talk, at a distance, through an open window or screen, Lam said.
"There are a lot of things we know (about the virus) that we didn't know before, so we can find adapted ways to have more visits with loved ones that are safe," Martin said.
Ayati predicted pandemic isolation would leave lasting scars on a whole cohort of elders.
"Even if COVID-19 stopped tomorrow morning, we're going to have a very frail older adult population" with a shorter life expectancy, he said.
But there doesn't seem to be a rhyme or reason as to why the isolation adversely affects some people but not others, Lam said.
At Channing House, Chalmers Smith, a 91-year-old retired lawyer who now lives in skilled nursing at the facility, has managed to pursue his passion for music through the pandemic — even playing duets with his daughter, Sarah Smith.
Heartbroken that the shutdown would force an end to making music with her dad, Sarah Smith designed a visiting cube made of wood, Plexiglas and acrylic.
"I tried to think of a solution where we could continue to meet, and it had to be without masks, since I'm a bassoonist and can't wear one while playing," Sarah Smith said.
After a contractor friend built the cube, Sarah Smith donated it to Channing House, where father and daughter played outdoor duets through the summer.
Now that the cube has been moved indoors, where masks are required, Smith is again prevented from playing her bassoon — but said she's considering getting a second cube built for outdoor use so she and her father can keep on playing.
At Moldaw Senior Residences, Lily Anne Hillis, a yoga teacher in her 80s, is literally counting the days. Reached by phone on Monday, Oct. 26, Hillis said, "This is, for me, Day 227 of lockdown. Being alone for me is not a new thing, but this is way over the line."
Hillis continues to practice yoga in her apartment, teach yoga and take classes on Zoom, walk in her neighborhood and drive for groceries but said the protracted isolation is wearing her down physically and mentally. At the same time, she appreciates the health precautions and said she's in no rush to return to group dining or movie theaters.
"I'd like to say that after this length of time, things are getting easier, but in my experience, it's getting harder," she said.
Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.