Is Assisted Care the Place to Spend Flu Season?

Before I came to live in the retirement community, I was in my house alone a great deal of the time. I slept alone, ate alone, watched television alone, made messes and cleaned them up alone, walked alone outdoors in the afternoons. Because of covid the fewer people I saw up-close, the safer I was.

The beginning of the pandemic had already caught me away on a book tour, but once I risked another four hours in the air with a hundred people and got back home, I felt I was surely safe.

On the other hand, I had to go to the grocery. I needed a haircut. There was that long-standing appointment with my dentist. I wanted to go to church.  (A young friend did some shopping for me. I let my hair grow and apologized to the dentist, who might have been relieved. At church I sat where an usher put me, surrounded by empty seats, and “passed the peace” with hand signals.)

I am good at using time alone, but I missed my friends. Sometimes one would drop by for a ten-minute visit, bringing a bowl of soup or a piece of cake, and we would sit on opposite sides of my living room wearing masks or visit on the front stoop, shifting our weight from one foot to the other. Regardless of the circumstances, I felt inhospitable when I did not invite people in.

The bright spot in my week was Friday evening when my son and his wife arrived from half an hour away, bringing dinner. We had decided to trust one another.

Sometimes I think about the contrast between my life then and now, living in the retirement community. When I came here I had not even imagined how long covid would be with us or how much it would change some of our lives. And the reason I asked at the top of this article if this is the place to spend flu season is that we have come to realize that covid will not totally go away but will be impacting our lives for the foreseeable future. We have to compare it in this way to the flu that attacked the world viciously in 1918, taking the lives of many people, young and old, creating havoc in the medical system and work force, and giving the scientists an urgent assignment. Sound familiar?

We didn’t get rid of the flu; we just learned to control it.

Now I hear that covid will be the same. We will win but not a total victory. We will forever expect covid and be obliged to respect it. 

Therefore. . .the question: Is a continuing care community the place to be if there is a covid-season like flu season?

Based on the current response to covid, this is what I can say:

Numerous people who work in a senior community will come in the mornings and go home in the afternoons and a few others will come in to handle the night shift. No one can know what all these people did while they were away. Surely they will be vaccinated, however. If they refuse, they will lose their jobs. Nevertheless they may carry in with them some strain of covid and/or the flu.

Visitors to the community now (and we can assume during any epidemic) are limited and asked to follow CDC guidelines for wearing masks. Their temperature is taken at the door. They must sign in at the reception desk, answering numerous other nosy questions, all designed to protect the people who live inside. Such rules may be revised to fit danger levels, but one thing we can know. The owners and administrators of such a community are deeply invested in every resident’s well-being. An outbreak of a contagious disease inside their walls would be a public relations disaster.

As a resident, you cannot be required to accept vaccination, but the administration may arrange a community vaccination event and boast of a percentage like 97%, while the rest of the country struggles to reach 75% fully vaccinated.

It helps that in the senior community residents will probably not have to go out somewhere to get vaccinated. Everyone will go (maybe down the hall to some common room) within the announced time frame, having been given a specific minute in the schedule. In the designated space there will be a doctor and a team of people with needles and the vaccine.  The process will be organized, coordinated and swift. You will sign a consent statement. You might watch one or two people sit down, expose a shoulder and accept a shot. Then it will be your turn.

Afterwards you might be escorted across the hall to a room equipped with comfortable furniture, drinks and cupcakes, and happy music in the background suggesting that this is actually a party. After some short, designated length of time, you will be given permission to leave. (There is an outside chance of some reaction to the shot, and in this community no one is leaving your health to chance.)

In spite of all precautions, a few residents will get the virus and be sick. In the case of covid, regular tests will be given. People testing positive will be required to isolate in their apartments, whether or not they have symptoms. A few residents, usually people with other serious health problems, will be taken to a hospital. Contact tracing will reveal the people who spent close-up time with them and these will be tested.

The administration might ask everyone to wear masks. I don’t know for sure that this precaution will survive into the future. I just know that most people will do as requested (if not for themselves, for the sake of their neighbors), and a few will not. People in a continuing care community will be just a broad sample of the community outside, except that it will tend to be elderly people.

So, is this the place to be during a public health hazard?

I learned recently that more than 201,000 of the nearly 920,000 deaths from covid in the U.S. were in nursing homes. I mention this only to clarify that assisted care communities are not nursing homes. A nursing home is a place for very ill people. Often the patients share rooms or lie in wards with numerous beds close enough that one nurse can be responsible for multiple cases. These institutions are notorious for the spread of diseases, and people who are already sick are more likely to die.

What I can say for sure about any retirement community is that you will live closer to other people than you did in your home. If your neighbor on the hall or someone you gravitate to in the dining room has covid, you are likely to be exposed.  But the chances are much higher that both of you are protected. Life inside is designed to keep you safe and reasons for going out are limited.

In this environment if you are exposed to covid you probably will know it. The nursing staff also will know and be watchful. If you test positive or for any reason need to isolate, the dining room staff will take your order and deliver meals to your room three times a day.

But, so long as you are negative, you are still free to leave and come back. You will record your departures and arrivals on the same tablet that visitors use as they come and go. You will be asked about your temperature and other possible symptoms of illness, especially when you return. In illness and in health, the community has some responsibility for protecting you and is accountable to your family. This could be the crucial factor in choosing a safe environment for your declining years.