As Coronavirus Slows Its Spread In Elder Care Homes, Residents Still Face Another Health Battle: Loneliness

Mapleton Care Center Coronavirus Outbreak
Hart Van Denburg/CPR News
The Libby Bortz Assisted Living Facility in Arapahoe County had a COVID-19 outbreak that claimed six lives. It was declared resolved on May 14.

In March and April, hundreds of residents in nursing homes died as COVID-19 ripped through elder care facilities. It took months for facilities and the state to build better testing capacity, create isolation plans for sick residents and expand access to personal protective equipment, but over the last several weeks, new outbreaks in nursing homes have declined significantly.

According to outbreak data released Wednesday by the Colorado Department of Public Health and Environment, only one nursing home and one independent living facility reported new COVID-19 outbreaks this week. This is the lowest single week total for outbreaks at elder-care facilities since mid-March.

While the immediate threat of COVID-19 outbreaks has declined, health experts have now turned their attention to another serious risk the virus poses to the well-being of nursing home residents: loneliness.

Most residents in nursing homes have not seen anyone from the outside world since March 12, when a state public health order designed to limit the spread of COVID-19 banned visitors from entering nursing homes and assisted living centers. That same order also limited communal activities in most facilities, leaving many residents in almost total isolation.

While these isolation measures were deemed necessary to protect elderly residents, who are particularly vulnerable to COVID-19, isolation also carries health risks for older adults.

“What we know about loneliness is that it is linked to poor health indicators. So it can increase a person’s likelihood to develop more medical problems,” said Dr. Sheri Gibson, a geropsychologist at the University of Colorado — Colorado Springs. "Among older adults, it has even been linked to early mortality."

Some residents in elder care facilities fear the restrictions on their freedom and the isolation more than contracting the disease. Claudia, a resident at a transitional rehabilitation facility, said she’s been confined to her room since the public health order took effect. Claudia asked that her last name not be used because she feared retribution from the facility where she was living.

“For the length that it has gone on, it is just wearing away at the people here,” she said. "The people that were ill before are getting more ill, the people that were depressed, they're getting more depressed. I have leaned on my faith so hard and my faith has kept me strong, but I'm getting to the end of my rope too."

Besides not seeing her family and other residents, Claudia said the pandemic also took away what independence she did have in the facility where she lives. Simple things like being able to make her own coffee in the kitchen or fetch food from the dining hall are now handled entirely by the staff in order to limit contact between residents.

The pandemic-induced restrictions have taken away many of the basic pleasures and needs of older adults in elder-care facilities, Gibson said.

“One of the benefits of living in nursing homes that residents often talk about is that they feel safe in nursing homes. The pandemic has ripped that away,” she said. “This has put a lot of pressure not only on the resident to manage that type of isolation, but also on families who know that their loved ones are isolated.”

In response to rising concerns of the mental health of elder-care residents, Gov. Jared Polis announced last week that the public health department was creating a plan where people could get passes to visit their family members in nursing homes. The new system will allow people who test negative for COVID-19 to get a 48-hour pass to visit a family member or friend at a nursing home.

In a press conference Wednesday, public health officials confirmed that they were preparing to allow visits, but were unsure when the new program would launch, citing the ongoing risks of COVID-19 infiltrating elder-care facilities.

“The [health] department and the governor's office are extremely concerned,” said Randy Kuykendall, the director of health facilities for CDPHE. “But I think it's important to remind all of us that this is not over even though the curve has been flattened. With the populations being served in these facilities, we're concerned because we're probably only going to get one chance to get this right.”

While Kuykendall acknowledged that the state’s efforts to protect elder-care facilities likely helped reduce new COVID-19 cases there, he attributed much of the reduction in outbreaks to the general decline of COVID-19 in the state as a whole. He warned that elder-care facilities remain at high risk for outbreaks.

"I don't think they have turned the corner,” he said, referring to elder-care facilities. “We all agree and understand that we're in for a long battle with the disease until such time as vaccinations come along.”

New outbreaks for the week of June 10

The number of new outbreaks has fallen across all sectors in Colorado, not just elder care facilities. The state only reported a total of 11 new outbreaks this week, which included two grocery stores, three indoor workplaces, two warehouse-type facilities, a prison and a gutter cleaning company.

Aguirre Law Group

  • Date outbreak confirmed: 06/03/20
  • Type: Indoor workspace
  • County: Adams
  • Number of COVID-19 cases: 5 staff positive

Alpine Waste and Recycling

  • Date outbreak confirmed: 06/05/20
  • Type: Waste management
  • County: Adams
  • Number of COVID-19 cases: 4 staff positive

Bank of the West

  • Date outbreak confirmed: 06/05/20
  • Type: Office
  • County: Adams
  • Number of COVID-19 cases: 2 staff positive, 1 staff probable

Chateau Des Mons

  • Date outbreak confirmed: 06/10/20
  • Type: Assisted living residence
  • County: Arapahoe
  • Number of COVID-19 cases: 5 residents positive, 7 staff positive

City Market Store #433 El Jebel

  • Date outbreak confirmed: 06/08/20
  • Type: Grocery Store
  • County: Eagle
  • Number of COVID-19 cases: 4 staff positive, 2 staff probable

City Market Store #434 Eagle

  • Date outbreak confirmed: 06/08/20
  • Type: Grocery Store
  • County: Eagle
  • Number of COVID-19 cases: 4 staff positive

Federal Correctional Institution Englewood

  • Date outbreak confirmed: 06/04/20
  • Type: Prison
  • County: Colorado
  • Number of COVID-19 cases: 4 inmates positive

FedEx Ground Henderson

  • Date outbreak confirmed: 06/05/20
  • Type: Distribution Center
  • County: Adams
  • Number of COVID-19 cases: 8 staff positive, 9 staff probable

Next 1 Labs

  • Date outbreak confirmed: 06/08/20
  • Type: THC Laboratory
  • County: Adams
  • Number of COVID-19 cases: 4 staff positive

Rocky Mountain Gutters

  • Date outbreak confirmed: 06/03/20
  • Type: Gutter cleaning
  • County: Garfield
  • Number of COVID-19 cases: No data provided

Vi at Highlands Ranch

  • Date outbreak confirmed: 06/09/20
  • Type: Independent Living Facility
  • County: Douglas
  • Number of COVID-19 cases: 6 residents positive, 1 resident probable, 3 lab-confirmed deaths, 1 probable death, 2 staff positive, 8 staff probable