PHILADELPHIA — For the first six months of the pandemic, Kim Boddy could see her mother only through a window.
Marguerite Forbes, who has had Alzheimer's disease for 10 years, spent most of those months sitting in her room at a nursing home. Boddy was "beside herself" with worry over her mother's condition and the time they were losing.
After September, there were visits — separated by six feet and plexiglass — every couple months. Forbes, who is now 90, just found them confusing.
Once the two were vaccinated, Boddy could see her mother more often and assess the damage that nearly a year of inactivity and isolation had added to the ravages of old age and dementia. Forbes, who had by then moved to the nursing home at Rydal Park, a Jenkintown retirement community, had stopped walking. She wasn't communicating well before, but her language had deteriorated. Her hands shook. Forbes fed herself before, but had started letting others feed her. Worse, when Boddy saw her, "she was just blank." There was no sign of recognition.
For about a month starting in late March, Boddy, who lives in Montgomeryville, was able to visit every day. She fed her mother. She saw the older woman tap her foot to music and sing. They could touch, a connection that now transcends words. Boddy is a realist about what time and the coronavirus have done, but sometimes she sensed a recognition in her mother's eyes.
Their visits are on pause now because two residents and a staff member tested positive. Boddy worries that her mother's minor gains will be lost. "I'm hoping she won't forget me again before I'm able to see her in person," she said.
As vaccination has allowed nursing homes to open up a little, thousands of family members are seeing older loved ones with a disturbing clarity not possible during FaceTime calls and window visits. Even under the best of circumstances, the oldest seniors tend to decline over a year. But experts on dementia and aging say there is little doubt that isolation and loneliness steepened the slope for many. The pandemic was especially hard for nursing home residents with dementia, they said, but even some elders who live alone in their longtime homes suffered from lack of social contact and oversight.
The agony of the lockdown is now yielding to a transition that also feels hard. Caregivers such as Boddy are grappling with physical, cognitive, emotional and behavioral changes in their loved ones. One of the next pandemic frontiers will be figuring out how much of the last year's damage can be undone.
"We are concerned that it will take some time to recover from the double whammy of the direct effects of the virus as well as the indirect effects," said Sarah Lock, AARP's senior vice president for policy and brain health.
"The real question is how much of [the damage] is reversible, and we don't really know the answer to that yet," said Karl Steinberg, a San Diego geriatrician who is president of AMDA-the Society for Post‑Acute and Long‑Term Care.