Kentucky Geriatrician Says Start of Nursing Home Visits Can Help Elders Bounce Back after Isolation

Jul 16, 2020

Dr. Laura Morton is a geriatrician who is an associate professor at the University of Louisville and a certified medical director who works with long-term care facilities.
Credit Dr. Laura Morton

Visiting at nursing homes across Kentucky began July 15, after in-person visits were suspended for several months to prevent the spread of COVID-19.

Residents had been keeping in touch with family and friends through social media and by peering through windows. 

Now, visits to skilled nursing facilities have restarted, with many state required health precautions in place, including social distancing and the wearing of masks. 

Restrictions were eased on other types of long-term care facilities, including assisted living and personal care homes, on June 29.


WKU Public Radio Reporter Rhonda Miller spoke with Dr. Laura Morton, an associate professor of geriatrics at the University of Louisville. Dr. Morton is a certified medical director and works with three long-term care facilities in Louisville, which have mulitple levels of care, including independent living, personal care and skilled nursing. 

Dr. Morton has a lifelong interest in long-term care and working with older adults.  When she was in 8th grade she was a volunteer for Little Sisters of the Poor, a Catholic organization dedicated to serving the elderly poor. During college, she workd as a Certified Nursing Assistant. 

Miller:

Dr. Morton, thank you so much for talking with me today. We know that nursing home residents have not been able to have visitors for the past several months to prevent the spread of COVID, especially to the elderly. Now that the visits are just beginning again, let's just look back a little bit. What were you finding with the people you were working with, as far as isolation created by not being allowed to have visitors?

Morton:

It has been a really tough few months for the residents who live in these facilities. They have been without visits from family and friends. They, many times, have been without visits from companions who come in regularly. So, for a lot of our residents, they have experienced sadness. They've experienced some physical decline, some cognitive decline because they haven't had that stimulation, that interaction that is very needed. We know that so much of our physical well-being is tied to that mental and social stimulation. And so, it's been a very challenging time to balance the risk of the infection and the virus with people's mental health and well-being. I know everybody's looking forward to these visits and getting those back up and running.

Miller:

Now that the visits are beginning again, what kind of suggestions would you have, especially for family and friends who are visiting? Because it seems that one of the issues I've been reading about is that when the residents of the nursing homes sort of look forward to a long time to deal with this virus, and the fact that there are so many precautions, it seems that it's really affected them? So, I'm wondering what you would advise for visitors.  Should they talk about the long-term? Should they...try to focus on the present, or what do you suggest?

Morton:

Well, I think the most important thing is that they really just are there and how excited they are to see their loved one. It's OK to talk about the virus. If you have somebody who is aware of what's going on, I'm sure that they want to share those emotions and that anxiety, whether it's the fact that we're all wearing masks now, we're all wearing all of these gowns and gloves and things that are kind of scary to residents. They're also scary to the family members. So, I think it's really important to talk about those things. If you have a loved one who is who may have some cognitive impairment, then maybe it's not the best thing to talk about. Maybe you talk about good memories or how happy you are to see them. The tricky thing with a lot of these visits, is that there are still some limitations, including the social distancing. So, it may not look like the visits you had pre-COVID times, when you could run up and give somebody a hug.

Miller:

Have you seen much of this decline or depression? I'm just wondering if you've seen that or you think maybe these few months have not been long enough to have a major impact.

Morton:

No, I think they've had a significant impact on these older adults, the more frail, and even on some of the residents who are younger, but maybe in that congregate living setting. Because they haven't had that stimulation that is so important to our mental health. I've seen people who are losing weight, who do have more depression, who--without that social socialization--are not eating as much, and they haven't had the family come in that may eat with them at time. So that has precipitated a decline. And sometimes in people who have some cognitive impairment, it can even precipitate a cognitive decline as well. So, you may see their dementia worsen, just because they don't have that stimulation.

Miller:

And do you think the nursing home staff, the medical people, will be able to, sort of, help the residents catch up, or recover from this emotionally?

Morton:

That's a tough question. And I'm hopeful that as we get some family members to come back in, and those friends, as well as those group activities and some of the dining, even if it's on a smaller scale than it was previously, that that will help get people back on track.

Miller:

Thank you. Dr. Morton. Thank you so much for talking with me. I really appreciate it. 

Morton:

Well, thank you so much for having me. I enjoyed it.