The pandemic kept nursing home residents and their families apart. Photographers for The New York Times were there when they finally reunited.
A daughter holding her mother’s hand. A son overcome that his 95-year-old mother survived the pandemic. A stoic family patriarch, suddenly in tears.
After a year of excruciating lockdowns, these were the scenes at nursing homes and other long-term care facilities as they began to open up this spring. Before the arrival of vaccines, one in three coronavirus deaths in the United States had ties to nursing homes and similar facilities.
The New York Times sent photographers across the country to document the reunions between family members. For many, it was the first time they were able to be together, hold hands and hug in more than a year.
In interviews, which have been edited and condensed for clarity, families recalled a deep fear that they would never see their loved ones again. When the time finally came, they were flooded with a year’s worth of emotion in a single instant: joy, relief, love — and grief for all the time that had been lost.
Jim Tinkler, 84, has been a resident at Focused Care at Fort Stockton in West Texas since 2018. During the pandemic, his wife, who had also lived at the facility, died after a battle with Parkinson’s disease. Their family could not visit before her death. This month, Mr. Tinkler reunited with his son, Wayne Tinkler, 48, daughter-in-law, Beverly Tinkler, 53, and grandson, James Tinkler, 15, for the first time in more than a year.
BEVERLY TINKLER: I was the first to walk into the room. He looked up and saw me and just immediately put his head down and started crying. I went up and gave him a hug. It was very overwhelming, just the joy of seeing him again. He would just take Wayne’s hand and hold it and start crying, and then the same thing with James. I’m sure he felt that he had been abandoned. I don’t know that he understood why we couldn’t come, just that we quit coming.
WAYNE TINKLER: They were in separate rooms, because of my dad’s dementia and my mother’s Parkinson’s. But they were right across the hall from each other, and he would typically go down there most every day. My mom passed away Jan. 29. We did have a funeral for her, a graveside service, but my dad was locked down at the nursing home. My main concern was he wouldn’t know us when he finally saw us. It was really good that he knew who we were. Just him knowing that we were there, that we were back, was a huge relief.
Con Yan Muy, 93, has been a resident at the San Francisco Campus for Jewish Living nursing home since 2019. Anita Li, 24, grew up with her grandmother and previously visited daily. For a year during the pandemic, she saw her grandmother only a handful of times through a window or at a distance. Even now, her visits remain limited, as is the case at many facilities.
ANITA LI: I was hiding in the bathroom when she came in. It was a surprise. She didn’t recognize me initially because I had my mask on. I am going to be honest, I was kind of sad. I am one of the most involved persons in her life, and she couldn’t recognize me. I immediately just started patting her legs and her arms for better blood circulation. I had brought some dumplings and also brought her some sesame balls that she really enjoys. We made a video for the rest of the family for her to say hi.
It’s like a sigh of relief that we could finally be together, but also knowing that this was a one-time thing, and not really sure what the future holds. Am I going to see her every week face to face? Can I eventually take her out on walks where she can get some sun? What is the new normal, and how much can we be involved in her life post-quarantine?
Marie Fabrizio, 95,has been in assisted living at Reformed Church Home in Old Bridge, N.J., since 2017. During the pandemic, she saw her family for limited visits through a window or outdoors at a distance. When her son, Dan Fabrizio, 59, surprised her with a visit last month, it was the first time they had been able to embrace in more than a year.
MARIE FABRIZIO: Of course I miss my family. It’s lonely. Thank God, I have friends who are here. We play bingo. We have arts and crafts. Seeing my son, it was a surprise. I was crying, and he cried with me. It was such a beautiful feeling. I didn’t want him to leave. It’s hard to let go.
DAN FABRIZIO: It was like a year in review — all the things that went through my mind in the past 14 months. Thinking, what if my mom passed away? Thinking about the things we wish we could have done, the things we sacrificed. We have a beach house down at the Jersey Shore. I take her down personally three times a year — Memorial Day, July 4 and Labor Day. Thinking that she would not have had that chance, and just being hopeful she has the chance to do that this summer. Hearing my mom’s voice in person — it just felt like, it wasn’t a recording. It wasn’t the telephone. It wasn’t a Zoom. It was live. She got through this. I sat in my car, and I cried.
Catherine O’Mahoney, 82, came to ArchCare at San Vicente de Paúl in New York City in 2015 after a cancer diagnosis. Because of the pandemic, Carolyn Austin-Tucker, 62, had not seen her mother in more than a year until they were approved for a visit this month.
CAROLYN AUSTIN-TUCKER: She looked beautiful. She had her new glasses on. They did her hair. She had a beautiful beige lace top on. I brought her lo mein with extra shrimp, Lorna Doone cookies and a ginger ale. She smiled a lot. She laughed a lot. She was happy. The dominant emotion was happiness, to see her well, looking good. I was a little saddened because I realized the year that we missed. Aging is a process, and every moment is precious. The whole reality set in. We missed all of that time. We were happy to see each other, but it was bittersweet.
Dolores Hiwiller, 90,has been living at Quality Life Services – Sugar Creek in Worthington, Pa., since 2018. Before the pandemic, her daughters Karen King, 67, and Sue Shirey visited their mother multiple times a week. Aside from window visits, it had been a year since they had seen each other in person.
DOLORES HIWILLER: I didn’t see them in person at all. Only through a window. I missed touching the most. Holding. It was pretty awful. I took one day at a time. That’s all I could do. With the help of the Lord, I made it through each day. When I could finally see them, that was a very wonderful day. It’s like we had gotten through the worst that there was. We had made it.
KAREN KING: It was from March of 2020 through March of this year. She would occasionally have panic attacks. I’m a psychologist. My job was to to calm her down. And then she got Covid. It was scary. I thought we were going to lose her. The first day, we didn’t know we were going to be allowed to touch her. My mother and I are not “hug me all the time and give kisses.” We were brought up in a German family — we got a pat on the shoulder. But just being able to touch her, I was crying. I cried the whole way home. I didn’t know how much I had missed it until I got it back.
Warren Young, 64, came to the Marigold At 11th Street, an assisted living facility in Washington, D.C., about seven years ago after suffering a stroke and heart attack. In this case, it was his mother, Lucille Young, 87, who had been waiting to visit her son.
LUCILLE YOUNG: I used to come and visit him almost every weekend. We’d sit and talk, laugh about old times. The pandemic happened, and that was it. It was pretty hard for me not being able to see him, being a mother.
WARREN YOUNG: This past year has been a nightmare. You can’t go out, go walking, do things for yourself. You can’t associate with family. I liked Sunday dinner. She’d come over on Sunday and drop dinner off before going to church. We’d sit and talk and watch TV. During the pandemic, I waved from the window and talked to her on the phone. You miss some things when you don’t get to do them, you know? I missed my mom. This is the lady that raised me, birthed me, took care of me. From a distance is all right, but it’s not like that personal touch.
Texas did not report any COVID-19 deaths in nursing homes until mid-April 2020, despite reports of outbreaks starting in March. By April 15, the state reported that 98 nursing home residents had died. For the next three months, the reported death toll mostly stayed below 100 people per week.
A deadly summer surge began in mid-July, when the state reported 209 nursing home resident deaths from COVID-19 in one week. August was even deadlier: The state reported more than 400 nursing home resident deaths in a single week. Cases and deaths started to decline in the fall, although they remained higher than during the spring.
The second peak came after the holidays, when coronavirus surged across Texas. For three weeks, Texas reported more than 400 nursing home resident deaths every week. In January alone, more than 1,400 nursing home residents died.
Nursing home residents and staff began to get vaccinated in December, resulting in a steep decline in cases and deaths starting in late February. By March, the state reported fewer than 50 deaths linked to COVID-19 among nursing home residents each week.
Overall, Texas reported that nearly 9,000 nursing home residents died of COVID-19 from April 2020 to April 2021. In total, one out of five COVID-19 deaths reported in Texas were of nursing home patients.
Early in the pandemic, COVID-19 deaths in Texas were concentrated among nursing home residents — about 40% of all deaths reported in Texas in June. That proportion began to decline as the pandemic became more deadly for people outside of nursing homes.
One year into the pandemic, COVID-19 has taken a heavy toll in nursing homes and other long-term care facilities. When the coronavirus invaded nursing homes in March 2020, 1 in 5 infected people older than 80 had to be hospitalized, and nearly 8% of them died.
As of April 14, 8,961 nursing home residents with COVID-19 have died in Texas — nearly 10% of the state’s estimated 90,000 nursing home residents. That’s about 20% of the COVID-19-related deaths reported for the state. More than a dozen facilities lost at least 30 residents to the virus.
“It’s just a monster,” said Cristina Arizmendi Mirelez, administrator of the Amistad Nursing and Rehabilitation Center in Uvalde, which cared for about 100 people when the pandemic began and reported 10 deaths and 41 total COVID-19 cases to the state over the past year.
One year ago this month, the state released its first data showing the toll the pandemic was taking on nursing home residents. By Easter 2020, 1 in 6 COVID-19 related deaths in Texas were nursing home residents.
Within a month, the death toll in Texas nursing homes reached nearly 500.
The following 12 months would bring nightmarish death tolls, isolation, panic and grief for hundreds of thousands of nursing residents, staff and families.
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Lynda Langford and her husband, Ray, raised their son on their 4,000-acre ranch in Uvalde, about 90 miles west of San Antonio. She taught English and computer skills at the local high school before retiring two decades ago.
In 2019, 74-year-old Lynda took a spill in their home out in the country and broke her arm and shoulder. The pain medication made her dizzy, and even after she stopped taking the meds, her falls happened more frequently. Home care was hard to come by in their rural area.
When the pandemic hit, the couple was close to making a difficult decision to move Lynda into long-term care so she wouldn’t be home alone while Ray was working on the ranch.
“I’ve never been away from home without my husband,” she said. “It scared me.”
Phillip Hopkins, president of TAG Management Services, which runs nine rural nursing homes including Amistad, where Langford would soon be living, wasn’t particularly worried about early reports about the coronavirus, which seemed like another virus scare that would likely fizzle out.
“I was watching the news, and I thought, ‘This is going to be another swine flu or something like that,’” said Hopkins, a 25-year veteran of the business.
When the novel coronavirus outbreak became a full-fledged global pandemic, he said, “We were all on our heels. We had a pandemic plan, but we’d never really dealt with it before.”
Then, in March 2020, cases of the virus began showing up in Texas nursing homes.
“That first case, it’s like your heart stopped,” Hopkins said.
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Arizmendi Mirelez couldn’t believe the phone call she received from Hopkins in mid-March, instructing her to shut down the Amistad facility to visitors the following day as part of the governor’s statewide disaster declaration and on orders from federal officials.
“My facility was always full of families and visitors, and to think that I have to lock those doors and not let anyone in was unheard of,” she said. “It was scary for my residents. I thought, ‘What are they going to do? They’re so used to their wives or daughters or sons being here every single day. How are we going to fill that void for them?’”
Amistad nurse Maria Perez remembers the pain of seeing residents waving at their loved ones through windows as the death count began to rise across the nation.
“You can see the toll that it takes on the residents,” Perez said. “But you know, unfortunately, it was for their own safety.”
Administrators at facilities across Texas began daily phone calls with one another and with the Texas Department of State Health Services. New rules from Austin and Washington D.C., changed often, sometimes daily, as officials desperately tried to keep the virus out of the facilities.
“It was just like a bunch of pigs on roller skates.”
President at TAG Management Services
Administrators at Focused Post Acute Care Partners, which runs 31 facilities in Texas, had to communicate new rules about protective gear and other protocols to some 2,300 employees nearly every day, said CEO Mark McKenzie.
“Once we got into the flow of it, it almost felt like Groundhog Day, every day,” McKenzie said. “We’d wake up, we’d have two new modifications to the modifications from yesterday. Early on, we were just all stunned.”
Hopkins described the first few weeks as pure chaos: “It was just like a bunch of pigs on roller skates, you know. We were just going all different directions.”
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Hopkins said he and other nursing home administrators felt they were fighting an invisible enemy. With no COVID-19 testing being done for asymptomatic people in Texas in the early months, it was impossible at first to tell whether the virus was getting past their safeguards.
Then residents began dying, and the deaths mounted throughout the spring. Something close to panic began to creep into some communities.
Shortly after the Focused Care nursing home in Crane County, near Odessa, reported its first case in May, County Judge Roy Hodges issued a court order to quarantine residents and staff until everyone could be tested.
“I was shocked when … two armed law officers showed up at our doors in Crane and refused to let anyone in or out. They blocked the front and back doors of our community,” McKenzie said in an editorial at the time.
Three dozen employees — more than half the facility’s staff — quit that day, fearing that one day they’d go to work “and would never get to home again,” McKenzie said.
No one had tested positive in Crane County in nearly two months. Before that, the county had only two confirmed cases. When Focused Care’s residents and staff members were tested that week under a court order, 21 people were confirmed to have the virus, according to reports. Among the five employees infected was a local high school student. Traditional graduation celebrations for the school district were canceled.
Nursing home officials and residents breathed a sigh of relief when Gov. Greg Abbott ordered testing for all residents in May.
When the first round of test results came back at Focused Care at Corpus Christi, none of the 47 residents or 53 staff members were positive, said Taneicha Grady-Bravo, the facility’s executive director of operations.
Upon hearing the news, she said, the staff let out a loud cheer, exchanging air hugs and high fives across the room.
Grady-Bravo sat down in her office and cried.
“That was a turning point for us to say, ‘OK, we got this, let’s go.’”
The relief didn’t last. Within a couple of months, the Corpus Christi area became a hot spot, grabbing national headlines when a 6-week-old infant died from the virus and again when nearly a quarter of all tests citywide came back positive for the virus.
That’s also when the first COVID-19 case showed up at Focused Care at Corpus Christi. There would be 18 more infections and four virus-related deaths among its residents by the end of September, according to state data.
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Lynda Langford was terrified.
At the end of July, Texas nursing homes recorded their deadliest seven-day stretch since the pandemic began, with 423 deaths reported.
And Langford was about to move into one.
“You’d read the news, and the nursing homes were the worst places for COVID,” Langford said. “In San Antonio, the big city next to us, they were having horrible times. Just running rampant through a whole building. And a lot of [nursing home residents] didn’t survive. That scared me.”
After a few days in an assisted-living facility, Langford moved into Amistad in August. She went immediately into a quarantine unit for two weeks.
When she saw all the safety protocols the staff were going through every time they came into her unit, she felt safer.
“I’ll never forget, they’d come in my room and do whatever they were going to do, and then they’d walk out and take all that stuff off — that blue gown, the masks, all of that — and every time they came into my room they’d do that,” Langford said. “And I just couldn’t believe it. But they did, and I never saw them cut corners.”
“That’s a horrible thing, to watch those ambulances go by.”
Resident at Amistad Nursing and Rehabilitation Center
She often sat at her window, which faced the street in front of the facility entrance, and watched ambulances come and go at all hours of the night. She knew many of the people inside the ambulances were COVID-19 cases. Several, she said, didn’t come back.
“That’s a horrible thing, to watch those ambulances go by,” she said.
Socializing in the common areas and the dining room wasn’t allowed, per COVID-19 regulations, but when one of the residents died, Langford said, everyone would stand in their doorways, cry together and talk about happy memories with their friend — a socially distant memorial.
Near the end of summer, the forced isolation of nursing home residents was drawing increasing criticism across the nation. That led to state and federal officials making the decision to allow “essential caregivers” — usually a friend or family member who regularly visited before the lockdowns — to be trained, screened and allowed regular visits with their loved ones inside the nursing homes.
In August, Abbott began permitting nursing homes that had no active COVID-19 cases among residents, and no cases among staff for the previous two weeks, to allow limited outside visits.
Only a small portion of the state’s nursing homes met that criteria at the time.
At Focused Care at Brenham, the change was immediate, said Jeannie Dupree, executive director of operations. She remembers a man who was in hospice care and stopped eating when his wife couldn’t visit him every day after the lockdowns began.
“But then once we encouraged her to apply to be an essential caregiver, he perked up,” Dupree said. “It was such a radical change that they’re actually looking at getting him off hospice.”
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Langford celebrated her 74th birthday at the nursing home in October. Her husband, their son and his wife and children were there, along with friends.
“We had my birthday party through the window. All my friends came and stayed outside, I was inside,” she said, chuckling. “It’s better than nothing, but it’s not good.”
For Langford, it was the second milestone she’d missed because of the pandemic. In May, she and her husband had planned a large family celebration for the couple’s 50th wedding anniversary at their favorite place along the river north of Uvalde, but they canceled it because of the pandemic.
Langford still wipes away tears when she thinks about it.
Throughout autumn, deaths across the state and the nation began to drop, and nursing homes in Texas saw the same decline.
“We had my birthday party through the window. All my friends came and stayed outside, I was inside.”
Resident at Amistad Nursing and Rehabilitation Center
In Corpus Christi, Focused Care’s Grady-Bravo said that by September, her staff was fighting exhaustion and burnout. The facility started trying to boost morale through “virtual vacations” — themed weeks with food and music representing various vacation spots around the world. The first one was Hawaii.
“They absolutely loved it,” Grady-Bravo said of residents and staff. “We still do it. Everyone looks forward to it.”
The holidays brought a fresh round of challenges as state and federal officials told nursing home operators that residents must be allowed to leave and go visit family over Thanksgiving and Christmas.
It was welcome news for some, but it brought fears of a holiday-fueled “third wave” of COVID-19 deaths.
“Sometimes there’s a disconnect between the directive and what a lay person would think is a common-sense approach, and we have to follow the directive,” McKenzie said. “They could take their loved ones home during the holiday, and we couldn’t stop it, and they could bring them back.”
At Focused Care at Summer Place in Beaumont, two residents tested positive for COVID-19 after one of them went home for Thanksgiving, McKenzie said.
In Uvalde, Langford celebrated the holidays while separated by glass from her family, who again gathered outside the window. But she avoided catching the virus, even as the nation endured its highest-ever spike in deaths and hospitalizations.
The week before Christmas, the first batch of the coronavirus vaccines began arriving at Texas nursing homes.
Meanwhile, at Texas nursing homes, deaths spiked a second time, with a high of 410 in one week in early January.
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Amistad was among the first facilities in the state to receive vaccines, and staff began receiving doses on Dec. 23.
Langford didn’t need convincing when her turn came in January. She remembers taking the polio vaccine orally on a sugar cube while she was in high school in the 1960s and how that saved her generation from a childhood illness that paralyzed 2% of those who contracted it.
“I didn’t hesitate,” Langford said. “I’ve got a better shot with the vaccine than I do without it. I feel like I can get the virus now and live through it.”
More than 70% of the nursing home’s residents, or their families on their behalf, agreed to the shot when it was first offered, said Arizmendi Mirelez, the Amistad facility administrator.
But Hopkins said staffers were harder to convince. Only about a third of the staff agreed to get vaccinated, although those numbers went up “once more people started getting vaccinated and didn’t grow tails,” he said.
As of mid-March, nearly 90% of the staff and residents at Amistad had gotten at least one dose. Meanwhile, Focused Care facilities reported more than 70% of residents vaccinated and more than half of its staffers. At least one Focused Care facility near the Panhandle has 90% of its staff and residents vaccinated, McKenzie said.
By April 6, 1,212 of the state’s 1,223 nursing homes had administered vaccines to residents or staff, according to the state health department. But the virus hasn’t been defeated in Texas nursing homes.
In mid-February, a historic snowstorm and freeze delayed a vaccination clinic at Focused Care Brenham, and shortly after, 18 residents and staff tested positive for the virus in the facility’s only big outbreak since the pandemic began. Some of those residents had recently received the vaccine, but the injection may not have had not had a chance to become fully effective yet, Dupree said. Four of the infected residents died, although COVID-19 was not confirmed as the cause of death. Three of them had declined to be vaccinated, company officials said.
It was a critical reminder that in spite of the relaxing of state pandemic restrictions recently, her company had good reason to keep its protocols in place, she said.
“You realize that we definitely need to still keep our vigilance and keep everything going, because you never know,” she said.
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With more residents being vaccinated and Texas removing restrictions on masking and business capacity, nursing home administrators celebrated a move in late March by state health officials to allow vaccinated residents to get unlimited close-up visits for the first time in a year.
Hopkins can’t wait to hear the sounds of a nursing home bustling with visitors, socializing and joking and bickering in the common areas, rather than the relative quiet of the last few months.
“When I walk into the nursing home, I want to hear it. I want it to be loud, you know? Something going on. I want to hear the residents in the dining room,” he said. “I like that kind of stuff. It’s just happy.”
Langford knows she’ll probably never move out of the nursing home — she doesn’t believe she’ll ever be able to safely be alone while her husband works on the ranch — but has high hopes for being able to embrace her new life there once the worst of the pandemic passes.
Her first wish is to celebrate her 51st wedding anniversary in May — and have the party that she had to cancel last year.
Earlier this month, she was finally able to hug her husband for the first time since last summer. It was a moment, she said, of pure joy.
“It felt great,” Langford said. “It was awesome.”
Each day, nursing homes report the number of residents who died due to COVID-19 to the Texas Health and Human Services Commission. Between May and July 2020, the Texas Department of State Health Services also provided data from nursing homes. DSHS gathers other state health statistics, including the reported COVID-19 deaths statewide.
The weekly death numbers published here were compiled by subtracting the cumulative number of nursing home resident fatalities reported statewide each Wednesday. The week of Texas’ winter storm in February, the state did not update nursing home COVID-19 data until Thursday, so that data was used instead.
Emily Albracht and Miguel Gutierrez Jr. contributed to this report.
Every day for a year, Kathy James peered at her mother through the window of an assisted living facility outside Chicago and dreamed of the day they would be together again.
That moment finally came this month, when Ms. James packed a goody bag full of family photographs, a Sunday copy of The Chicago Tribune and a container of potato soup, and met her mother, Renee Koerber, 90, inside the nursing home.
“I said, ‘Mom, we’re in the same room!’” said Ms. James, 63, her heart swelling with relief.
They had made it.
But sitting several feet apart in a common area, where they were not allowed to hug, Ms. James was also startled at how frail her mother looked. She seemed to grow tired after just 15 minutes. “I thought I would be so happy,” Ms. James said. “And I just feel such grief because of the year of time I have lost and I will never get back.”
Many American nursing homes have begun to welcome visitors again after a year of excruciating lockdowns. The Biden administration this month published sweeping guidelines allowing indoor visits in most cases. It is a profound change that comes as vaccinations ramp up, reaching nearly 100 million Americans, including a majority of people in nursing homes.
Even as the head of the Centers for Disease Control and Prevention warned this week of a possible fourth coronavirus surge, nursing homes are so far holding steady, reporting drastically fewer cases and deaths since the start of vaccinations. The improved outlook means that across the country, people are once again greeting loved ones in nursing homes with bouquets of flowers, with homemade pudding and lemon bars, with news from children and grandchildren.
“A year lost is a big loss,” said Pauline Boss, a family therapist and professor emeritus at the University of Minnesota.
Nursing homes now offer an early glimpse at what everyone may face in trying to go back to normal after a year of separation and stillness. Some reunions may be tinged with grief, others with reminders of all that has changed.
Dr. Boss said the experience of families coming back together a year into the pandemic reminded her of research she had done on husbands returning home to wives after war, or cancer patients who suddenly learn they are in remission. “Things don’t quite get back to normal,” she said.
Nursing homes have been centers of the pandemic since the beginning, when an outbreak was first identified at a facility outside Seattle. Across the country, one-third of all coronavirus deaths have been linked to nursing homes.
As a geriatrician in San Francisco, Dr. Teresa Palmer, 68, was well positioned to advocate for her 103-year-old mother, Berenice De Luca Palmer, after federal officials recommended last March that nursing homes shut down to visitors. Dr. Palmer did local news interviews, checked on her mother often over Zoom and even accompanied her to occasional doctor’s appointments.
But when Dr. Palmer finally walked into her mother’s room this month, she was shocked to find that her mother, who had shrunk to 98 pounds, was spending all of her time in bed.
Dr. Palmer tried to raise her mother’s spirits, helping her write a letter to a cousin one day, bringing pizza for lunch the next. But by the third day, it became apparent that the problem was far more serious.
Dr. Palmer took her mother to a hospital, where she said her mother was told she had an advanced form of pancreatic cancer.
“I’m sad and angry,” said Dr. Palmer, who has found herself reflecting on all that her mother missed in the past year. Trips to the beach. Sunflowers in bloom. Family meals complete with pasta, wine and the elder Ms. Palmer, the matriarch of their Italian family, presiding over the dinner table.
“It’s the quality time that has been lost,” said Dr. Palmer, who has since brought her mother home for hospice care.
For others, emotions have ranged from euphoria to concern.
“My mom is really different,” said Shirley Kwong, of her 85-year-old mother-in-law, who lives in a nursing home in the Bay Area and has grown more confused after a year apart. “Worse than before.”
Adriane Bower, 59, thought her mother, Angeline Rujevcan, 89, looked older, maybe a little weaker. Still, Ms. Bower said she was “over-the-moon happy” just to be able to sit with her at her nursing home in Crestwood, Ill. Though they were not allowed to hug, she knew she was one of the lucky ones.
But like many policies during the pandemic, the federal guidelines have rolled out haphazardly across the country. Some people have been allowed to hug, hold hands and visit in their loved one’s room. Others are required to schedule 30-minute appointments in public areas.
Almost no facility is completely back to normal, and with coronavirus cases ticking upward again, some fear that even the limited access could be halted again. Under federal guidelines, one new case can temporarily shut down visitation in a nursing home, though visits may resume if an outbreak is not widespread.
In New York City, Henry Grullón, 50, had been anxiously waiting to see his grandmother, who lives at a large facility in the Bronx. Until last week, New York state guidelines required that facilities be coronavirus-free for 14 days before allowing visitors.
So it was a welcome surprise when his grandmother, Catalina Perez, 98, was wheeled into the lobby on Friday. Mr. Grullón’s mother, who is 81 and had been despondent over their separation, inched toward her, crying. “I need to hug her,” said his mother, Ana Grullón, who set aside rules urging families to stay apart and embraced her mother for the first time in a year.
“She kept just saying, ‘mom, mom, mom,’” Mr. Grullón said. For the moment, he pushed aside his worries that his grandmother had lost weight and seemed depressed amid the pandemic. “My God, it was incredible,” he said.
Experts worry that some of the physical and cognitive changes experienced during the pandemic could become permanent because it is often difficult for older people to regain strength after losing weight or becoming bed-bound. The lost year has been particularly consequential for people with dementia, some of whom no longer recognize family members.
“That is time that you are not going to get back with that person,” said Lori Smetanka, executive director at the National Consumer Voice for Quality Long-Term Care, an advocacy group for residents and families. “We don’t know how to reverse that.”
A year ago, Janet Hooks still recognized one person in the haze of her dementia: her husband of 62 years, Chauncey Hooks. Each day, she scanned the hallways of her nursing home in Worthington, Pa., outside Pittsburgh, waiting for him to visit.
But at the beginning of the pandemic, Mr. Hooks grew suddenly ill with what doctors said was the flu. He died March 12.
After holding her father’s hand in his final moments, a daughter, Lori Turberville, drove from the hospital to her mother’s nursing home to break the news. By the time she arrived, the facility had been shut down.
Ms. Turberville dreaded sharing such upsetting news with her mother over the phone, and decided to wait until she could comfort her in person.
“I didn’t think it was ever, ever going to last this long,” she said.
A year later, Ms. Turberville, 60, is thrilled to be able to have daily visits again. Brushing her mother’s hair and feeding her small bites of vanilla swirl ice cream have sparked something inside her mother in ways that window visits never did. Still, she has yet to tell her mother about her father’s death.
Her mother is weaker than she was a year ago, she said, and doctors have advised her that conveying that news now may do more harm than good.
So Ms. Turberville has taken to reassuring her mother with some version of the truth: “You know how much he loves you.”
Still, she worries each time she catches her mother’s gaze searching the halls.
“It really does go through your mind: Is she waiting for him to walk down there?” she said. “Sometimes I feel like, after 62 years of marriage, she deserves to know.”
While the visits have brought peace to many nursing home residents who feared they would never see their family again, others are still waiting for something else: independence.
Before the pandemic, Bruce Carmona, 63, regularly left his long-term care facility in the Chicago area, taking himself out to concerts, riding the train downtown or simply going out to grab a beer.
“I put 1,200 miles on my wheelchair,” said Mr. Carmona, who was paralyzed in an accident in 2018 and had grown to enjoy the small pleasure of cruising around town, listening to country music on his stereo and feeling the wind on his face.
Despite the new guidelines, many residents are still not allowed to leave their facilities for extended trips. So although Mr. Carmona is vaccinated, he said he is still largely confined to his room.
“If I could get out, that gives me freedom,” he said. As it is, he said, “I’m in prison.”