PROVINCETOWN — Last Friday, March 20, Seashore Point condominium owner Bruce Mason had just returned from a meditation class with other residents. At the same time in Yarmouth Port, Fran Turgeon was packing up to leave her apartment at Heatherwood, a senior independent living community, after receiving notice from management that the first case of coronavirus had been confirmed there.
Both 84-year-olds own their condominiums in multi-unit complexes filled mostly by elderly occupants — those at greatest risk from the highly contagious virus.
Yet management’s approaches to that risk were very different at the two complexes. The reasons for those differences, and the lack of consistent policies to protect vulnerable people from an epidemic, have many older residents of the Outer Cape and their loved ones worried.
At Heatherwood, residents have been instructed to self-isolate since March 15, said Turgeon, formerly of Eastham. They’ve been told not to walk the hallways for exercise, which normally happens frequently, or to congregate in groups. Heatherwood stopped serving meals in its dining room on March 15 and began delivering them to residents’ doors. After lunch on March 20, the kitchen was shut down completely, with management citing a lack of staff.
At Seashore Point, groups led by outside teachers have been canceled, Mason said. But the condominium owners still had use of a coffee bar and could gather in the mail area and use the gym, said Barbara “Mae Bush” Stevens. Seashore Point stopped service in the dining room only on March 19, but meal delivery continues there.
Despite what seem to be stricter precautions, it was the Heatherwood residents who got the memo: “We regret to inform you there is a confirmed case of the coronavirus at Heatherwood.”
The memo, from Director Scott McClellan, described the patient only as someone “at Heatherwood” without specifying whether the person was a resident or a staff member or how management might proceed with determining specific contact risks or related protocols. McClellan advised residents to “stay in your home to help all of us stay safe. This is a good time to reach out to your family and let them know there is a confirmed case at Heatherwood. Your family may choose to have you stay with them until this crisis passes.”
Management then informed the 190 or so homeowners that meal service would end that day. Many Heatherwood residents are over 80 years old and some require significant help, including prepared meals.
Turgeon said she was leaving immediately because she no longer felt comfortable there, not knowing whom to avoid contact with.
Chris Hannon, chief operating officer of Pointe Group Care, which bought Seashore Point last year, said, “We are doing everything we can to prevent coronavirus at this property and we take it very seriously.” Management has provided training and information on social distancing, he said, but, “the independent living residences are not specifically covered by any state or federal guidance beyond that issued for society at large.”
Barnstable County has the oldest population in the state, with the number of people over 65 at least double the state average. According to the U.S. Census, seniors make up 32 percent of the population in Provincetown, 41 percent in Truro, 34 percent in Wellfleet, and 38 percent in Eastham.
Care for seniors has never been more important. The U.S. Centers for Disease Control and Prevention report that 8 out of 10 coronavirus deaths in the U.S. have been people over age 65.
The gray areas of elder care for those who remain in their own homes are pronounced. Caregivers (often elderly spouses) are in as much danger as the frailest member of the family, and yet they feel most obligated to keep up with their normal activities, said Molly Perdue, co-founder of the nonprofit Alzheimer’s Family Support Center.
All 50 monthly self-help groups of the support enter have now been canceled, she said. She and her staff of 22 part-timers are instead calling group members and other clients frequently.
“If anyone is sick, we call them every day,” said co-founder Melanie Braverman.
Under unprecedented circumstances, the nonprofit is trying to be practical, Braverman said. The most important step is to create contingency plans in case a caregiver gets ill. Compiling medication lists and arranging food and medication deliveries so someone else can step in is critical.
Many seniors depend on home health aides, and asking them to stay away is not practical, Braverman said. Rather, she advised, ask the agency providing the aides what their policies are: do they take employees’ temperatures and otherwise screen them, and do they provide protective gear? The state Dept. of Public Health (D.P.H.) has issued guidance and a checklist for in-home care providers, including restrictions on nonessential visitors, temperature taking, and use of personal protective equipment.
Nursing Homes and Assisted Living Rules
Coronavirus rules are much clearer at nursing homes and assisted living facilities. On March 15, the D.P.H. banned all nonessential visitors and advised staff and visitors who are not restricted — those necessary for medical assistance or people coming to visit a dying relative — to be screened. Anyone with a fever is not to be allowed into nursing facilities.
The same rules apply at assisted living communities, which generally offer help to residents for all non-medical living needs — dressing, cleaning, cooking, and medication — though the residents still live alone in separate apartments.
At Chatham’s Victorian Assisted Living, all residents’ temperatures are checked daily, said Celeste Fox, the executive director. Also, staff and visitors must wear masks, she said.
“The mailman won’t let us take his temperature, so we have him leave the mail between the first door and the second door,” Fox said. “We have two sets of doors at the main entrance to our facility, and he leaves them in the little room in between.”
Residents can leave only for essential medical appointments and are driven by family members.
Gladys Johnstone, who lives at the recently renamed AdviniaCare nursing facility at Provincetown’s Seashore Point, turned 98 on March 18. Her birthday celebration was going to be a huge family affair involving relatives from all over the country. Instead, it was scaled down to just her and her son, Doug Johnstone of Provincetown. He visits with her through her first-floor window.
Though everyone is worried about older residents, Gladys herself said she’s just slightly bored.
Gladys is Provincetown’s oldest registered voter and holder of the Boston Post Cane. At her age, she said, “You realize you cannot control it and you never could.”
Provincetown resident Ilona Royce Smithkin, who turns 100 on March 27, said nearly the same thing. Living alone on Commercial Street, Royce Smithkin has hired help five days a week, and friends who don’t hug or kiss. She is not stressed out.
“Life goes on, the world is pretty crazy, but we have to make the best of it,” she said. “Each day it’s a surprise. Every day when I wake up, I move my hips and I move my lips and I say, ‘Wow. I’m still here.’ ”
Devin Sean Martin contributed reporting for this article.