In the wake of concerns about the coronavirus spreading, Nevada Senior Services, an adult day care company with locations in Las Vegas and Henderson, remains open, but not without changes to its facilities.

The company disinfects its centers throughout the day and night, and conducts more staff training around precautions about the coronavirus, also known as COVID-19. It carefully monitors clients’ health, and staff look for any potential symptoms of the disease, said Jeffrey Klein, the president and chief executive officer of Nevada Senior Services. “At the first sign, a cough or a sneeze, our nurses are on it,” he said.

Staying open is important for caregivers and family who need someone to tend to their loved ones while they’re at work. But it’s also crucial for the well-being of older Americans, especially in times like this, Klein said. “It’s important for life to go on,” he said. When in communities with few cases of the coronavirus, older adults should continue to socialize, as well as eat well, stay hydrated and keep in good spirits, he added.

As a result, the centers will remain open until the community’s health status changes or if there is a steep drop in attendance, which has already begun to happen, Klein said.

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Older adults are most at risk of complications (or worse) if they’ve contracted coronavirus — but they’re also at risk of loneliness and depression, which may become inadvertent effects of the spreading disease. Becoming socially isolated could diminish their mental and emotional health.

Still, some adult day care centers, nursing homes and assisted living centers are not so lucky. Fears of the coronavirus are spreading faster than the disease itself, and because of the risks to older adults, some centers have been forced to close or restrict access to loved ones, potentially leaving patients to feel afraid and alone — or completely shut out.

The risk to older adults

The coronavirus is officially a pandemic as of this week, according to the World Health Organization, and medical experts are advising everyone to wash their hands often and stay away from large crowds as much as possible. Older adults are at a higher risk of suffering from complications of the coronavirus, the Centers for Disease Control and Prevention said, as are people with heart and lung diseases.

There are nearly 128,000 confirmed cases of coronavirus around the world, and over 4,700 deaths. More than 68,000 people have recovered, according to the Johns Hopkins Whiting School of Engineering’s Center for Systems Science and Engineering. The United States has more than 1,300 positive cases of coronavirus, and 38 deaths — all but eight of which are in Washington state. Only five people have tested positive for the coronavirus in Nevada, where Nevada Senior Services is located.

The Life Care Center in Kirkland, Wash. is an unfortunate example of the consequences of an outbreak among older adults. Prior to the spread of the disease at the facility in mid-February, there were 120 residents, but since then, 26 people have died, the center said in an update. Now there are 47 residents left at the facility, 26 of whom tested positive and 12 of whom tested negative. Five tests are pending and four results were inconclusive.

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What older Americans are being told to do

The CDC suggested older Americans stay at home and stock up on foods and medications. They are also told to limit contact with others whenever possible.

Older people only see a higher rate of depression than their younger counterparts when they have conditions that limit them, said Peter Lichtenberg, director of the Institute of Gerontology and the Merrill Palmer Skillman Institute. This does not bode well for this demographic, considering it is the same one being told — repeatedly and from all angles — to remain isolated. “Because they are the ones who will be most vulnerable, they are being told to avoid large crowds and limit exposures,” he said. “Programs for older adults and senior centers are really preparing for potential cancellations.”

Loved ones mean well when they tell their older or sick family members to stay home, but they may need to try a different approach, Lichtenberg said. “It is good to have these conversations but not dictate to older people — they don’t like it and it backfires,” he said. “If we say it too harshly, we bruise their identity as a competent person.”

Others may not have a choice. Nursing home industry leaders have suggested centers close their doors or limit outside access to the facilities. The American Health Care Association and the National Center for Assisted Living created a checklist for screening visitors, including family, friends, employees and government officials. The checklist has questions about international travel, coronavirus-related symptoms and purpose for visit.

The mental and emotional effects on this group — and what to do

Family members and friends should have open discussions with older adults about these restrictions, whether they are at a facility or are being told to self-quarantine themselves as protection, Lichtenberg said. “Find out what the older person knows about the virus, what they’ve heard, how they feel about it and how nervous they are about it,” he said. “And also what they know about the recommendations for keeping themselves as safe as possible and how they apply in their lives.”

Loneliness is dangerous — sometimes, even more so than obesity, according to research presented at the American Psychological Association in 2017. People who had greater social connections had a 50% reduced risk of dying early than those who didn’t, according to research from 148 studies, involving 300,000 participants. Social isolation, loneliness and living alone played a significant role in premature death, another set of 70 studies representing 3.4 million people in North America, Europe, Asia and Australia found.

Staying safe from the coronavirus is imperative, but concerned loved ones should consider additional steps to keep older family members and friends comfortable during this stressful time. “It’s good for families to have a plan right now,” said Amy Goyer, the family and caregiving expert at AARP. That includes creating a household plan about gathering supplies at home, such as toilet paper and food, and creating a strategy to continue communication throughout the ensuing weeks.

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Technology will play a key role in getting through the following weeks of coronavirus-fueled quarantines, shutdowns and visitor restrictions. Families and friends can help their older counterparts by setting up televisions, phones or tablets with streaming services, so that older adults can entertain themselves with their favorite shows, new documentaries and movies, said Andrea Cohen, chief executive officer and co-founder of HouseWorks, an independent private home health care company.

Americans may be advised to socially distance themselves from others, but that doesn’t include over the web or phone. They can download programs to video chat, Cohen said, or if that technology isn’t available, a regular phone call will do. If their loved ones are religious and often go to church, a synagogue or other services, look into whether any are being streamed — as Pope Francis did with a recent sermon. Remind them to charge their devices, and double-check Wi-Fi is strong where they’re located.

Physical health is also important, and at risk of deteriorating if left forgotten, so older adults are still encouraged to take walks around the block or move around their homes, such as with fitness videos or apps.

“Whenever there’s an outbreak like this, it can be emotionally stressful for people of all ages,” Goyer said. “For older adults, even more so — if they’re feeling upset, don’t make them feel they are overreacting. A lot of people are feeling that way and they need reassurance and to have a plan in place.”