Locked down in old age: Years of coping skills help, but there’s also the sense that time is short

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PHILADELPHIA — As a child, Edith Kalech fled what was then Czechoslovakia to escape the Nazis. Her family settled in New York, where her inability to speak English made her a target.

Later, Kalech, who is now 91, endured a bad marriage, early widowhood and then widowhood again. In November, she moved to Lions Gate, a Voorhees, N.J., retirement community, to get more social interaction.

Before she could totally settle in, the coronavirus started raging through New York and New Jersey, especially in nursing homes where medically fragile seniors lived close to one another and staff. Lion’s Gate went into lockdown. Elders like Kalech were told to stay in their rooms except for brief walks in the hall. Isolation was their new challenge, one that many who work with older Americans fear could have serious mental health consequences.

Nir Barzilai, who is scientific director of the American Federation for Aging Research, is studying a group of centenarians. Only one has died since the pandemic, a 106-year-old who became isolated and stopped eating. “She’s a casualty of COVID-19, but not from the virus, but from the loneliness,” he said.

Kalech, who is in independent living at Lion’s Gate, which also offers assisted living and nursing home care, says she’s doing OK. “It’s not the best of times, but it’s also not the worst of times, as Dickens said,” she said.

“I am not terribly unhappy. I’ve been through worse.”

Gayle Perlmutter, who also lives at Lions Gate, is more upset. Now in her early 80s, she was a baby during World War II and considers herself a product of the relatively pleasant Elvis Presley era. Her husband, who is 11 years older, is having health problems. She feels cooped up. She hates how her hair looks. She cries easily now and often feels sad.

“This has changed my personality,” she said. “I’m not the Gayle that I was.”

She is well cared for. Anything she needs is delivered to her door, but she suspects isolation was a factor in the deaths of some older friends. “Being locked up in a prison, that’s almost what it feels like,” she said. “Here’s your food. It’s on the ledge.”

Like younger people, members of the oldest generation are responding to virus-related restrictions in many ways, but with an extra burden of fear. They know they are much more likely than their children or grandchildren to die or need hospital care if they get sick. Some also feel a different kind of time pressure. The road they see ahead is short. Yes, they can apply a lifetime of coping skills and wisdom to this new crisis, but they don’t want to waste precious time.

Jeanette Axelrod, president of the Lions Gate resident council, will turn 90 in September. She wishes she was making memories with her grandchildren and great grandchildren. She has a 2-year-old grandchild who knows her mostly as a picture on a cell phone. “That’s heart breaking to me,” she said.

She’s a voracious reader. She calls friends. Her eight children call her. She walks “endlessly.” Still, she misses mahjong and Scrabble with friends. She is trying to “rise above” the boredom, but worries about neighbors who never leave their rooms. “Many of them,” she said, “are just being etherized.”

Talya Escogido, a Philadelphia psychologist who specializes in geriatrics, said her clients with mild cognitive impairment are having the hardest time. They’ve lost routines that were helping them function and they lack the intellectual resources to adjust to the changes. She thought nursing home patients might be OK, since they have the most staff members around them, but they miss their families. Phone calls and window visits have not filled the void. “It’s obviously not the number of humans,” she said. “It’s the quality of humans that count.”

Another struggling group, she said, is recent widows who have not yet rebuilt their lives. Some are feeling “lost and completely untethered,” she said. “They’re feeling the loss so much more.”

Judith Coche, a 77-year-old psychologist with offices in Center City and Stone Harbor, said that, whenever people are experiencing something big for the first time, it “stops traffic.” She said how her clients have reacted has more to do with personality than age. Some were already anxious, and the virus has heightened their fears. They are obsessing about “what ifs,” like “What if someone breathes on me?”

Lion’s Gate is still strongly encouraging its independent-living residents to stay home, but soon will introduce activities to allow residents to meet safely outside or in a large room. Public health experts have cautioned that assisted living facilities and nursing homes should be among the last places to reduce restrictions because their populations are so vulnerable.

At the same time, nursing-home medical directors are worried that continued isolation will lead to physical and cognitive deterioration in their patients. “I think some people will have irreversible worsening as a result of this isolation,” said Jim Wright, medical director of a Virginia nursing home where about 85% of residents tested positive for COVID-19. He wants group activities to return.

John Beaty, 74, who lives at Cheltenham Nursing and Rehabilitation Center in Philadelphia, has begged to go outside. He walks in the halls, but said there’s little else to do but watch TV and sleep. He loves to read, but can’t without new glasses. “It’s really frustrating, depressing, because there isn’t anybody to talk to.” He said he’s sleeping 13 hours a day. “It’s my way of escaping this place,” he said, “because I dream a lot, and most of my dreams are happy.”

Some independent older adults said that worries over recent civic upheaval intensified the pandemic’s pain. Thelma Reese, an 87-year-old Center City woman, has a new book on older activists to promote and has kept herself busy. But she’s also worried about a viral invasion with no known end. “I have occasional crying jags which seem to come from nowhere,” she said. “I have moments of solid depression on days that start out fine that seem to come from nowhere. Some of it, it’s probably just fear. The thing is that it’s more than the pandemic.”

She remembers wartime air raid drills as a child, but this is worse. “This is the worst time I think that this country has ever seen in my lifetime,” she said. “It’s the first time I’ve felt that we really could be losing our form of government.”

Meanwhile, Don Fletcher, a 101-year-old retired Presbyterian minister who lives at Lion’s Gate, is missing dinners with friends and family, but is having no trouble staying busy. He bought a cross trainer and is using it three times a day. He started writing books at 80 and is now writing short stories. “I do it quietly and on my own, so the isolation does not bother me at all,” he said. “This time is not normal for most, but I am not normal. I enjoy the quiet.”

Coche has loved spending more time with her husband and walking, carefully, with friends. Escogido said many of her patients are finding joy in their new computer skills. Randy Padula, 85, has gone low tech. His granddaughter bought him coloring books and crayons. “I can’t put them down,” said the resident of Allegria at the Fountains in Atco. “Time just flies.”

Jettie Newkirk, who lives alone in West Philadelphia, is also finding staying home relatively easy. “Since I’m not driving any more, I was kind of on lockdown anyway,” she said.

Newkirk, 84, has learned how to use Zoom. People have brought her food. She attends virtual prayer meetings at church and helps with voter registration efforts. A lawyer, she’s still doing some work. “My schedule didn’t change that much,” she said.

She sometimes sees a granddaughter who lives one street away. “We do a distance hug,” she said. “She wraps her arms around herself and I wrap my arms around me. That’s my hug.”

She found the recent protests inspiring. “I see this as a very exciting time, and I’m glad that I lived to see it,” she said.

Barbara Lavin, 82, moved into Lions Gate two weeks before COVID-19 changed everything. Her husband died six months ago. She has reason to feel miserable, but she doesn’t. “Time goes by very quickly,” she said. “I don’t know what I do. Probably half the time, nothing.”

She feels no pressure to pack her days with experiences. “I don’t think I’m dying so soon,” she said. She gets lots of calls from her two children and five grandchildren.

“You reap what you sow sometimes,” she said, “and, right now, I’m very happy with what I’m reaping.”

It has crossed Kalech’s mind that she may not outlast the virus. She tears up as she describes the people who helped her during the worst periods of her life. She’s grateful that people are helping her now. She’s optimistic she’ll live to see more normal life. “I very strongly feel that this too shall pass, and it’s doable in the meantime.”


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