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At 89, She Fears Dying Alone More Than the Coronavirus Itself At 89, She Fears Dying Alone More Than the Coronavirus Itself
(8 days later)
Shatzi Weisberger recognized the symptoms of a heart attack. Her chest seized up and pain shot down her left arm. Ms. Weisberger, 89, a retired nurse, did not want to die alone in her apartment. But if she went to the hospital, she was afraid that she would get the coronavirus there and die among strangers, cut off from the people she cared about.Shatzi Weisberger recognized the symptoms of a heart attack. Her chest seized up and pain shot down her left arm. Ms. Weisberger, 89, a retired nurse, did not want to die alone in her apartment. But if she went to the hospital, she was afraid that she would get the coronavirus there and die among strangers, cut off from the people she cared about.
“I know I’m vulnerable because I’m almost 90,” she said. “I would not go to the hospital under any circumstances.”“I know I’m vulnerable because I’m almost 90,” she said. “I would not go to the hospital under any circumstances.”
Ms. Weisberger had long ago planned for her end of life: a friend had promised to sit with her in her last days; an acupuncturist would ease any pain; when it was over, an undertaker would ice her body until burial. Alone in her apartment that night, with the city mostly locked down, she realized that whatever happened to her in the next days or months, she would likely face it alone.Ms. Weisberger had long ago planned for her end of life: a friend had promised to sit with her in her last days; an acupuncturist would ease any pain; when it was over, an undertaker would ice her body until burial. Alone in her apartment that night, with the city mostly locked down, she realized that whatever happened to her in the next days or months, she would likely face it alone.
“It’s going to be horrible not being able to get out of bed to go to the toilet or get food,” she said.“It’s going to be horrible not being able to get out of bed to go to the toilet or get food,” she said.
Death had other plans for Ms. Weisberger. She willed herself to relax and finally fell asleep. By morning in her apartment she felt better. “Another day, hallelujah,” she said. “No fever, another day.”Death had other plans for Ms. Weisberger. She willed herself to relax and finally fell asleep. By morning in her apartment she felt better. “Another day, hallelujah,” she said. “No fever, another day.”
For New York City’s 1.7 million older adults, this has become a second epidemic: the fear of dying alone. For many, it will do more harm than the virus itself.For New York City’s 1.7 million older adults, this has become a second epidemic: the fear of dying alone. For many, it will do more harm than the virus itself.
Many have not seen their relatives or friends since early March, when the restrictions on travel began. Then the public libraries closed, restaurants, senior centers, YMCA and YWCA’s, houses of worship. Hospital emergency rooms, where older adults might salve the bumps of aging, are now the most dangerous spots in New York.Many have not seen their relatives or friends since early March, when the restrictions on travel began. Then the public libraries closed, restaurants, senior centers, YMCA and YWCA’s, houses of worship. Hospital emergency rooms, where older adults might salve the bumps of aging, are now the most dangerous spots in New York.
Though young people get sick from the disease or transmit it, the overwhelming majority of people who die — 80 percent, according to an analysis of early data by the federal Centers for Disease Control and Prevention — are age 65 or older.Though young people get sick from the disease or transmit it, the overwhelming majority of people who die — 80 percent, according to an analysis of early data by the federal Centers for Disease Control and Prevention — are age 65 or older.
And many fear that if they do get sick, even hospice will be lonely, because of the health risks in gathering people around.And many fear that if they do get sick, even hospice will be lonely, because of the health risks in gathering people around.
“You count on people for support and to be your advocate,” said Dr. Robert Roca, chairman of the council on geriatric psychiatry at the American Psychiatric Association. “The notion that they won’t be there can be extremely distressing.”“You count on people for support and to be your advocate,” said Dr. Robert Roca, chairman of the council on geriatric psychiatry at the American Psychiatric Association. “The notion that they won’t be there can be extremely distressing.”
As the quarantine wears on, Dr. Roca said, isolated elders are especially prone to brood on their fears, and to magnify them. This brooding, in turn, intensifies loneliness and anxiety, which both have severe health consequences. The virus does not create these fears, but it enlarges them in people who are most vulnerable.As the quarantine wears on, Dr. Roca said, isolated elders are especially prone to brood on their fears, and to magnify them. This brooding, in turn, intensifies loneliness and anxiety, which both have severe health consequences. The virus does not create these fears, but it enlarges them in people who are most vulnerable.
It is one thing to imagine dying on a ventilator, or not being able to get one; it is another to imagine doing so alone.It is one thing to imagine dying on a ventilator, or not being able to get one; it is another to imagine doing so alone.
“We’ve been bombarded with messages about how bad it is to isolate ourselves,” said Wendl Kornfeld, 71. Now isolation is an official goal.“We’ve been bombarded with messages about how bad it is to isolate ourselves,” said Wendl Kornfeld, 71. Now isolation is an official goal.
Ms. Kornfeld lives on Manhattan’s Upper West Side with her husband, Barry, who is 11 years older. “We never leave the house without that last hug and saying I love you,” she said. “In the past it was always theoretical. But now, if one of us should get really sick and go to the hospital, that might be the last time we see each other.”Ms. Kornfeld lives on Manhattan’s Upper West Side with her husband, Barry, who is 11 years older. “We never leave the house without that last hug and saying I love you,” she said. “In the past it was always theoretical. But now, if one of us should get really sick and go to the hospital, that might be the last time we see each other.”
For Ilin Lo, 87, the anxieties began back in January, with reports of a new virus spreading in Wuhan, China. Ms. Lo, who speaks little English, lives alone in Fresh Meadows, Queens, and until recently relied on the Nan Shan Senior Center in Flushing for both food and social connection. Her children live in California.For Ilin Lo, 87, the anxieties began back in January, with reports of a new virus spreading in Wuhan, China. Ms. Lo, who speaks little English, lives alone in Fresh Meadows, Queens, and until recently relied on the Nan Shan Senior Center in Flushing for both food and social connection. Her children live in California.
“I’m very afraid of dying alone,” she said, speaking through an interpreter. “If I had a normal illness I could ask my children to come to New York. But with the coronavirus, I cannot ask them.”“I’m very afraid of dying alone,” she said, speaking through an interpreter. “If I had a normal illness I could ask my children to come to New York. But with the coronavirus, I cannot ask them.”
She also cannot ease her fears by sharing them at the senior center. Instead, she said, she watches television all day, which only amplifies them.She also cannot ease her fears by sharing them at the senior center. Instead, she said, she watches television all day, which only amplifies them.
Adding to these fears is the nature of the novel virus, said Karl Pillemer, a gerontologist at Cornell University. Most causes of death for older people are fairly slow and predictable, with time to gather relatives and say goodbye. Covid-19, by contrast, is fast and unknown. “It’s a different narrative than the one we’re used to,” he said.Adding to these fears is the nature of the novel virus, said Karl Pillemer, a gerontologist at Cornell University. Most causes of death for older people are fairly slow and predictable, with time to gather relatives and say goodbye. Covid-19, by contrast, is fast and unknown. “It’s a different narrative than the one we’re used to,” he said.
Dr. Pillemer said the fear of dying alone was a fear of losing control of the dying process. “People want a feeling of agency,” he said. “The frightening reality is that coronavirus patients are not going to be at home. It’s going to be an abrasive hospital experience where they don’t have the people they want around them. To be conscious and aware and be entirely deprived of visitors, it’s upsetting even to think about.”Dr. Pillemer said the fear of dying alone was a fear of losing control of the dying process. “People want a feeling of agency,” he said. “The frightening reality is that coronavirus patients are not going to be at home. It’s going to be an abrasive hospital experience where they don’t have the people they want around them. To be conscious and aware and be entirely deprived of visitors, it’s upsetting even to think about.”
As disturbing as the prospect is for elders, it is often scarier for their children. Pam Loshak has had almost no contact with her father since the state banned visitors from nursing homes on March 13. Her father, Eliot, 87, is in the Mary Manning Walsh nursing home in Manhattan, part of a small chain that has had more than 200 coronavirus cases. Because of a traumatic brain injury, he cannot manipulate a telephone, so Ms. Loshak has had to rely on aides in the home any time she wants to talk with him. But this requires the aide to touch both him and the telephone, and the staff at the home, as at many, do not always have the protective equipment to make that safe.As disturbing as the prospect is for elders, it is often scarier for their children. Pam Loshak has had almost no contact with her father since the state banned visitors from nursing homes on March 13. Her father, Eliot, 87, is in the Mary Manning Walsh nursing home in Manhattan, part of a small chain that has had more than 200 coronavirus cases. Because of a traumatic brain injury, he cannot manipulate a telephone, so Ms. Loshak has had to rely on aides in the home any time she wants to talk with him. But this requires the aide to touch both him and the telephone, and the staff at the home, as at many, do not always have the protective equipment to make that safe.
“If he were to get sick I would not be able to go see him,” Ms. Loshak said. “It’s just a nightmare. You work so hard.” Five years ago, when he was hit by a car, she was with him every day during his rehabilitation from the brain injury. “It was just an incredible amount of time and energy spent out of love to care for him,” she said.“If he were to get sick I would not be able to go see him,” Ms. Loshak said. “It’s just a nightmare. You work so hard.” Five years ago, when he was hit by a car, she was with him every day during his rehabilitation from the brain injury. “It was just an incredible amount of time and energy spent out of love to care for him,” she said.
Updated June 24, 2020
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
Now she can do none of that. “You feel helpless not just because the virus is out there,” she said, “but because the people taking care of him don’t have the equipment that they need to take care of him.”Now she can do none of that. “You feel helpless not just because the virus is out there,” she said, “but because the people taking care of him don’t have the equipment that they need to take care of him.”
“I don’t want him to be lying in his bed, terrified,” she added. “On my last call I assured him that I was OK and he was OK.”“I don’t want him to be lying in his bed, terrified,” she added. “On my last call I assured him that I was OK and he was OK.”
The isolation at the end is intensified by the shortages of masks and gloves, said Diane E. Meier, director of the Center to Advance Palliative Care. Many hospice workers cannot go into homes where there is coronavirus because they lack protective equipment. In hospitals like Mount Sinai, where Dr. Meier works, chaplains often minister by telephone for the same reason. Instead of family around them, the dying patients get a video conversation or a telephone placed by their ear, she said.The isolation at the end is intensified by the shortages of masks and gloves, said Diane E. Meier, director of the Center to Advance Palliative Care. Many hospice workers cannot go into homes where there is coronavirus because they lack protective equipment. In hospitals like Mount Sinai, where Dr. Meier works, chaplains often minister by telephone for the same reason. Instead of family around them, the dying patients get a video conversation or a telephone placed by their ear, she said.
Dr. Meier suggests families use these to communicate five thoughts, even if they cannot be present.Dr. Meier suggests families use these to communicate five thoughts, even if they cannot be present.
Thank you.Thank you.
I forgive you.I forgive you.
Please forgive me.Please forgive me.
I love you.I love you.
Goodbye.Goodbye.
“Very few families aren’t in tears by the end of that list,” she said.“Very few families aren’t in tears by the end of that list,” she said.
She also advised against catastrophizing the virus: most elders will not get it, and among those who do, even the very old, most will survive. “That’s the problem with mortality statistics,” she said. “They don’t tell you about all the people who made it through.”She also advised against catastrophizing the virus: most elders will not get it, and among those who do, even the very old, most will survive. “That’s the problem with mortality statistics,” she said. “They don’t tell you about all the people who made it through.”
And many elders thrive even now. Betty Mosedale, 87, whose son used to call once a month, said he now calls almost every day.And many elders thrive even now. Betty Mosedale, 87, whose son used to call once a month, said he now calls almost every day.
“It would be sad being alone, but I’m not afraid of that,” she said. “When you die, you do die alone, even if you have family around. It’s a solitary experience.”“It would be sad being alone, but I’m not afraid of that,” she said. “When you die, you do die alone, even if you have family around. It’s a solitary experience.”
But for others, dying alone feels like missing a last chapter on a life, said Rabbi Simon Hirschhorn, who counsels residents at the Hebrew Home in Riverdale, where death is a regular event. The people present at the end, he said, give focus to the death. “Now, if that is limited or impossible, it’s as if you might die in vain,” he said. “You become part of a statistic rather than a person whose life is at the end.”But for others, dying alone feels like missing a last chapter on a life, said Rabbi Simon Hirschhorn, who counsels residents at the Hebrew Home in Riverdale, where death is a regular event. The people present at the end, he said, give focus to the death. “Now, if that is limited or impossible, it’s as if you might die in vain,” he said. “You become part of a statistic rather than a person whose life is at the end.”
For many older people, that is the true signature of the virus: not the fear of dying, but the fear of dying alone.For many older people, that is the true signature of the virus: not the fear of dying, but the fear of dying alone.