.Senior Care During Covid—How Care Homes and Nonprofits Shifted to Support Elders During the Pandemic

Though the World Health Organization declared Covid-19 a pandemic on March 11, 2020, when Covid actually started in the United States is a somewhat difficult question.

In early March a cruise ship, called the Grand Princess, docked off the coast of San Francisco, found Covid cases among its passengers. Shortly afterwards, Bay Area health officials announced shelter-in-place orders, and hospitals began to exceed capacity as case counts soared. By late March–early April, countries had sealed their borders, sports teams had canceled their seasons, schools had shut down and people had begun wearing masks and social-distancing.

This distancing was challenging for every demographic, but some were undoubtedly hit harder than others. The elder community was one of those groups, not only relying on the support of others to survive—whether in a facility or at home receiving care from a family member or hired provider—but also the most susceptible to Covid-19. Dangerous for everyone pre-vaccine, the virus became increasingly lethal for people older than 50, with the Centers for Disease Control putting those above 85 at the highest risk of death. Though these numbers weren’t immediately available in the months following March and April 2020, enough about Covid’s lethal effect on elders was known to require their almost total isolation from the rest of the community.

The problem is that isolation can also be lethal. The CDC, through the National Academy of Sciences Engineering and Medicine, cites loneliness and social isolation as significantly increasing the risk of premature death, even rivaling risks caused by smoking, obesity and physical inactivity. Pre-existing or not-yet-onset health issues like dementia, heart failure and depression significantly increase as a result of loneliness and social isolation.

All of these issues were made worse by the pandemic, highlighting the country’s lack of preparation for such an outcome and the cracks in our healthcare system.

Now, nearly two full years after the Grand Princess docked in the San Francisco Bay, Marin and Sonoma county elder facilities take a look back at what they’ve been able to do for their residents to ensure their quality of life and survival.

Executive Director of Solstice Senior Living in Santa Rosa Paul Peck spoke with me at length about how the organization has pivoted to meet residents’ needs during the last two years. When I asked Peck how he handled the emotional struggle of the pandemic, he spoke initially about the challenges he faced as a director, and how senior-living centers have been affected from a staffing standpoint.

“A lot of executive directors have left the industry as a result of this pandemic,” he said. “The turnover, and the struggle to hire line staff, has been significant. Some caregivers were making $1,000 a month between unemployment and the additional government stimulus, and they didn’t want to come back to work. I’ve been down a business office manager and a maintenance director for three months, and I’m finally heading to fully staffed again.”

Regarding social isolation and loneliness, Peck said it was a matter of doing everything they could to return to daily activities and dining as a community, because even though residents were delivered daily activities to their rooms, the separation was challenging.

“Really the main thing was keeping in communication,” he said. “I put out a memo every seven to 10 days to keep them updated, and meet with them on a monthly basis to update them on the facility’s staffing, progress and so on. Keeping the residents up to date as things change helps them feel connected.”

“When we finally got everyone their second round of vaccines, in March 2021, we were able to gather in-person again, which was such a lift on people’s spirits. And we redid our whole community during the shutdown. … To return not only to one another, but to a totally redone facility, really boosted their spirits,” he added.

A Spring Lake Village employee who had not received permission to speak to the press by our print deadline echoed Peck’s sentiments of keeping residents informed, also saying technology, a bigger part of all of our lives then we could ever have previously anticipated, has proved a major source of connection for seniors during the acute periods of the pandemic and beyond. 

“We had to learn to come up with ways to help our residents, and to stay connected—to teach them everything that we do. I can honestly tell you that seniors are now using cell phones, ipads, computers and email and Zoom meetings who probably never would have otherwise as a source of communication, and that has kept us connected,” the employee said. “They’re sharp, and I’m constantly surprised at what people can learn. And, truly, the need for connection exploded, so we had to figure out how we could keep people healthy while keeping them connected. And I think we were pretty successful.”

I asked Marin County-based nonprofit Vivalon, which serves the senior community, how they responded to the dangers of senior isolation.

“​​Since Vivalon provides essential services, we pivoted without missing a single meal, ride or class,” Chief Operating Officer Nancy Geisse said. “Throughout the pandemic, we have provided our classes free of charge to encourage participation, offered free delivery of our Jackson Café meals and Brown Bag Pantry groceries, and even when we reopened continued these services knowing some older adults were still isolated. Throughout the pandemic, combating social isolation has been a top priority for Vivalon, and we will remain devoted to fighting loneliness in Marin’s older adults.”

Vivalon CEO Anne Grey said, “At Vivalon we know all too well that a key social determinant of health is social isolation amongst older adults … . As we addressed social isolation during the pandemic, we found loneliness prior to the pandemic was even larger than we had thought. We’ve always incorporated social connection into our programs and services … but we now know we have to do more. We’ve launched technology-training programs for our seniors, to make sure they’re able to stay connected with contemporary tools.” 

It’s an ongoing conversation that Sonoma and Marin Counties, along with their respective health and aging boards, will continue to address as circumstances develop. Teaching seniors how to use modern tools like cell phones, Zoom and other forms of internet-based connection seems to have played a vital role in fighting pandemic-related isolation, as well as continuing to keep them informed on the changing circumstances and variants so they don’t feel kept in the dark. Still, basic decency—continuing to treat seniors like respected and valued members of the community—is vital to their continued health during these trying times.

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