20 Seconds: A Matter of Life or Death

It has been nine months since I have embraced my loved one.

Nine months since she gave me a kiss on my forehead. Nine months since I held her hands. Nine months and the only face-to-face, inside or outside visits without glass between us have been supervised and lasted a maximum of 30 minutes, still keeping our six-foot distance with no touching.

As the months pass, Covid-19 restrictions have taken a gradual toll on long-term care facility residents, family, and staff. Though window visits are allowed, how do you hug someone through plate glass? On the occasions when restrictions are relaxed, allowing the visitor to enter a designated space with the loved one and without a window barrier, there is still no touching. Six feet distance is maintained, masks must be worn—and a designated staff member supervises the 30-minute visits.

Physical Separation, Emotional Trauma

Imagine the mental trauma of residents diagnosed with dementia—who cannot understand Covid-19 or the mandated visitation restrictions—as they wonder why their loved ones don’t come near them anymore; don’t touch them; have “abandoned” them? Have you seen the videos of loved ones and residents crying trying to get to each other, yet intercepted by staff in an attempt to comply with regulations?

Not only are residents affected; think how difficult it is on the staff to intervene and prohibit an elderly father, mother, spouse from coming near their loved one. Aging in America is funding a study by the LeadingAge LTSS [Long-Term Services & Supports] Center at the University of Massachusetts, Boston, to capture and analyze staff turnover since March 2020 in skilled facilities? The US Department of Health & Human Services has also released a report on the challenges faced by the facilities and, more crucially, on the staff at those facilities.

So a question arises: Are elders silently dying of Covid, not from Covid? Are the well-intended restrictions of social isolation killing them softly?

Failure to Thrive

The lack of touch due to social isolation from loved ones is the new silent killer. The absence of touch as a result of the mandated physical/social distancing supports a diagnosable medical condition, “failure to thrive,” in already vulnerable individuals.

What does failure to thrive look like? Weight loss, increased confusion, restlessness, decreased appetite, decreased mobility, agitation, and a host of other signs of symptoms. The less elderly residents understand about Covid and the restrictions, the greater the risk of failure to thrive. Additionally, facility staff are stressed out, burned out, and morally distressed, resulting in decisions to leave their current employer for less stressful environments.

Zoom and its Shortcomings

The staff at my loved one’s facility has graciously accommodated Zoom visits for us to communicate. We see each other, smile, we can talk, we can read each other’s facial expressions just as in “real life,” but that’s where it stops. My loved one tears up when she sees our faces on the computer screen—as do I. We hold back our tears, but it haunts us for days that we are not able, literally, to reach her.

As important as these visits are, they are not the same as touching. All we desire to do is hug her and allow her to hug us. How do you hug through a hand-held phone? How do you touch through a tablet?

Oxytocin in 20 seconds

A dear friend and nurse extraordinaire, Kay Mantiply Clark, shared a study with me a year or two ago that says a 20-second hug increases trust and compassion through the stimulation of Oxytocin. 20 SECONDS.

Here is a snippet from that article:

Oxytocin is released in the body when a person considers themselves to be secure, safe and connected to their loved ones. Through the release of this chemical, the brain knows that everything is safe and that there is no need to worry.

And now we look at the second question: At what point do we consider the benefit versus the burden of Covid restrictions on our elderly? Having weighed the problem, what do we do to resolve the barriers that have been thrust upon them?

Proposal

Because of the collateral damage of Covid-19 possibly hastening death in our institutionalized elderly population, I believe one family member should be designated an approved essential care worker who is allowed to enter the facility daily to interact with their loved one.

Just as staff come and go daily—undergoing all restrictions of masking, temperature checks, and frequent hand washing—so should the designated family member be permitted to do the same, with the same restrictions.

30 Minutes; 20 Seconds; an Extended Lifetime

Allowing a visit for a maximum of 30 minutes per day, three times each week, by one designated person (family or close friend if there is no family connection) is a step in the right direction to re-introduce preservation of humanity. Visits would be supervised, and guidelines would, of course, be strictly enforced. Each designated visitor on those three days per week must provide a 20-second hug before leaving for the day. That is the only touch allowed—and the only one that will release Oxytocin in the loved one’s system.

I would like this approach to be considered as an important, even essential, intervention to nurture our elders back to their optimal level of stability. Love heals. Let’s advocate for this and put this in action.

Read more on the 20-second hug at www.thecrazyfacts.com/hugging-20-seconds-releases-oxytocin-can-make-someone-trust.

Dr. Sharon Kelly-West is a registered nurse and Bioethics and the Law adjunct faculty at Mars Hill University School of Nursing. She serves as a member of the NC Commission for Public Health.