Mechelle Alvarado had a hard time deciding to move her dad, partially paralyzed from a stroke, into a skilled nursing home. “I’ll be here every day,” she promised him three years ago.

And indeed, Alvarado says, she popped in almost daily. She took him to church on Sundays and to breakfast once a week. She did painting classes with other residents, too.

Nearly two weeks ago, she stopped in for a quick visit at his Galveston County complex before leaving for a rare weeklong trip to Florida with her kids.

“I’ll be back next week,” she told her dad, a Marine veteran and constant jokester whom she considers a best friend.

Alvarado, 49, hasn’t been able to see her dad since, and with nursing homes under federal and state orders to keep out almost all visitors, she might not see him for weeks to come.

The reality of the danger he and others faced hit home Thursday, when officials announced that a man between 80 and 90 years old living in a northwest Harris County nursing home died after being hospitalized from the illness.

Rules have been in place since March 13 to bar nursing home visits unless for end-of-life reasons, in hopes of preventing the new coronavirus from spreading among a vulnerable population.

Effects of such separations are sinking in for Alvarado and countless others with family members in nursing homes, which provided 24-hour care for 1.3 million Americans in 2015. Residents typically need daily assistance, often more than relatives can handle, and range from older adults to those recovering from surgery.

Under the new rules, residents are no longer supposed to have group activities or eat all together. For Alvarado’s 72-year-old dad, who was once always on the go, it’s hard not to be able to leave, his daughter said.

“He wants to get out, but he understands that he can’t,” she said. “I know where he is, and I know he’s safe, so I’m OK.”

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The new rules, and the loneliness that come with them, were hard to stomach — but so was knowing older people were more likely to have complications from COVID-19, the disease caused by the new coronavirus.

The Centers for Disease Control and Prevention found that 8 in 10 deaths reported in the U.S. were adults 65 and older. More than 20 deaths in Washington state were connected to a nursing home in Kirkland run by Life Care Center, which also operates homes in Texas. Illinois’ governor revealed this week that 18 residents and four employees at a Chicago-area nursing home tested positive. The first coronavirus patient to die in Texas was 97.

So family members now are trying to figure out how to stay in touch with those they love. And nursing home staffers are helping by facilitating video chats and calming residents plugged into the news.

They are getting creative: In at least one Paradigm nursing home, they played hallway bingo, with residents sitting near their doorways, and a staff member calling out numbers from the hall.

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Alvarado’s dad, Richard, is one of some 100 people living at Bayou Pines Care Center in La Marque. The father worked for years in a shipyard and later as a landscaper. He liked to barbecue and hang out with his family on the porch.

Now he is eating meals alone in his room, as directed. “Nothing to do here,” he said by phone.

Bayou Pines staff called family to tell them of the change in visiting rules. Staff had new requirements, too: When they arrive, employees have their temperatures taken and fill out a symptoms questionnaire.

“It’s a big change,” said Shelly Crow, who oversees the nurses there, “but everyone seems to be going with the flow to do what’s best for them — the residents — because they’re so at risk.”

All over the region, such facilities are adapting. Bayou Pines employees went to get more puzzles and activity books. They and other senior living providers suggested grandchildren and other kids stuck at home send letters to residents.

Some nursing homes ordered iPads to lend to residents so they could make video calls with family. Nurses at various Park Manor facilities made “angel rounds,” checking in for the sake of saying hello.

“The staff, they become almost like family because they’re the ones there,” spokeswoman Leticia Caballero said. “As long as they can see our team, our staff, our nurses who know them, that helps. ... It’s a tough thing.”

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When Alvarado got the news that visits were ending, she had the same questions as others: Could she visit with her dad from 6 feet away outside on the porch? (No.) Could she talk with him while looking through the window, as others have tried? (No.)

At the Northwest Health and Rehabilitation Center in Harris County, family members can drop off food, books or other items at the front door.

At the Bridgemoor Transitional Care facility in San Antonio, a nurse came across a patient talking to two relatives through an open window, which is forbidden.

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“It’s the patient really at the end of the day we’re most worried about,” said Mark Fritz, president of the company, “making sure they feel safe, and trying to explain why this is happening.”

Alvarado settled on calling her dad through Skype — which took some getting used to.

The Bayou Pines staff took it a step further and offered for residents to take photos with different props. One was a white board on which they could scrawl a message to pose with.

They wanted it to be lighthearted, and Alvarado’s dad, though wishing his daughter could be there, didn’t miss the chance to crack a joke.

“How about a Corona?” said the white board he posed with. “Not the COVID-19!”

On Wednesday, Alvarado returned the message. She, her daughters and other relatives spent six hours making more than 100 cards, one for every resident at Bayou Pines and a few extra for him.

Alvarado printed out an image of a corona beer, cut around the edge and put it in her card. She planned to deliver the pile Thursday, even if she couldn’t go past the front door.

emily.foxhall@chron.com

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