We now know just how vulnerable older adults in long-term care have been during the pandemic. COVID-19, especially in the pandemic’s early months, cost many their lives far too early. Even today we are seeing the disease bring premature death to the elderly, especially at facilities with lower staff vaccination rates. Just two days ago, NBC news reported the following disheartening NEJM study results:

“People in nursing homes are much more likely to die of Covid-19 if the staff caring for them remains largely unvaccinated, a study published Wednesday in the New England Journal of Medicine found.”

Other forms of decline accelerated by the lockdown.

But the isolation from family members and other external contacts imposed by the many months of lockdown had other less easy to measure costs. This month’s Reflections essay, “Again in a Heartbeat,” by Jeanne Kessler, MSN, RN-BC, details her own dawning awareness that something had begun to change in her mother as time went by during the lockdown at her assisted living facility.

Suddenly her mother couldn’t talk on the phone any longer. This wasn’t like her at all. Her attention span had shortened drastically. There were other worrisome indications. While someone who didn’t know her mother and her history might have just accepted the change for the worse in her cognition, since she already had some dementia, Kessler had studied delirium, and knew that it can easily be confused with dementia.

Distinguishing delirium from dementia.

The change in her mother’s mental status while in isolation had been just too rapid, and Kessler decided to bring her home. 

Lab and physical exam results ruled out a medical cause for her delirium, which I therefore attributed to the effects of her COVID-imposed lack of stimulation, altered routine, and isolation.

Gradually, with regular interaction, she was able to bring her mother back to her baseline level of cognition. I’m just giving the bare bones of the story here, and it’s worth reading for the clear narration and many convincing details that draw us into the essay.

Again in a heartbeat.

Near the end of this short essay, Kessler sums up the situation with eloquence.

My mom, who is still living with us for the time being, is a good mother who sacrificed a lot to give me a good start in life. How could I do any less for her in these later years of her life? I’m sad for the many elderly who died alone, afraid, and unable to say goodbye to loved ones. I’m grateful that I had the resources to do what I did for my mom. I would do it again in a heartbeat.

The article will be free to read for the rest of December.