Even before COVID-19, the lines from marriage vows, “for better or worse, in sickness and in health” took on a different meaning when one person in the marriage needed long-term care in a nursing home. This became even truer when we found ourselves in the middle of a pandemic. Suddenly and unexpectedly, policies intended to keep nursing home residents safe led to unimaginable consequences for the couples divided by the doors of a nursing home.
Last year at this time, COVID-19 began to hit nursing homes hard causing numerous infections and many deaths. On March 13, out of an abundance of caution, the Centers for Medicare and Medicaid Services stopped nursing home residents from receiving outside visitors, in an attempt to prevent further spread of COVID-19 and additional deaths. This order had the unintended effect of cutting off spouses from each other for many months. Recently, researchers from the University of Maryland Baltimore County and Bowling Green State University in Ohio sat down with the spouses left behind on the outside to learn more about their experiences, and the stories we heard were heartbreaking.
In honor of Valentine’s Day, we wanted to recognize those spouses by sharing their stories. One wife, whose husband has lived in a dementia unit since a car accident 15 years ago, said she missed the everyday experiences most. Before COVID she would visit often and they would sit and talk, watch TV and hold hands. Visiting over the last 11 months has been much more limited. After several months of no visits at all, the nursing home where he is finally allowed her to come in for scheduled, time-limited, in-person visits, but it has been different than before. Staff are always present during these short visits to make sure COVID protocols are not broken, “which is very hard,” she said.
Similarly, getting together for meals was a regular aspect of intimacy and daily life for another couple. With the COVID-19 restrictions, the wife went from visiting “every day, twice a day to [her husband] now having nobody and being in a room all by himself.” Window visits and Skype visits were the only options, and for them these were no better than talking on the phone because her husband is legally blind and has a diagnosis of Alzheimer’s disease. His health has declined over their time apart. Now, it is “just horrible,” she says.
Another wife had an established routine of going to see her husband daily at the nursing home to share dinners and to participate in other social activities, all of which she lost when COVID restricted her ability to visit. She and her husband were able to continue to talk by phone daily, but she was frustrated by the lack of access and sad for the people who live there. After many months, the nursing home arranged for residents and loved ones to visit through the window, but even then, those visits were for 15 minutes only. Finally, when her husband was dying, she was allowed to have an in-person, indoor compassionate care visit. That visit, the last time she was ever to see her husband, was carefully monitored to ensure that she followed protocols and did not overstay her time.
A fourth wife said she and her husband have been married for 45 years and she missed everything this year — birthdays, anniversaries, all those events they have shared every year for most of their lives. It was particularly sad for her because with her husband’s advancing dementia it was likely the last of their anniversaries.
While restricting our daily activities and sheltering in place has become a new normal for many of us, the longing for one’s partner on this holiday should never be normal. On this Valentine’s Day, remember all those who are separated from their spouses due to COVID restrictions, and if you are tired of quarantining with your spouse, hug them a little tighter tonight.
Nancy Kusmaul (nkusmaul@umbc.edu) is an associate professor at the University of Maryland Baltimore County. Vivian Miller (millevj@bgsu.edu) is an assistant professor at Bowling Green State University.