Her father fell victim to the pandemic. But it wasn't Covid-19 that killed him. - Yahoo News

Chester Peske, 98, loved to sit in the lunchroom at Copperfield Hill and talk to the other memory care residents about everything from the weather to the history of the highway that connected his hometown to downtown Minneapolis, 6 miles away.

When the pandemic hit, long-term care facilities across the country, including Copperfield Hill, shut their doors to visitors and largely kept residents to their rooms, suspending most group activities and communal meals to protect residents from Covid-19.

Even more isolated in quarantine after his Covid-19 diagnosis, he was becoming quiet and disengaged, even with the staff members who tended to him, a nurse later told her.

Social isolation was listed as a contributing cause of death for at least nine other Minnesotans — almost all long-term care residents — from June to September, according to state death records; no deaths in the previous two years cited social isolation as a cause.

The phenomenon is far harder to track than the number of Covid-19 deaths linked to long-term care facilities — 84,000 as of early October, according to the Kaiser Family Foundation — as it is unusual to list isolation as an official cause of death.

One recent study of a Chicago-area nursing home found that from December 2019 to the end of April 2020, two-thirds of the residents had lost weight, in some cases dramatically — a change that researchers attributed to reduced social interaction, the cessation of family visits and schedule changes due to the pandemic?

“Sometimes the doors to their rooms are open, and you just see someone sitting in a chair with tears running down their face,” Aronson, who is assisting San Francisco’s response to the pandemic in long-term care facilities, said.

Do you have a story to share about how the coronavirus is affecting nursing homes.

While most states have begun allowing some form of routine in-person visits for long-term care facilities, the guidelines vary widely, and many restrictions remain — not only to protect residents, but also vulnerable front-line staff members, many of whom are low-wage Black and Hispanic workers.

Many nursing homes have resumed communal dining and group activities, but still require residents to remain distanced from one another.

hit a new record number of Covid-19 cases, and nursing homes from Massachusetts to Wisconsin are reporting new outbreaks.

At the same time, policymakers need to weigh the competing risks, said David Grabowski, a health policy professor at Harvard Medical School, who recently served on an independent federal commission that recommended expanding in-person visitation at long-term care facilities.

But while deadly coronavirus outbreaks at nursing homes tend to grab headlines, the slower-moving health crisis inside these facilities caused by social isolation and confinement remains largely invisible.

New York was the first state to ban visitors from nursing homes in mid-March, and other states quickly followed suit.

At least 6,600 long-term care residents in New York have died from Covid-19, an undercount that doesn’t include those who died after they were taken to the hospital.

While nursing home cases and deaths have ebbed since the spring, New York has remained cautious about reopening long-term care facilities to visitors.

Premier Genesee was preparing to begin outdoor visits under the state’s new guidelines when a staff member tested positive in late July, pushing back the reopening, as required by the state.

Noody and other angry family members held a local rally in early September protesting the state’s visitation restrictions; other grassroots groups have held similar protests elsewhere in New York and other states.

The Covid-19 restrictions are especially painful when residents themselves can’t understand why their family members have stopped coming to visit.

More than half of nursing home residents have moderate or severe cognitive impairment from Alzheimer’s, dementia and other conditions, according to the Centers for Medicare and Medicaid Services.

Before the pandemic, Adele Billig constantly circulated throughout her nursing home in Delray Beach, Florida, always showing up for bingo, poker night and karaoke, where she loved belting Frank Sinatra.

Even when family visits resume, there are usually significant restrictions in place.

Markese and other family members are now pushing New York officials to create a program that would enable them to be recognized as “essential caregivers” — a designation that would allow them to provide hands-on assistance and companionship for loved ones in long-term care facilities.

In June, Indiana became the first state to permit essential caregiver visits for family members who had tended to residents at least two times a week prior to the pandemic, subjecting them to the same Covid-19 testing requirements as staff members.

Markese knows how deadly Covid-19 can be; 11 residents and one staff member have died of the virus at her grandmother’s nursing home, according to federal data.

“If we follow the same protocols in place as the staff members do — the staff members who bathe my grandmother and help toilet her and help comfort her by holding her hand — then why can't I hold her hand.

To address the impact of prolonged isolation, the Centers for Medicare and Medicaid Services issued new guidance in September to help expand “compassion care” visits in nursing homes.

In addition to allowing end-of-life visits, facilities could also permit families to visit residents who are losing weight or dehydrated and need encouragement to eat or drink, as well as residents who are “experiencing emotional distress, seldom speaking, or crying more frequently,” the new guidance said

State and local governments, however, can still impose stricter rules for nursing home visits and usually give facilities considerable leeway in deciding when to reopen

Nearly eight months into the pandemic, some long-term care facilities are still struggling to protect themselves from Covid-19

Without adequate protections in place, in-person visits could put both residents and staff members at greater risk

“We too are concerned about prolonged social isolation for our residents,” the American Health Care Association, which represents for-profit long-term care facilities, said in a statement

Several weeks after his death, Minnesota enacted a policy allowing essential family caregiver visits in long-term care facilities, including Copperfield Hill