Care home isolation takes 'heartbreaking' toll on Albertans as pandemic drags on
Concerns growing about mental health impacts of locking down nursing homes
Loneliness. Fear. Agitation. A relentless desire to escape.
The world of 91-year-old Naomi Charles has collapsed. And her daughter, Calgarian Ruth Dantes, can only watch from afar.
Like thousands of other Albertans living in continuing care, Charles has been deprived of family visits — mostly isolated in her room — as public health officials and care home operators wage war against COVID-19.
Charles has vascular dementia and moved into a Calgary assisted living facility, Millrise Seniors Village, in November.
Prior to the pandemic, she suffered from some memory lapses. But she was strong. Her family would visit her daily — for hours at a time— and bring her homemade food in an effort to ease the transition.
All that came to a halt when it became clear Alberta's continuing care facilities were bearing the brunt of the COVID-19 pandemic and were ordered to lock down. The cherished daily family visits stopped.
"This loneliness of not being able to touch and feel and put her arms around us — that is the worst part," said Dantes.
Charles was diagnosed with COVID-19 in April after an outbreak in the care home. She's been hospitalized twice since then. And other than a brief visit as she was being discharged from the hospital and a half hour outdoor visit last week, she hasn't seen her family.
According to Dantes, her mom has been isolated in her room for weeks at a time as a result of her COVID-19 diagnosis and precautions after her hospital stays.
"The loneliness. The sadness. There is fear. She's got so much fear she can't sleep some nights," Dantes said.
Charles doesn't understand why she can't see her family and frequently talks about being abandoned. Her mental health has deteriorated dramatically since March, and according to her daughter, she's like another person.
In an effort to calm her, Charles's doctor has prescribed anti-depressants.
She's become aggressive at times, driven to get out of the building.
She recently tried to escape from her care home in the middle of the night. Staff found her in the parking lot at 3:30 am.
"She was talking to the doctor yesterday and she said, 'is there anything you can give me to just die?'" Dantes said.
"Now, to see her like this, is a little bit heartbreaking."
"It just makes me so sad because I'm sure this is just one of so many cases of this happening," said Kirsten Fiest, assistant professor of critical care medicine at the University of Calgary.
She is researching the mental health impacts of restricting family visits in nursing homes and hospitals during the pandemic.
She's not surprised to hear stories like this.
"The impact that family members can have on the mental health and cognition of people living in those facilities cannot be understated. They are essential members of the care team," Fiest said.
"Fear, anxiety, distress, depression. These are things that it wouldn't be surprising to see manifest — based on the research that we know outside of COVID — in individuals who've been isolated for long periods of time, especially those who are in long-term care facilities.… They almost certainly are frail, are older and have chronic health conditions that put them at risk for these things."
According to Fiest, mental health problems such as anxiety and depression are under-recognized in long-term care, so vigilance, now more than ever, is key.
"I do think the magnitude of the problem is probably larger than we'll ever know."
Alberta looking at easing restrictions
Alberta Health says it has heard from families with similar concerns and it is looking for ways to ease the visitor restrictions in continuing care homes while still keeping residents safe.
At the end of April, the province decided to start allowing limited outdoor visits in some situations.
And Alberta's chief medical officer of health, Dr. Deena Hinshaw, is considering further steps. She conducted three telephone town halls this week asking for input from residents, families and care home operators.
"I think it will make a big difference," said Fiest, who believes now is a good time to allow more family visitation with strict controls in place.
For her part, Ruth Dantes worries all this may come too late for her mother and many others.
She's been told her mom now needs a higher level of care and will very likely have to move to another facility.
"It has been traumatic. Emotionally, for me and my family, it has been hard."