A 91-year-old man in a North Carolina nursing home calls his wife four times a day just to hear her voice. At a New Jersey facility where 285 staff and residents have tested positive for the novel coronavirus, a Navy veteran says the pandemic is worse than war. A grandmother living alone in Brooklyn feels her heartbeat quicken when she hears ambulance sirens close in on her block. And in Dallas, a 71-year-old has started to dread the daily calls from friends and family telling her another person from her hometown in rural Louisiana has died.
Across the country, nursing homes and assisted-living facilities are being pummeled by the coronavirus. A Washington Post analysis found that more than 1 in 4 nursing homes, which are regulated by the Centers for Medicare and Medicaid Services, have had at least one reported case of the coronavirus among residents or staff. Together with assisted-living facilities, which are not regulated by the federal government, nursing homes account for 174,381 cases and 42 percent of deaths nationwide, according to the Kaiser Family Foundation.
The grief, loneliness and fear that have characterized the last 11 weeks for many Americans are intensified inside these facilities, where stay-at-home orders and other social distancing measures mean no socializing and no visitors. Precious routines like bingo and shared meals have been disrupted and, in some cases, residents have been forced to relocate. Every day the crisis persists, those in long-term care facilities are forced to confront the risks of living in close quarters with other vulnerable residents — and the possibility of dying alone.
“He is in a golden prison, and so am I,” said Cary Johnston, who has not been able to visit her husband in the skilled-care wing of their retirement community in Davidson, N.C., since mid-March. “I know he is not going to live forever. Neither am I. But I don’t want to lose him this way.”
Gary Barfield, 76, an Air Force veteran, said his experience at a nursing home in St. Charles, Mo., where 20 residents have died of the virus, has been “like being back in ’Nam.”
“Losing that many people in such a short period of time was hard to take,” said Barfield, who successfully fought the virus.
In McKinney, Tex., Evangelina Lovato, 79, said she feels like crying when she talks to her children on the phone. But she never does. Instead, she tells them she is staying strong, is taken care of and has made peace with dying.
“When the time comes, mijo, that’s it,” she tells her son. “There’s nothing we can do.”
Stuck in quarantine, residents cope with the solitude through puzzles, Zoom calls and religious services blared on smart devices, and with books, naps and limited doses of cable TV. They take laps around their facility or walk the length of their room.
“We are in charge of our own happiness,” said Rita Seiler, an 88-year-old in Kirkwood, Mo., who lost her husband of 65 years in August.
Patricia Perry, a retired radiologist, said the decades she spent alone in her lab prepared her well for isolation. She has no plans to leave her apartment in an assisted-living facility in Reston, Va., until a vaccine is found.
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“Look, if it’s a choice between being bored and being dead,” said Perry, 83, “I know which one I’d go for.”
Resilience in older people is closely correlated with their experiences earlier in life, including their past nutrition and education, and varies among individuals, said Pamela Saunders, a Georgetown University neurology professor who heads the university’s master’s program on aging and health. Success for one person might mean getting out of bed and walking 20 feet, while for another it might mean a game of pickleball.
In Maryland, Candra Hardy drove to the Frederick nursing home where her great-aunt lives after struggling for days to reach her. Talking through a window, she found that the once fiercely independent woman seemed to have aged years in a matter of months. Terry Tocci, a fashion designer outside Los Angeles, has tried with mixed success to comfort her father, who tested positive for coronavirus in a nursing home in Massachusetts.
“Am I normal?” Ed Tocci asked her on a recent phone call.
“You’re normal, Pops,” she reassured him.
Loneliness directly impacts health and can intensify cognitive decline, depression and anxiety, said Dan Blazer, a longtime psychiatry professor at Duke University. Video calls, social media and window visits do help, he said, but cannot replace the benefits that come with in-person communication — especially touch.
“Can you imagine being in a place for an extended period of time where no one other than a nurse taking your temperature is touching you?” Blazer said.
The residents interviewed for this project envision a future for themselves past the coronavirus crisis. They’re waiting to sink their feet into beach sand, dance at weddings and quinceañeras, and cradle grandchildren they have yet to meet.
Barfield, the Air Force veteran, said that since he recovered, he has been dreaming of strolling a mile to the nearby park, where wild deer eat apple slices out of his hand. Jerry Goldstein, 89, and Doris Goldstein, 88, said they yearn for the day they can return to the beaches they love. Alma Koyasako, who as a teenager was forced to live in an internment camp for Japanese Americans, said she wants once again to sing with friends.
“I am 92 — I may be one of the oldest ones here,” Koyasako said from her assisted-living facility in Sacramento. “But regardless, we are human beings.”
There are 2.5 million people living in nursing homes and assisted-living facilities in the United States. Here are 12 of them, in their own words:
“They’re afraid for me, afraid that I’ll get it because I’m older. I say, ‘I’m okay, mijo. They take care of us.’ ”
Evangelina Lovato, 79
Grandmother in a large, close-knit family who moved from her home El Paso to Baybrooke Village Care and Rehabilitation Center in McKinney, Tex., seven months ago for physical therapy.
“My son and daughter, they’re scared too, for their kids. They have two kids, two boys. My son says, ‘I’m already tired, mom,’ and I say, ‘I know, mijo.’ The other day, he went running in a park close to his house. He said, ‘Mom, it felt so good to feel the air, to see the plants.’ That’s what I miss too. Going outside and not worrying about anything. … They’re afraid for me, afraid that I’ll get it because I’m older. I say, ‘I’m okay, mijo. They take care of us.’ I try to be strong so they won’t be so afraid. It will affect their mind, thinking of me, and they work so hard. My son is an engineer and he uses his head a lot, so I don’t want him to worry about me.
“I told him, ‘When the time comes, mijo, that’s it. If God is going to take us, he’s going to take us. There’s nothing we can do.’ ”
“We had our pictures on the wall from our whole life. And we lost that. That was the most difficult time — giving up the home that we belonged to, and our friends.”
Anthony Rubino, 91, and Lois Rubino, 87
Navy veteran and his wife living at Paramus Veterans Memorial Home in New Jersey, where more than 285 staff and residents have tested positive for covid-19 and 81 have died, including the Rubinos’ long-term aide. After testing negative, the couple were moved from their regular quarters to a separate wing.
Tony: “My wife, Lois, was moved first. She was moved in the morning, and I didn’t know if I was negative or positive. I didn’t know if I was going to join my wife. That afternoon, they found out I was negative and I had tears in my eyes. ... It was a little tough, to go from one section to another. In the other section, we had our pictures on the wall from our whole life, married life. And we lost that. That was the most difficult time — giving up the home that we belonged to, and our friends. ”
Lois: “I play the piano and organ, and I’d play it here. [The other residents] would join in. If they were around, they’d hear us singing and they’d come and sing. I could play the piano or the organ with them and get it going. They loved it. We all loved it. We don’t have that opportunity right now.”
“We try to talk about fun things and liven it up, say something funny and laugh, but deep down inside, our minds go back to all the people we’ve lost.”
Pearl Dixon, 71
Great-grandmother who retired to Lakewest Assisted Living in Dallas after decades working as a nursing assistant in nursing homes. Originally from a small town in northeast Louisiana, where she says she knows dozens who have contracted the coronavirus.
“In my 71 years, I’ve never experienced anything like this. ... It’s a small town where everybody knows everybody. It seems now like every time I get on the phone, it’s somebody else from my hometown who has passed away.
“I had a step-granddaughter; she had asthma and she died from the virus. ... I was married to her grandfather and I knew her since she was a child. She was the same age as my son. It was devastating because they couldn’t have a funeral for her. The family didn’t believe in cremation but that’s what they had to do. It was a lot of turmoil. I couldn’t sleep too good.
“We try to talk about fun things and liven it up, say something funny and laugh, but deep down inside, our minds go back to all the people we’ve lost.”
“Where we used to sit together, we now sit at least six feet apart to have our meals. It is not as fun. It is pretty hard to have a conversation.”
Alma Koyasako, 92
Lives in ACC Maple Tree Village, an assisted-living facility in Sacramento, where she moved because she did not want to be a burden to her family. From age 14 to 18, she lived in an internment camp for Japanese Americans. She had eight siblings, all of whom have died.
“I have lost all my friends, believe it or not. … I moved here in February of this year. Not too long after that, things became a little bit more difficult. We can’t have the singalong, which we would do every so often. We had all kinds of games we would play, and they would get songs we used to sing years ago, like ‘Go Sit Under the Apple Tree.’ All the songs that were popular years ago. ... Where we used to sit together, we now sit at least six feet apart to have our meals. It is not as fun. It is pretty hard to have a conversation, especially because a lot of the women are hard of hearing or have hearing aids. So far I have been very fortunate not having to need those things.
“I did break my tooth, but my dentist wouldn’t take me. I really would like to have that fixed. It’s ground down to the point where I don’t think they could do anything with it now. I’m not sure how I did it.”
“The number one thing I miss the most, by far, is my husband. And now, he is quarantined and I’m quarantined, and all we can do is talk on the telephone.”
Cary Johnston, 84
Lives in The Pines at Davidson in North Carolina, where she met her husband, Edward Townsend, 91, a retired Presbyterian minister, in 2008. He moved into the community’s skilled-nursing facility a year and a half ago, and she has not been able to visit him since mid-March.
“I miss seeing my friends. That was a social occasion. I used to eat in the middle of the day. From 12 to 1:30, I was with people in a beautiful dining room and we were being served with linen napkins in a lovely setting and all. I miss that. I miss it terribly. Most of all, the number one thing I miss the most, by far, is my husband. ... I would go see him at least twice every day and spend time with him. And now, he is quarantined and I’m quarantined, and all we can do is talk on the telephone, which we do four or five times a day. At least we can do that. That is what I miss by far the most. And that is what has changed the most.
“I know that if he got the virus, he probably wouldn’t last very long. He’s got preexisting conditions. So I want him to be safe, but I sure do want to see him, too. And he wants to see me very much, and that influences me too.
“We would go out to eat once a week. Now I would be afraid to take him, or myself, to a restaurant. I think that from now on, when we get where I could take him out again — obviously, I can’t right now — but say three months from now, if I’m allowed to take him out, I’d be afraid to. I think what we would do is it would be fun to just get out and go to a McDonald’s or a Burger King or a Chick-fil-A or whatever and just go through the drive-through and be with each other and eat some different food. Like I say, we have wonderful food here. But you get tired of it.”
“We’d sit on the bench that got the tables so we can play our dominoes. Now, we can’t wait to see each other. Can’t wait to get to the park and play dominoes.”
Rosa Lee Hickman, 75
Born and raised in South Carolina, but came to New York City in 1964 and never left. Moved to Moffat Gardens, an assisted-living facility operated by RiseBoro Community Partnership in Brooklyn two years ago after retiring as a nanny.
“I used to go to the park over in Bed-Stuy, seven days a week, 11 a.m. to 8 at night.
“My friends and I, we’d sit on the bench that got the tables so we can play our dominoes. When we finish playing, we sit there for a while, talk. I mostly listen to them and once in a while, they’ll ask, ‘Ma, what you think? Ma, what you got going on?’ They call me ‘Ma’ because I’m older than they is. I haven’t played dominoes since February. And I used to play every day. ... Those Jamaican guys, they think they can beat me. But that ain’t hardly so. They be there trying to beat me. Now, we can’t wait to see each other. Can’t wait to get to the park and play dominoes.
“I know at least six people who got the virus. Three of them, we used to play bingo together over in Queens. I felt terrible when I was told. I worried for a couple hours real bad, then it eased off my mind. Every time they tell me, I worry for a while. Then it goes off my mind. I can’t keep worrying all the time. I got to take it off my mind.”
“I have a friend, and she and I have figured out a way to see each other. If I go to the window in the piano room and she comes to the window and then we talk on the phone, then we have a visit.”
Rita Seiler, 88
A retired teacher and widow who lives in Aberdeen Heights, an assisted-living facility in Kirkwood, Mo. She and her identical twin met their respective husbands on the same night at a party in Chicago.
“I lost Joe on the 1st of August. So when this all started, it was a very lonely time for me. I started working on puzzles and practicing more to keep myself busy and keep my mind moving.
“I have never known what it was like to be alone. I tease people and I say, ‘I never even had a room of my own.’ But you know, I have learned after Joe died, this is the first time I have ever been alone. And I was 87. But I am doing okay. We have here a geriatric psychiatrist who talks to us of course after a loss or something like this, or if you need a certain medication, she needs to see you at least once every three months. She asked me of course how I was doing. I said, ‘To tell you the truth I am doing better than I thought I was going to do.’
“I usually get up around 6 and get dressed fully. I have laid out what I am going to wear that day the night before and I get dressed, and by 7, I am ready to start my day. Somebody comes in to take my vital signs. ... Then I usually head out of here. I usually go into the piano room and either work on a puzzle or practice or do a little of both.
“I have a friend, and she and I have figured out a way to see each other. There is a window in the piano room and one over in the exercise room. If I go to the window in the piano room and she comes to the window and then we talk on the phone, then we have a visit.”
“Recently, I’ve been listening to a lot of gospel music. With the virus out, I guess I’ve gotten closer to God.”
Marilyn Washington, 71
Former flight attendant who moved into A.G. Rhodes in Atlanta in 2012. A new and enthusiastic user of Zoom and Google Duo.
“I have a lot of things to do in my room that take up my time. I have trouble reading, so I have books on tape that I listen to. My nephew sent me this Echo 8 that you can listen to music on, watch movies on and make telephone calls. That’s really a lot of fun, the Echo.
“Recently, I’ve been listening to a lot of gospel music. With the virus out, I guess I’ve gotten closer to God. There’s a church in Atlanta that has a devotion Monday through Friday at noon and I enjoy that. I look at my church online on Sundays.
“You know you could get a whole family together on Zoom? Because we did that. We had our whole family. I had not seen my nephew in Florida in years. But I got to see him and talk to him on Zoom.
“When it’s all over, if I could get somebody to come pick me up, I would love to go to my mama’s grave. When I first went to her grave was when she first passed [in November]. Now, they’ve put the headstone up and I would love to go see the headstone. My sister took a picture of the headstone and sent it to me, but I’d really like to go see it myself.”
“But I am not going to go out and be brave. ... I could not live with myself if I knew that I had infected somebody else because of my laxity.”
David Zoller, 86, and Joan Zoller, 83
Live in Bishop Spencer Place, a retirement community in Kansas City, Mo. Married for 62 years, they have five children and report they are “still having fun.”
David: “You turn on the news and all you hear is this damn virus. You’re going to have to be damn lucky to avoid this thing. I can’t see why it wouldn’t come here. Given time, somebody is going to run into somebody who has the virus. But they are doing the best they can.”
Joan: “We feel really, really safe here. I don’t know about him, but I intend to live this out. I am getting used to staying here and find enough to do. I had a to-do list and I had to stop on two or three of them because of making masks. I have plenty to do.”
David: “I just do whatever hits my fancy at the time. I was very concerned about getting this damn camera to work. I spent the last 15 or 20 minutes before you called, I was on YouTube trying to search, how do you turn this damn camera on?”
Joan: “We are not going to live anyplace else but here, as long as we’re alive. And we know that sometime, we are going to die. But I am not going to go out and be brave. ... I could not live with myself if I knew that I had infected somebody else because of my laxity. It’s not just something we are living with right now. And I’m not worrying about it. I’m going to be doing what I am doing. When it is time to go, I’m going to go.”
David: “She’s hoping she goes before I do because she can’t run a computer.”
Joan: “It’s terrible.”
“Is this the end time and is this the way the Lord is warning us? I don’t know. I just don’t know.”
Betty Isbel, 88
Self-described “busy bee” who spent her two weeks in isolation sewing 150 masks for the health-care workers at River Valley Estates in Yuma, Az. Received a “virus” quilt for Mother’s Day, which her three daughters took turns sewing.
“There’s no need to be lonely. Go do something. Read a book! Go for a walk! Do a puzzle. No, nuh-uh. I know some people who are lonely and I try to tell them, ‘Get a book, get a puzzle, find a craft to do.’ I never understood people getting lonely because there’s so much to read and so much to do to keep your mind busy. Books are good for you.
“I was an adult when [polio] was happening. I knew people who had it and died from it and this reminds me of that. It was kind of like now — you didn’t know whether it was contagious, didn’t know where you got it, how you got it. I was so glad when a vaccine came out. Everybody knew somebody who got polio. It was prevalent.
“With [covid-19], I’m worried. I don’t know the end story so I’m concerned. There are so many possibilities. Is this the end time and is this the way the Lord is warning us? I don’t know. I just don’t know.”
Excerpts were edited for clarity and length.
