Instead of being able to throw a party worthy of matriarch Barbara Burr's milestone birthday, the coronavirus pandemic forced her family to improvise.
The mother of nine, grandmother of 22 and great-grandmother of 37 was instead whisked outside of her home in Eau Claire, Wisconsin, on April 18 — her 90th birthday — for a surprise car parade in her honor.
"It is was extra special, out of this world," Burr said. "Only I felt so bad when they all left and I couldn't give them all a hug."
Burr, who lives with her 95-year-old husband, Gerald, is hoping she will get a chance to hold them all again in her arms.
"It could take years," she said of what she calls "this germ that's floating around," adding that by then, "I'll be long gone."
Even as stay-at-home protocols are lifted across the country, health experts are recommending that older Americans stay indoors and avoid contact with potential virus carriers — including family members who aren't sheltering in place with them. That means that until a vaccine is readily available, grandparents will lose precious time with their children and grandchildren.
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There is, of course, good reason for all that social distancing: COVID-19 poses a disproportionate danger to seniors. In New York, the hardest-hit region in the country, 84.5 percent of deaths attributed to the virus were of people aged 60 or older, according to the state's health department.
"The relationship between grandparents and grandkids are important for mental health and emotional health, as well physical health," said Alison Bryant, senior vice president of research for AARP.
"You know grandparents just enjoy it, but there are real health implications of not being able to spend time with grandkids."
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In the absence of regular physical contact, other types of contact are key.
Bryant said family members can make a big difference by using phone calls and video chats to maintain contact. Seeing the faces of loved ones is important, preferably with some kind of regular routine.
Amy Fuchs, owner of the Elder Expert consulting service, has said there is a marked difference in the way seniors are handling the dislocation caused by COVID-19 that overlaps with their ages.
"What I find is that the younger cohort (aged 60-75) is more adept at social media and technology and smartphones," said Fuchs, a clinical social worker. "So I'm a little less worried about them, because they have the ability to access Zoom or other platforms to be in touch with their families."
For her clients over 80, particularly those who live alone, however, Fuchs is already seeing an increase in memory issues weeks into the forced isolation.
"They've lost the social interaction, and you don't realize how much they gain from that," said Fuchs. "They live for the trips to the grocery store. They live for the trips to the pharmacy. They live for the trips to the physical therapist."
That isolation has been particularly stark for seniors who have come down with the coronavirus and forced to battle for their lives in hospitals or nursing homes, where family members are barred from being at their sides.
The last time Kristen Lathrop saw her grandmother, Goldie Mae Moran, was as Moran was being whisked from an ambulance into the emergency room of Hartford Hospital in Connecticut. Because of the highly contagious nature of the disease, the staff did not allow Lathrop to get too close.
"I kind of shouted across the room to let her know that I was there, because I didn't know if she didn't have a phone," recalled Lathrop, a psychiatrist. "She was like, 'Where are you?' And I just wanted her to know I was there. I said, 'I love you,' and I just kind of knew that those would be my last words to her."
Her grandmother died days later, at 5:28 a.m. on her 88th birthday, with a hospital staffer at her bedside to hold up a phone for family members to say goodbye.
"These are moments when you want to hold someone's hand and look them in the eyes so they can see your face to give them some closure," Lathrop said.
Seniors, however, do have one advantage over their younger counterparts in adjusting to this radical new societal landscape — life experience.
"For a lot of older folks who have gone through challenging situations through their lives, they can rely on skills they developed over those previous experiences," said Dr. Ellen Whyte, director of geriatric psychiatry outpatient services at the University of Pittsburgh's Western Psychiatric Hospital.
And if there is another silver lining, it's that the proliferation of the coronavirus has brought with it a simultaneous spread in empathy. The whole idea of "flattening the curve" is based on the idea of not getting someone else sick, especially when the risks increase with age. Grocery stores across the country are restricting access at specific times, often early in the morning, to allow seniors a chance to shop, while social media is full of stories of good Samaritans buying food for their elderly neighbors.
"Now, people who are not senior citizens are sort of experiencing some of the isolation that many senior citizens face day in and day out," Whyte said. "So hopefully they'll be more sensitive to that isolation that can occur as people get older and reach out more to our older relatives, friends and neighbors on a regular basis — not just through this crisis, but going forward."
In Wisconsin, Burr's family celebrated the birth of her first great-great-grandson, Royale, in March.
But while the nonagenarian has already crocheted a blanket for the newest addition to the Burr clan, she can't meet him in person because of the lockdown.
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And Crystal Burr, one of her 22 grandchildren, worries that the family is on a ticking clock.
"We all worry about the health of my grandmother and grandfather, and we worry if we're going to get the chance to hug them ever again," the younger Burr said. "Their health is declining and it's heart-wrenching to think about."
"Every day is a gift," she added, "but tomorrow is never a promise."