The Last Days of Loneliness

Long-term-care residents who have been confined to their rooms for months have to wait a bit longer before they can finally receive a vaccine.

Two nursing-home residents look out a window.
Craig F. Walker / The Boston Globe / Getty

I expected Mary Ellen Scott to sound sad. This year—Scott’s 18th as a resident of the Montrose Health Center in southeastern Iowa—has been especially hard on people in nursing homes and assisted-living facilities. Nationwide, nearly 40 percent of all coronavirus-related deaths have happened in long-term-care facilities; my grandmother died of COVID-19 in April after contracting the virus in her Minneapolis assisted-living community. In these places, many residents who have been confined to their rooms for months are now counting down the last lonely days before they can finally receive a vaccine.

Scott, though, was chipper when she answered the phone. Like others, she’s struggled with the long months of isolation. But she’s gotten used to being alone. When you’re 88, she told me, “it’s not like you’re gonna be running around anyway.” She reads a lot and calls her children, whom she misses dearly. Like the rest of us, she’s just muddling through.

COVID-19 hit Iowa in the spring, and Scott has been unable to attend group dinners or bingo nights ever since. Fortunately, confinement suited her, at least at first. For months, she kept to the same routine. She’d sleep in every day—“someone’s always on my case to get up”—and take her morning pills with a glass of prune juice. She’d make her bed and brush her teeth before spending hours in her chair with a book, or sewing a little, or rearranging her belongings: a hairbrush in a different drawer, a new set of pictures on display. In the afternoon, she’d take a nap, and after that, it was suppertime. (“You’re a good sleeper,” I told her. “I know!” she replied). She feels healthier, more spry, in the evenings, so after dinner, she’d stay up late watching home-remodeling shows or news programs. She’d request her favorite snack from the dining-room fridge. “If I wait until midnight, nobody says anything about my pickles except the night nurse,” she said.

She missed seeing her children in person; she’d tried a window visit with her daughter, Christie, who lives in town, but it felt too strange to repeat. Otherwise, her new loner lifestyle was “glorious,” she said. Before COVID-19, she was always having to decide “Am I gonna do this [activity] or stay in my room and do what I really want to do?” With lockdown orders in place, she could read and write and watch TV, uninterrupted.

In October, Scott caught COVID-19. Actually, everyone at Montrose did, or at least that’s how it felt. Several residents and staff came down sick with the disease, she learned from the aides who visited her room. Three of her neighbors in the nursing home ultimately died of coronavirus-related complications. Christie called often to bring her news from the community, and one day, Scott watched from her window as a woman in the house across the street was carted away in an ambulance. Scott felt tired and weak from the disease, but she was never scared. “It’s gonna happen one of these days, one way or another,” she told me. But Scott didn’t die. She slept it off. And after a few days, she was fully recovered. She credits her confidence—and her survival—to her faith in God. “I have a very strong belief, and that’s where my security comes from,” she said.

It wasn’t until last month that Scott really began to feel the weight of the year. She couldn’t escape the feeling of restlessness, the desire to leave her room, to roam the hallways, to soak up the sunlight on the front patio. She daydreamed about driving to Christie’s house, something she did often before the pandemic. She craved a visit from her son, who lives in Duluth and whom she has not seen in nearly a year. A few weeks ago, administrators at Montrose Health Center loosened some restrictions, allowing residents to watch the finches in the aviary or go outside and win some cash at two-to-a-table bingo. Scott is happy about these developments. But group dining is still prohibited, and she cannot leave the premises or accept any visitors.

The promise of the newly authorized vaccines has given long-term-care staffers hope. Inoculating the staff and the nearly 20,000 residents of Iowa’s nursing homes would mean that things could open back up again—that residents could be social, and potentially even visit with family members. But although most states have begun vaccinating frontline health-care workers, many people in long-term care are facing serious delays. Nursing-home residents in Iowa will have to wait until at least December 28 to receive their shots, due to a federal rule requiring states to have at least 50 percent of the amount of vaccine they need on hand before they start inoculating residents. Further delays have been caused by the fact that CVS and Walgreens, which are administering the vaccine in nursing homes, require consent from residents and their families, which in many cases hasn’t yet been given. A staffer at Montrose Health Center told me that the residents might not get the vaccine until as late as January 14. To top it off, several states are getting significantly fewer vaccine doses than local health officials were anticipating.

Scott does not spend any time thinking about the vaccine. She filed the concept away in the back of her brain long ago. She’s already had COVID-19, for one. Plus,“I’m so old that I don’t care that much, really,” she told me. But Scott is relieved that her neighbors and the Montrose staff members, whom she loves, will finally get inoculated. She’s also generally avoided thinking about Christmas and the fact that, like so many Americans, she will not get to be with her family for the holiday this year. Instead of dwelling on the problem, she is spending her free time making Christmas cards—one for each of her two children, six grandchildren, and 22 great-grandchildren.