BRISTOL, R.I. -- They’d waited so long for their reunion. They didn’t realize how painful it would be.
The Galligan family hadn’t been together since March 12, when the coronavirus was beginning to spread fast through Rhode Island, and all of the nursing homes and assisted living facilities closed to outsiders to try to stop the virus’ rampage.
On that afternoon at Saint Elizabeth Manor in Bristol, Charlie Galligan hugged his mother tight and tried to explain what was happening. Audrey, now 84, has lived at the nursing home for seven years after suffering a traumatic brain injury. Jack, her husband of 61 years, visited every day, even as he slid into dementia.
Galligan and his wife, Kerry Crane, care for Jack at their home, with help from CNAs, and they felt helpless as he sank into depression without daily visits with his wife. When they drove by the home and blew kisses to Audrey’s window, Jack asked why they weren’t stopping.
Earlier this month, Governor Gina M. Raimondo and Health Director Dr. Nicole Alexander-Scott announced that nursing homes could resume visits on July 8, with restrictions. But the reality of how the visits work, as the Galligans and other families have discovered, is more difficult than it appears.
Only one person is allowed per visit; two in special circumstances. Some facilities only allow outdoor visits, which are canceled in heat or inclement weather. Some facilities only allow one or two visits a day in total, which means residents wait weeks for their turn. New COVID-19 cases force facilities to close for two weeks, which restarts the clock on visits.
Many are still waiting.
On the inside, the nurses and CNAs -- who’ve been the families biggest advocates -- see the toll this isolation has taken on the residents. Marisa Silva, a CNA who cares for Jack Galligan and works at Saint Elizabeth Manor, remembered a resident who didn’t respond when Silva asked how she was.
“I said, ‘Why don’t you want to answer?' She said, ‘It’s not worth it,‘” Silva said. “They are sad, and they are dying. Many residents have died already and haven’t seen their families. They only allow the family to come there when they are dying, when they can’t talk.”
Now, as the governor and state health officials shift their focus to reopening schools, the families of the elderly are feeling forgotten. They’ve contacted the governor’s office and Department of Health, appealing for creative solutions. And, for mercy.
“Just letting them live out their days in misery and isolation, what lives are we preserving?” said Galligan. “What’s the value in these lives we’re preserving if we’re not letting them be with the people they love and want to be with?”
He and other families worry that they are running out of time.
The residents of nursing homes and assisted living facilities have suffered greatly during the pandemic. Since March, there have been outbreaks at 52 longterm care facilities and 10 assisted living centers, and these have made up the majority of all COVID-19 deaths in Rhode Island.
The state Department of Health developed a standard plan for homes to safely allow visits. While there are basic guidelines -- limited visiting hours, mask wearing, and having visits outside whenever possible -- most of the homes came up with their own versions, said spokesman Joseph Wendelken.
Yet, one new case of COVID-19 among residents or staff closes a facility for two weeks, delaying all visits. However, Wendelken said, health officials will take the circumstances of the case and the facility into consideration.
Each nursing home and assisted living facility is adapting differently. Some, with the approval of health officials, allow visits in private rooms or common areas. One provides microphones for residents who have trouble hearing visitors who are six feet away and wearing masks. Some have tents for visits outside.
At Berkshire Place in Providence, which had one of the bigger outbreaks with nearly 170 residents infected with COVID-19, visits have resumed outside. Administrator Ken Rotella said the visits are limited so each of the 143 residents has a chance to see loved ones.
The home can host two visits at a time in a lawn area in front of the facility, but Rotella said they plan to expand to have a patio so they can add more visits.
He’s unsure about what will happen when the colder weather comes. “We’re hoping that things improve so we can bring them inside,” Rotella said.
Kathleen Heren, the state’s long term care ombudsman, hears the complaints from families: the short visits, the inability to touch, the threat of new COVID-19 cases delaying visits for weeks.
Now, there’s the potential of a strike at five nursing homes, where unionized caregivers are fighting for a boost in their wages and safer working conditions. Caregivers at Genesis Pawtucket Nursing Center, Hopkins Manor, Genesis Greenville, Charlesgate Nursing Center and Bannister House have announced their intention to strike on Aug. 5 if there is no settlement on their contract proposals.
The homes won’t be able to have visits outside during the strike, Heren said.
She said she understands how frustrated families are over the restrictions, but believes that the Health Department and nursing homes are doing their best to accommodate visitors.
These residents are the most vulnerable to the virus. “The old nurse in me says that it’s better if you’re a little uncomfortable than you kill your mother and father,” Heren said.
They were once people out in the world, a state trooper, a radio announcer, a teacher, a registered nurse, a ballerina, spouses and parents. That’s how they are remembered by their families, not just as residents with Alzheimer’s disease and dementia, living at “The Cove,” the memory care unit at Saint Elizabeth’s Home in East Greenwich.
More than other residents of nursing homes, people with dementia rely on daily care from their family members. They need help with meals and those with mobility problems need help getting up to walk and assistance with toileting.
That’s what Roni Ferraro did for her husband, Louie, every day for six years. She and other family members of residents here are as much a part of their care as the busy nurses and CNAs. “We don’t just visit -- we are active participants in their care,” Ferraro said. “We are the eyes, ears and voice for our loved ones.”
Without her there every day, Ferraro said, her husband has declined. She used to do his physical therapy and get him up to walk. He’s no longer ambulatory. He has sores. She used to spend at least two meals a day with him, helping him eat solid food. Now, his food is pureed.
“This all happened in four months, because you’re not getting individual attention in a nursing home,” she said.
She still hasn’t been able to see him; visits are granted by lottery and her number hasn’t come up. When she does finally get to see him, she’s afraid of what his condition will be.
“My husband and other residents will be collateral damage,” Ferraro said. “It won’t be COVID that will kill them. It will be a chain of events.”
There should be some creative solutions to allow loved ones more access to residents, said Maria Tavarozzi, whose mother is a Cove resident. While they are grateful for the dedication of the nurses and CNAs, they see how this pandemic has worn them down, Tavarozzi said.
“It’s not a job, it’s a ministry for the CNAs, and we are very concerned we’re going to lose people because they’re exhausted,” she said.
The families of The Cove persisted and were finally granted a Zoom meeting with Saint Elizabeth president and CEO Matthew Trimble on Tuesday to offer their ideas.
They know that the old way of life, before COVID-19, is gone, but they wondered if there could be adaptations for those with Alzheimer’s and dementia. They suggested better scheduling of visits and setting up a tent to allow more visits at a time. They asked to bring back dedicated volunteers, test them and give them PPE, so the volunteers can aid residents with Facetime and help them communicate with loved ones.
“He said the strategy was to start really slow,” said Susan Hodgin, whose father lived at The Cove until his death in May. “And we’re like, there’s no time for that.”
Hodgin said Trimble promised to give them answers next week. (Mary Rossetti, Saint Elizabeth’s director of marketing and communications, didn’t respond to the Globe’s requests for comment on visitations.)
They would do anything asked of them. They will be tested. They’ll be glad to wear PPE. Some are willing to pay for a room at the home and quarantine for two weeks, so they can help their loved ones with their care.
“We love our loved ones, and we’re not going to do anything to put them in jeopardy,” said Patti Cioe, whose aunt is in The Cove. “The patients are suffering, and so are we. We feel helpless.”
“And powerless,” Tavarozzi added softly.
Even if their loved ones don’t get the coronavirus, it is robbing them of time.
“I accepted when this happened, I would never be able to hug my husband again,” Ferraro said. “He’ll either pass away, or I won’t be able to touch him again.”
When Galligan was finally allowed to bring Jack to visit Audrey one recent afternoon, he realized how much they’d lost.
His parents used to spend hours each day together in her room, holding hands, repeating “I love you” to each other. For this visit, they were separated by plexiglass at a table that kept them six feet apart. They wore masks, and a staff member hovered nearby.
They had 30 minutes to make up for four months. Although Audrey beamed to see them, she and Jack could no longer communicate. After 61 years of marriage, they couldn’t touch.
“I miss my mom,” Galligan said later. “And I don’t know how long my father can go on this way.”
Amanda Milkovits can be reached at email@example.com