Caring for older residents in senior living is a balancing act

A recent op-ed in The Hill by Dr. Thomas W. LaGrelius raised some important clinical consequences from COVID-19-based policies that essentially “lock down” older adults residing in senior living communities across the nation. 

Dr. LaGrelius points out that many older adults now find themselves in isolation with increased inactivity and immobility, which can lead to increased confusion, anxiety and depression. Loneliness has certainly been established as a major problem if not a killer of people at all ages, but particularly for older adults. He argues that total lockdown is not an approach that protects seniors, and he instead argues for lesser precautions that do not isolate seniors from their loved ones and friends. 

Ultimately, senior living communities should do whatever they can to save lives. This means continuing to implement measures that limit seniors’ interactions, and therefore their potential for contracting the disease, while also allowing for some return to normalcy by providing opportunities for engagement. To save lives, senior living communities must strike a balance. 

Senior living communities should take the following five steps to achieve needed balance:

First, just as the national approach to reopening states has developed policies that reinforce leadership at the local level, the same should be true for senior living, as communities in different states have different realities. Local leadership in specific communities should develop policies and protocols that match their unique needs.

Second, communities must be guided by their ability to procure increased resources for testing and protective equipment. Federal and state governments must recognize that senior living communities need these resources in order to start easing restrictions. Given the known vulnerabilities of older adults to COVID-19, senior living should never be used as a place to admit others infected with COVID-19.

Third, senior living communities should develop innovative methods to permit family and loved ones to visit senior living residents in person. From the moment of birth to our last breath, humans require human interaction, touch and expressions of love. A person can go from thriving, to failing to thrive without such human and loving interaction. Implementing additional infection control measures is one way to permit such in person visitation. 

Fourth, communities should create protocols that allow for families to be bedside, as able, when a loved one has entered hospice. As a moral imperative, we, as a nation, should not accept current policies that restrict proper in person funerals and burial. There are enormous psychological factors regarding the proper death and dying experience and we need to do better.  

Fifth, ongoing updated guidelines detailing infection control, social distancing and a phased-in approach to returning to a normal way of life within the senior living communities are needed to educate, update and assist leadership return to normalcy while respecting proper infection control guidelines.

The senior living industry is blessed to have strong leadership, integrated networks of communication and loving and heroic frontline care providers. By taking the steps above, senior living communities can achieve a balanced approach that respects the holistic needs of older persons to thrive while meeting the ongoing needs to control infection and mitigate spread. 

But none of this will be made possible unless our government and nation prioritizes the older adult, the families of older residents and the teams of professionals who care for them. The senior living industry needs PPE, testing and funding to innovate methods that strike a proper balance. In the end, our approach and how we choose to behave towards our elders reflects the moral identity of our nation. 

I suggest if our policies adhere to basic human needs, lead with love, follow with kindness and are data driven we will achieve the balance needed at this time.

Paul D. Nussbaum, Ph.D, ABPP, is president of the Brain Health Center. He’s also an adjunct professor of neurological surgery at the University of Pittsburgh School of Medicine.