Long-term care facilities have had to implement strict guidelines in order to protect residents from a deadly virus. But now, facilities are facing another issue, dealing with the effects of social isolation on the elderly.

Kentucky began to lift restrictions on long-term care facilities Monday, even as coronavirus cases continue to remain steady or even rise nationwide, raising concerns about the vulnerable populations housed in such facilities.

However, one such facility has remained untouched by the virus.

McCready Manor, an assisted living facility in Madison County, has zero confirmed cases of COVID-19 according to Gil Shew, director of Saint Andrews Retirement Community, which includes McCready Manor.

"We have had no cases of residents or employees, so we must be doing something right," he told The Register.

But, residents and family members are not as worried about the virus as they are about being isolated. Now, they are concerned about mental health.

Tensions between residents and administration soon escalated after the implementation of a "social distancing barrier" around residents' porches.

According to Shew, the fence was installed after the Mother's Day holiday, when he said several residents were not adhering to proper social distancing.

"So this will give them the help they need to do that," Shew said.

But the residents disagree.

"(Administration) seems to put up restrictions that are beyond CDC (guidelines), so that's what's troubling me," Marlene Waller, a resident of McCready Manor told The Register. "The CDC guidelines — I understand — I'm an RN with a master's degree in nursing. I'm no dummy, but I feel like one because I'm fenced in."

The barrier, a small, mesh fence, is intended to restrict access to and from private doorways and enforce social distancing between residents and possible visitors.

As per state-mandated guidelines, long-term care facilities were closed to the public in mid-March. Entrances into the buildings were highly monitored, and workers at such facilities were — and still are — required to have their temperature checked prior to entering.

Waller, who lives on the first floor of the building, said getting in and out of her apartment has become harder because her porch is now fenced off. To leave the building, residents must exit through the main entranceway in the lobby.

In addition to this, visitation has also been made more difficult for Waller and other residents on the first floor. While family members could once enter the apartments through a private door, that area has since been blocked off by the fence. Waller stated some residents choose to go up to the second floor balcony and look down at their loved ones who stand on the other side of the barrier.

However, as Waller pointed out, many residents have hearing problems, and this practice results in conversations being yelled back and forth.

Which infringes on another right of residents — their privacy.

Per state mandate, facilities were also told to cancel group activities and no longer allow patients to eat in a dining hall unless social distancing could be observed.

Pearl Anderson, another resident of the manor, who has studied gerontology (the study of aging) and has a Master's of Social Work in aging, told The Register that the social isolation aspect is her greatest concern.

"(Residents) are cut off from what they need the most — the support of their families and friends," Anderson said. "If I were alone and maybe only had two or three social contacts or family, and I looked out and saw that fence, it would be one more barrier for me … It can be very damaging to a person who lives alone."

An example of whom is Don Roberts, another resident at McCready, who lost his wife in March to flu complications. Roberts now lives alone and with no one allowed to enter the building, he says his wife's things remain just as they were left.

"It has been three months since my child has been able to come see me," he said. "Her mother died in March and there are things (her mother) wanted her to have, and her grandchildren to have that she can't come get."

Both Roberts, and his daughter, Marla Steele, agree the fence is not their biggest concern, but that employees can come and go freely, but not the residents or their family members.

"We are just really upset that the workers can get in and go home every night and do their activities, and they aren't quarantined," Steele said. "...My mom died in March and I have had no time to go through her clothes and go thorough personal papers. I have told them I will get a test and they can take my temperature everyday and I just want to go straight to the room."

Like the other residents, Steele is worried about her father's mental health, and the loneliness he is facing.

"I am worried about their mental health and how they feel like they have lost freedoms," she said. "Elderly people still have lives, and my dad was telling me the other day, he doesn't feel like he does anymore."

Anderson and Waller make it clear they like living at the manor and they are well cared for. Anderson stated the food is good, the cleaning services are excellent and the staff are friendly. However, she reiterated her concern lies with the feelings of loneliness and isolation by those residents who are restrained from having visitation or even socializing with other residents.

New changes may provide much needed relief soon, though. Groups of 10 or less are now allowed to meet outside, and the dining room at the manor began to reopen on Monday. Additionally, the beauty salon has reopened.

Shew, and the community's board of directors, want residents to know they are not alone.

"My staff and I empathize with residents and family about their concerns," Shew told The Register. "We have not abandoned them during this very difficult time. We check on residents daily, deliver them meals, mail and our Activity Director, Kelly Benton, does an activity with them daily. They are loved and cared for almost as if they were with family."

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