Nursing Homes and Long Term Care After COVID-19: A New ERA?

Anna, 92 years old, former housekeeper, with a history of disabling stroke and disabling knee osteoarthritis, had been living in a Nursing Home (NH) for the last 6 years.In Anna's NH, 60% of the staff were affected by COVID-19.In March 2020, she was transferred to hospital due to hyperactive delirium where she was diagnosed with COVID-19 but then transferred to an alternative NH, designated for COVID-19 care.She died 2 days later having received palliative care but in unfamiliar surroundings.From the time her original NH was closed to visitors, until her death, she did not see any family members.Amanda, 87 years old, a widow and former schoolteacher, was diagnosed with Alzheimer's disease 8 years ago and moved to a nursing home 2 years ago.Prior to the outbreak she was able to follow a basic conversation and had limited mobility with a walker, participated in some group activities and had regular family visitors.She died after one month isolated in her room, initially because she had been in contact with another resident diagnosed with COVID-19 and later because of her deterioration.She did not experience the hallmark symptoms of COVID-19, and had a negative PCR for SARS-COV-2, but she became progressively more disoriented and spent more time in bed.