Some people who planned to move to senior housing now choose to live independently rather than together. Others wonder if it might be the right call to transfer to a setting where they can get more help.
These decisions, tough enough in ordinary times, are now fraught with uncertainty as the economy weakens and Covid-19 deaths rise, including tens of thousands in nursing homes and assisted living centers.
Teresa Ignacio Gonzalvo and her husband, Jaime, both 68, chose to build a house rather than move into a retirement community, where they moved from Virginia Beach, Virginia to Indianapolis later in the year to be closer to their daughters.
After hearing about lockdowns around the country due to coronavirus, Gonzalvo said, “We have realized that we are not ready to lose our independence.”
Alissa Ballot, 64, plans to leave her 750-square-foot apartment in downtown Chicago and take root in a multigenerational community where neighbors typically share eateries and recreational areas and often help each other.
“What I have learned during this pandemic is that personal relationships mean the most to me, not place,” she said.
Kim Beckman, 64, and her husband, Mike, were ready to give up being homeowners in Victoria, Texas, and join a 55-plus community or rent in an independent North Texas residential home before Covid-19 hit.
Now they are considering buying an even bigger house, because “if you want to be in the house all the time, you might as well be comfortable,” Beckman said.
“Everyone I know talks about this,” said Wendl Kornfeld, 71, who lives on the Upper West Side of Manhattan. She has temporarily presented the prospect of moving into a retirement community being built in the Bronx.
“My husband and I have to play it by ear; we’ll see how things play out” with the pandemic, she said.
In Kornfeld’s circles, people are more committed than ever to staying in their homes or apartments for as long as possible – at least for the time being. Their fear: If they move to an older living community, they may be more likely to encounter a Covid-19 outbreak.
“We’ve all heard of the huge number of deaths in senior facilities,” Kornfeld said. But people who stay in their own homes may have trouble finding affordable help there when needed, she acknowledged.
Avoid nursing homes in the midst of the pandemic
More than 70,000 residents and staff at nursing homes and care facilities had died of Covid-19 in mid-August, according to the latest count from the Kaiser Family Foundation.
This is an understatement because less than half of the states report data on Covid-19 in assisted living. No data are reported on persons living independently in senior housing. (Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.)
Nervousness around senior housing has spread as a result, and in July, the National Investment Center for Seniors Housing & Care reported the lowest occupancy rates since the research organization started tracking data 14 years ago.
Occupancy fell more in assisted living (a decrease of 3.2% from April to June compared to January to March) than in independent stays (a decrease of 2.4%). The organization does not collect data on nursing homes.
In a separate NIC survey of senior home managers in August, 74% said families had expressed concern about moving in, as Covid cases spearheaded in many parts of the country.
Overcome possible isolation
The potential for social isolation is particularly worrying as facilities retain restrictions on family visits and on group dining and activities. (While states have begun to allow visits outside nursing homes and care centers, most facilities do not yet allow visits inside – a situation that will increase frustration when the weather gets cold.)
Beth Burnham Mace, NIC’s chief economist and director of outreach, stressed that operators have responded aggressively by introducing new safety and sanitation protocols, moving programming online, helping residents buy groceries and other important supplies, and communicating regularly about Covid-19, both on – site and in the community as a whole, much more regularly.
Mary Kazlusky, 76, lives independently on Heron’s Key, a retirement community in Gig Harbor, Washington that does all this and more with a sister facility, Emerald Heights in Redmond, Washington.
“We all feel safe here,” she said. “Although we are strongly advised not to go into each other’s apartments, we can at least see each other in the hall and down in the lobby and down on the decks outside. As far as isolation, you are isolating here with over 200 people: There is always someone Nearby. “
An employee at Heron’s Key tested positive for Covid-19 in August, but has recovered. Twenty residents and staff tested positive in Emerald Heights. Two residents and an employee died.
Colin Milner, executive director of the International Council on Active Aging, stresses that some communities do a better job than others. His organization recently published a report on the future of the senior in light of the pandemic.
It calls on operators to introduce a wide range of changes, including the establishment of safe visiting areas for families both inside and outside; providing high-speed Internet services throughout the community; and ensure adequate supply of masks and other forms of personal protective equipment to residents and staff, among other recommendations.
Some families now wish they had provided care for older relatives in a more structured environment before the pandemic started. They find that older relatives who live independently, especially those who are fragile or have mild cognitive impairments, have difficulty coping with themselves.
“I hear from a lot of people – mostly older daughters – that we waited too long to move mom or dad, we had our heads in the sand, can you help us find a place for them,” said Allie Mazza, owner Brandywine Concierge Senior Services in Kennett Square, Pennsylvania.
While many operators introduced moratoriums on moving in early in the pandemic, most now allow new residents as long as they test negative for Covid-19. Quarantines of up to two weeks are also required before people can circulate in the community.
However, many older adults simply do not have the financial means to relocate. More than half of middle-income seniors – nearly 8 million older adults – cannot afford independent living or assisted living communities, according to a 2019 study.
And more than 7 million seniors are poor according to the federal Supplementary Poverty Measure, which includes spending on medical expenses and other drains on cash reserves.
Questions to ask
For those who are able to consider senior housing, experts suggest that you ask several questions:
• How does the facility communicate with residents and families? Has it had a Covid outbreak? Does it pass on Covid cases and deaths? Does it share the latest guidance from federal, state and local public health authorities?
• What protocols have been put in place to ensure security? “I want to know: Do they have a plan for disasters – not only the pandemic, but also floods, fires, hurricanes, blizzards?” Said Milner. “And beyond a plan, do they have supplies in place?”
• How does the community engage the residents? Is online programming – practice courses, lectures, interest group meetings – available? Is one-on-one interaction with employees possible? Do employees arrange online interactions via FaceTime or Zoom with the family? Are family visits allowed?
“Social engagement and stimulation are more important than ever,” said David Schless, president of the American Seniors Housing Association.
• What is the company’s financial status and occupancy rate? “Properties with an occupancy rate of 90% or more will, in my opinion, be able to withstand the pressure of Covid-19 than properties with an occupancy rate below 80%,” said Mace of the National Investment Center for Seniors Housing & Care. Higher occupancy means more revenue, giving institutions better advice on extra expenses associated with the pandemic.
“Openness is very important,” Schless said.
KHN (Kaiser Health News) is a non-profit news service covering health issues. It is an editorially independent program of KFF (Kaiser Family Foundation), not affiliated with Kaiser Permanente.