Since the start of the pandemic, the CDC has been closely monitoring trends for various diseases associated with the pandemic. In a typical year, the agency predicts around 4,500 dementia deaths per week. But in the past few weeks, that figure has approached 5,500, and experts can’t be sure what is causing the excess 1,000 deaths per week.
Many of these dementia deaths may indeed have died of undiagnosed Covid-19, especially during the spring when testing was scarce. But public health experts and nursing home administrators say it’s less and less likely as time goes by because there are more accurate tests and diagnoses. This spurred the search for alternative theories.
Frontline workers say chronic staffing shortages make it much harder to keep residents with more advanced stages of dementia safe from the virus and themselves. Many of their colleagues have quit for fear of bringing the virus back home to their families, and also because of increased stress and intense sense of futility. It is difficult, for example, to convince an Alzheimer’s patient to wear a mask.
“We’ve had a lot more falls due to a lack of staff. You just don’t have eyes on people, so they’re in more dangerous situations,” said an occupational therapist at a nursing home in California, who requested anonymity for fear of retaliation.
“It seems like an impossible battle,” added the worker. “You could put a mask on someone in the hall 100 times and it will be taken off 100 times.”
The absence of visiting family members, who can provide social support and help with practical care during normal times, adds to the burden.
“We’re trying to be advocates, social workers, caregivers, friends and cleaners for the resident. He’s putting a lot of pressure on the caregivers and the facility’s operation to make sure everyone has what they need,” Walters said. “Before the pandemic, we couldn’t even put socks on people and you could see them walking barefoot.”
Kevin Jameson, president of the Dementia Society of America, said in an interview that even in a well-managed facility, new safety procedures and changes to daily routines could be extremely stressful for residents with dementia. He fears that N95 masks in particular may scare residents and urged facilities to find alternatives.
“People are so masked and covered in these individuals’ care that it really becomes isolating for people with dementia,” Jameson said. “Their understanding of their world requires them to see and hear more signals to understand what’s going on.”
He added that residents with dementia tend to reflect the emotions of their caregivers, potentially worsening their condition if staff are visibly stressed and overworked.
Whatever the causes, the latest wave shows little sign of abating. According to the latest CDC screening, there were others 1.025 excess deaths from Alzheimer’s disease and dementia in the third week of August. According to Anderson of the CDC, this sudden shift in mortality has only a few parallels in modern times: the opioid epidemic, the record breaking 2017-18 flu season, and the coronavirus itself.