Out of Egypt and into the frying pan
April 5, 2020 11:11 AM Subscribe
My parents are bringing my grandmother from her nursing home to their house for Passover. How do I convince them that they need to be more stringent about social distancing?
This is an interpersonal question, and not about what the proper precautions are per se. My 90-year-old grandmother lives in a nursing home in Queens. She is of generally sound mind, but all of the residents have been confined to their apartments (appropriately), my grandfather died a year ago, and she is extremely depressed. My family are modern orthodox, and staying there would mean spending Passover alone with no ability to even interact with the rest of the family electronically, as doing so is against halachah. She wishes to come to their house for the holiday. My parents (both 59) do not have the heart to say no, and believe it is safe for her to come here based on the level of precautions they have been taking; leaving her stranded there for Passover is intolerable to them. I also feel that it is important to respect the agency of elders who still have the cognitive faculties to make decisions for themselves, which I believe she does. So convincing her or them not to take her out of the nursing home is probably not going to happen.
The problem is that I do not believe that we have been cautious enough so far (not thinking that she was going to come here), and if she does come I think they need to be more cautious than they have been. I (26F) have been at my parent's house since the pandemic began. We have all been socially distancing for weeks, and not leaving the house except for groceries and going for walks. We are in suburban Northern New Jersey; there are cases in our community, and our county as a whole is likely to be in bad shape within the next week or two. My brother (28) has been isolating in his house, but has come here multiple times, including today. He has decided that he will not come for Passover if my grandmother is here, and invited me to join him at his house instead. However, he was here today, and went grocery shopping with my mother. My mother and I have gone for walks, keeping our distance, and most recently wearing masks. We went for a walk yesterday (again, not thinking my grandmother would be coming here) into a park with significant foot traffic.
They believe that wearing masks, going out for groceries once a week, and going for walks is acceptable as long as they follow social distancing guidelines, and that they can continue to do so while my grandmother is here for two weeks. I feel strongly that this level is not sufficient if there is to be a 90-year-old in the house (and that she shouldn't come here based on the level we've been at for the past two weeks, but I can't win that fight). Their attitude is very much "one thing at a time"; "address problems as they arise"; "risks are unknowable and unevaluable"; "make the best decision you can and then stick to it". These are used to deflect and shut down any concerns that are raised in a thought-terminating manner, and are how they respond when I try to convince them that they need to be more cautious. For example, when I asked what they would do if someone started showing symptoms while she was here, the response was to get upset at me for pushing the issue, plus "we'll cross that bridge when we come to it." They are not willing to stop going out for groceries or walks. My parents both work from home, and haven't gone out much in the past year due to Jewish law around my grandfather's death, and so the pandemic has not disrupted their lifestyle much; because of this, I do not think they fully comprehend how bad it is. They are not immune to reasoning, but are generally more inclined to respond to tone than substance, and I've had trouble keeping my tone perfectly neutral while trying to convey to them that general guidelines designed to limit community spread are not perfect foolproof rules that will prevent them from getting the virus and spreading it to my grandmother, who will surely not survive catching it. Generally, if I do not agree with them and my tone is anything other than gentle or reflects any urgency, they will take it personally, get upset, and shut down the conversation. I feel that I am seen as a trouble-maker and disturber of the peace when I try to raise concerns.
Am I overreacting? Should I step back? If not, how can I effectively communicate to them that they need to be more cautious to preserve my grandmother's life?
(I recognize that other people are in much worse situations, they are being relatively cautious/reasonable, and this might overlap/reduce to a question about what the proper precautions are, in which case feel free to remove it. But I am trying to ask about how to handle the situation interpersonally.)
This is an interpersonal question, and not about what the proper precautions are per se. My 90-year-old grandmother lives in a nursing home in Queens. She is of generally sound mind, but all of the residents have been confined to their apartments (appropriately), my grandfather died a year ago, and she is extremely depressed. My family are modern orthodox, and staying there would mean spending Passover alone with no ability to even interact with the rest of the family electronically, as doing so is against halachah. She wishes to come to their house for the holiday. My parents (both 59) do not have the heart to say no, and believe it is safe for her to come here based on the level of precautions they have been taking; leaving her stranded there for Passover is intolerable to them. I also feel that it is important to respect the agency of elders who still have the cognitive faculties to make decisions for themselves, which I believe she does. So convincing her or them not to take her out of the nursing home is probably not going to happen.
The problem is that I do not believe that we have been cautious enough so far (not thinking that she was going to come here), and if she does come I think they need to be more cautious than they have been. I (26F) have been at my parent's house since the pandemic began. We have all been socially distancing for weeks, and not leaving the house except for groceries and going for walks. We are in suburban Northern New Jersey; there are cases in our community, and our county as a whole is likely to be in bad shape within the next week or two. My brother (28) has been isolating in his house, but has come here multiple times, including today. He has decided that he will not come for Passover if my grandmother is here, and invited me to join him at his house instead. However, he was here today, and went grocery shopping with my mother. My mother and I have gone for walks, keeping our distance, and most recently wearing masks. We went for a walk yesterday (again, not thinking my grandmother would be coming here) into a park with significant foot traffic.
They believe that wearing masks, going out for groceries once a week, and going for walks is acceptable as long as they follow social distancing guidelines, and that they can continue to do so while my grandmother is here for two weeks. I feel strongly that this level is not sufficient if there is to be a 90-year-old in the house (and that she shouldn't come here based on the level we've been at for the past two weeks, but I can't win that fight). Their attitude is very much "one thing at a time"; "address problems as they arise"; "risks are unknowable and unevaluable"; "make the best decision you can and then stick to it". These are used to deflect and shut down any concerns that are raised in a thought-terminating manner, and are how they respond when I try to convince them that they need to be more cautious. For example, when I asked what they would do if someone started showing symptoms while she was here, the response was to get upset at me for pushing the issue, plus "we'll cross that bridge when we come to it." They are not willing to stop going out for groceries or walks. My parents both work from home, and haven't gone out much in the past year due to Jewish law around my grandfather's death, and so the pandemic has not disrupted their lifestyle much; because of this, I do not think they fully comprehend how bad it is. They are not immune to reasoning, but are generally more inclined to respond to tone than substance, and I've had trouble keeping my tone perfectly neutral while trying to convey to them that general guidelines designed to limit community spread are not perfect foolproof rules that will prevent them from getting the virus and spreading it to my grandmother, who will surely not survive catching it. Generally, if I do not agree with them and my tone is anything other than gentle or reflects any urgency, they will take it personally, get upset, and shut down the conversation. I feel that I am seen as a trouble-maker and disturber of the peace when I try to raise concerns.
Am I overreacting? Should I step back? If not, how can I effectively communicate to them that they need to be more cautious to preserve my grandmother's life?
(I recognize that other people are in much worse situations, they are being relatively cautious/reasonable, and this might overlap/reduce to a question about what the proper precautions are, in which case feel free to remove it. But I am trying to ask about how to handle the situation interpersonally.)
Here in Ontario, we have a lot of families who feel very strongly about elders in long-term care facilities still being a part of the active life of the family. That's one reason that here in Ontario, we have an abundance of Covid-19 deaths being linked to long-term care. 36 outbreaks with 54 deaths linked to that. And many staff are ill.
I think whether your grandmother comes home for Passover is up to her and your parents, but I don't think it would be right for her to go back to her nursing home afterwards. I also think they should meet her on the curb to pick her up.
posted by warriorqueen at 11:24 AM on April 5, 2020 [45 favorites]
I think whether your grandmother comes home for Passover is up to her and your parents, but I don't think it would be right for her to go back to her nursing home afterwards. I also think they should meet her on the curb to pick her up.
posted by warriorqueen at 11:24 AM on April 5, 2020 [45 favorites]
Many care homes aren’t allowing residents back if they leave in these circumstances (rightly, in my opinion), so please make sure that issue has been addressed.
posted by a box and a stick and a string and a bear at 11:28 AM on April 5, 2020 [40 favorites]
posted by a box and a stick and a string and a bear at 11:28 AM on April 5, 2020 [40 favorites]
My mother (81) is in a nursing home that is totally locked down. If I took her out, she would not be allowed back in until the pandemic is over. That might be a good choice for your grandmother, depending on family dynamics. But I think that is how you should frame it. It's not only about her, but about all of her neighbors.
posted by mumimor at 11:31 AM on April 5, 2020 [9 favorites]
posted by mumimor at 11:31 AM on April 5, 2020 [9 favorites]
I agree entirely with Darling Bri. At 90, I imagine she would rather be with family on Passover and take her chances. The only issue I worry about here is your grandmother bringing a virus back to the home where other residents have not agreed to the choice she is making. It seems important that your parents stock up and then isolate themselves -- with her -- for a full 2 weeks after their last grocery shop outing to make sure that she's no risk to the other elderly people, even if that means she stays with you longer than planned.
posted by nantucket at 11:57 AM on April 5, 2020 [3 favorites]
posted by nantucket at 11:57 AM on April 5, 2020 [3 favorites]
Response by poster: Thank you for your responses! To clarify: my grandmother is coming to their house, I accept her decision, and I can't change that. My father will meet her at the curb, the nursing home will allow her back if she has been cleared by a doctor, and upon returning she would be quarantined in her apartment there for 14 days, which is already the status quo for every resident. She could stay here longer if necessary.
I agree that my parents need to stock up and then fully isolate themselves. My question is about how to effectively convince them of that. The week before Passover is already always stressful. They believe their current level of limited shopping and walks is sufficient, and get upset at any implication that it would be appropriate to lockdown further. Perhaps the consensus is that they are fine as is, but if not, any advice or resources about how to communicate to them that a full lockdown is necessary would be particularly appreciated.
posted by cosmic owl at 12:23 PM on April 5, 2020
I agree that my parents need to stock up and then fully isolate themselves. My question is about how to effectively convince them of that. The week before Passover is already always stressful. They believe their current level of limited shopping and walks is sufficient, and get upset at any implication that it would be appropriate to lockdown further. Perhaps the consensus is that they are fine as is, but if not, any advice or resources about how to communicate to them that a full lockdown is necessary would be particularly appreciated.
posted by cosmic owl at 12:23 PM on April 5, 2020
They believe that wearing masks, going out for groceries once a week, and going for walks is acceptable as long as they follow social distancing guidelines, and that they can continue to do so while my grandmother is here for two weeks.
Taking walks outside is fine as long as they aren't near anyone else. Going above and beyond the social distancing guidelines is best in my opinion. So if I'm out walking and someone else is walking towards me, I will cross the street. I think it is very unlikely to catch the virus from someone who is across the street.
About shopping, if they can get that down to once every two weeks at least, that would be better.
posted by wondermouse at 12:38 PM on April 5, 2020 [2 favorites]
Taking walks outside is fine as long as they aren't near anyone else. Going above and beyond the social distancing guidelines is best in my opinion. So if I'm out walking and someone else is walking towards me, I will cross the street. I think it is very unlikely to catch the virus from someone who is across the street.
About shopping, if they can get that down to once every two weeks at least, that would be better.
posted by wondermouse at 12:38 PM on April 5, 2020 [2 favorites]
Best answer: resources about how to communicate to them that a full lockdown is necessary
Trump Warns 'One Of The Toughest Weeks' Is Ahead, Says To Brace For 'A Lot Of Death' (NPR, Apr. 4, 2020)
Trump Warns 'One Of The Toughest Weeks' Is Ahead, Says To Brace For 'A Lot Of Death' (NPR, Apr. 4, 2020)
"The next two weeks are extraordinarily important," said [Dr. Deborah Birx, the White House coronavirus response coordinator]. "This is the moment to not be going to the grocery store, not going to the pharmacy, but doing everything you can to keep your family and your friends safe and that means everybody doing the six-feet distancing, washing their hands."posted by katra at 12:40 PM on April 5, 2020 [2 favorites]
Best answer: Can you just go shopping and stock up? You cannot control your parents or your grandmother and you know what’s going to happen and you think it’s important to stock up. So can you do that or can you ask your brother to bring stuff over for the household? That might be the most effective way to address that issue in particular, by just taking care of it yourself.
posted by Bella Donna at 12:50 PM on April 5, 2020 [7 favorites]
posted by Bella Donna at 12:50 PM on April 5, 2020 [7 favorites]
This isn't okay. Pikuach nefesh is relevant for not only your grandmother, but the other residents of her home. Your parents should be setting her up with a zoom connection to come to seder from where she is -- that's the law that should be broken to save multiple lives. There aren't any precautions your family could take that wouldn't expose your grandmother and her fellows to more risk, and she would be exposing you and your parents to greater risk as well. Making social connections during this time causes increased cases (and deaths) exponentially, not linearly. It's not ethical for your grandmother to go back home after seder and risk spreading illness in her building.
posted by shadygrove at 1:03 PM on April 5, 2020 [14 favorites]
posted by shadygrove at 1:03 PM on April 5, 2020 [14 favorites]
Best answer: I do understand what you are saying about accepting everyone's decisions. It might be interesting to look at what the Kashrut Subcommittee of the Rabbinical Assembly has to say about Passover this year.
posted by jessamyn at 1:49 PM on April 5, 2020 [12 favorites]
posted by jessamyn at 1:49 PM on April 5, 2020 [12 favorites]
Best answer: The OU guide here has language geared towards Orthodox Jews:
Individuals living alone or those absolutely unable to prepare for Pesach may choose to self-quarantine for 14 days, and then – if asymptomatic – may join with a welcoming local family that is similarly asymptomatic and that has been disciplined in staying home and limiting their interactions outside the home to the absolute minimum as described above.
These guests may join one family only for the duration, without additional company, and must carefully observe the mandated standards of scrupulous hygiene and social distancing. The elderly and high risk must seek medical advice before considering this.
posted by damayanti at 2:28 PM on April 5, 2020 [6 favorites]
Individuals living alone or those absolutely unable to prepare for Pesach may choose to self-quarantine for 14 days, and then – if asymptomatic – may join with a welcoming local family that is similarly asymptomatic and that has been disciplined in staying home and limiting their interactions outside the home to the absolute minimum as described above.
These guests may join one family only for the duration, without additional company, and must carefully observe the mandated standards of scrupulous hygiene and social distancing. The elderly and high risk must seek medical advice before considering this.
posted by damayanti at 2:28 PM on April 5, 2020 [6 favorites]
Best answer: You can also talk about khumra, and about the importance of being makhmir here where the stakes are literally life and death.
posted by trig at 2:50 PM on April 5, 2020 [4 favorites]
posted by trig at 2:50 PM on April 5, 2020 [4 favorites]
Jews prep for a pandemic Passover: Smaller but no less vital (AP)
Rabbi Noam Marans, director of interreligious relations at the American Jewish Committee, described the gravity of Passover during the coronavirus by reciting a key portion of the Haggadah, the sacred text Jews use on the holiday. “‘This year we are enslaved – next year we will be free.’ That aspiration is very real this year,” Marans said, looking ahead to a future victory over the disease. [...]posted by katra at 4:41 PM on April 5, 2020 [1 favorite]
The Chabad-Lubavitch movement of Hasidism has expanded its annual distribution of “seder-to-go” kits, which had typically been prepared for hospitalized or otherwise housebound Jews, to help serve families and individuals confined to their homes during a quarantine. Chabad projects it will distribute 250,000 seder kits throughout North America.
I understand that you are asking from the point of view that she is coming, and what can you do, so apologies if this is not helpful, but since you're talking about northern NJ, the Vaad of Bergen County has unequivocally ordered that no one should visit family for Passover this year out of safety for the greater community. It's the second letter on the site I linked -- if your family does this and lives in Bergen County, they are actively breaking halacha. Bergen County has the highest number of cases in the state (as Queens seems to in NYC), and the hospitals are already close to the breaking point. You have as much to fear from her giving this to your parents as you have of them giving it to her.
If they are planning to do this no matter what and in violation of this decision, the best route would be for her to stay with you from that point on, self-quarantining for two weeks, before returning to the nursing home. I'm not sure how the "if she has been cleared by a doctor" caveat would actually work - most doctors who have the ability to test for COVID-19 are not seeing patients without symptoms, let alone people who just want to be cleared (whatever that means). I would at the very, very least make sure that they understand exactly what that entails as far as the nursing home is concerned, and have a concrete plan on how they would go about this.
posted by Mchelly at 5:34 PM on April 5, 2020 [9 favorites]
If they are planning to do this no matter what and in violation of this decision, the best route would be for her to stay with you from that point on, self-quarantining for two weeks, before returning to the nursing home. I'm not sure how the "if she has been cleared by a doctor" caveat would actually work - most doctors who have the ability to test for COVID-19 are not seeing patients without symptoms, let alone people who just want to be cleared (whatever that means). I would at the very, very least make sure that they understand exactly what that entails as far as the nursing home is concerned, and have a concrete plan on how they would go about this.
posted by Mchelly at 5:34 PM on April 5, 2020 [9 favorites]
One other thing - who did your parents speak with at the nursing home that promised that your grandmother will be able to return? Do they have that in writing? Things are changing on the ground incredibly quickly, and over a three day yom tov anything can happen while you're incommunicado:
-- the nursing home could change their position on letting people back in, or letting people back in from affected communities
-- the Governor of either NY or NJ could institute shelter-in-place so that you would not be able to bring her back
-- Your parents were given false information about their policy from a well-meaning person with no actual authority.
-- Her nursing home could go into lockdown with no one but staff in or out, so that she can't return for the safety of the other residents
Not to mention the obvious - your grandmother could get sick or get your family sick, requiring a far longer quarantine.
So if they insist on this, make sure you insist that your grandmother bring more than a couple changes of clothing and anything else she might need for a much longer stay. I think this is a far bigger worry than how often to shop or wash hands.
posted by Mchelly at 6:01 PM on April 5, 2020 [5 favorites]
-- the nursing home could change their position on letting people back in, or letting people back in from affected communities
-- the Governor of either NY or NJ could institute shelter-in-place so that you would not be able to bring her back
-- Your parents were given false information about their policy from a well-meaning person with no actual authority.
-- Her nursing home could go into lockdown with no one but staff in or out, so that she can't return for the safety of the other residents
Not to mention the obvious - your grandmother could get sick or get your family sick, requiring a far longer quarantine.
So if they insist on this, make sure you insist that your grandmother bring more than a couple changes of clothing and anything else she might need for a much longer stay. I think this is a far bigger worry than how often to shop or wash hands.
posted by Mchelly at 6:01 PM on April 5, 2020 [5 favorites]
Best answer: I feel your pain, as my $#&!& 85-year-old dad still has to go shopping multiple times a week for things he doesn't even really need (but they have a special shopping time for people over 70! There were only 3 people at the store! Guess what, I don't care.) and my @$$#()!!3 brother WHO HAS BEEN EXPOSED TO SOMEONE WITH CORONAVIRUS still thinks it is a really great idea and no big deal at all to go visit mom & dad (85 and 83, and oh yeah, mom has stage 4 breast cancer to boot). And if that is not bad of course dad has to go over and visit brother and his ENTIRE FAMILY (who have collectively been to at least 5 different states include some of the major CV hotspots in the past couple of weeks) because it is somebody's birthday or whatever.
Have they heard of that modern invention, the telephone?
Anyway, many of us share your frustration, and it is true you just can't convince or argue or change the mind of other adults. But you have to continue the discussion and continue to present them with ideas and evidence.
So first off something that probably won't help: The CDC guidelines for people at higher risk. The problem with these is, your parents will read them and say, "Well OK, we are doing ALL of those and more. Hooray for us!"
However, for a point of comparison--and something I think it might be very, very helpful to have your parents read--is the UK guidelines for both those at higher risk AND those at extremely higher risk which they refer to as "shielded" or "extremely vulnerable" people.
I don't think your parents have really though through that they are in the "ordinary higher risk" category whereas your very elderly grandmother is in an altogether different category as an "extremely vulnerable" person.
For the extremely vulnerable person, you absolutely do need to go several steps higher in prevention and protective steps.
Also it goes without saying that not only the extremely vulnerable person but that person's entire household needs to follow those same guidelines.
posted by flug at 9:05 PM on April 5, 2020 [7 favorites]
Have they heard of that modern invention, the telephone?
Anyway, many of us share your frustration, and it is true you just can't convince or argue or change the mind of other adults. But you have to continue the discussion and continue to present them with ideas and evidence.
So first off something that probably won't help: The CDC guidelines for people at higher risk. The problem with these is, your parents will read them and say, "Well OK, we are doing ALL of those and more. Hooray for us!"
However, for a point of comparison--and something I think it might be very, very helpful to have your parents read--is the UK guidelines for both those at higher risk AND those at extremely higher risk which they refer to as "shielded" or "extremely vulnerable" people.
I don't think your parents have really though through that they are in the "ordinary higher risk" category whereas your very elderly grandmother is in an altogether different category as an "extremely vulnerable" person.
For the extremely vulnerable person, you absolutely do need to go several steps higher in prevention and protective steps.
Also it goes without saying that not only the extremely vulnerable person but that person's entire household needs to follow those same guidelines.
posted by flug at 9:05 PM on April 5, 2020 [7 favorites]
Also, I would second the point made by others above, that if grandma comes home then everyone should be 100% prepared for the idea that she very well might have to stay home.
She might be able to go back right after passover OK. But also it might be a month before she can go back, or two months, or six months, or a year or maybe never.
Again, even if she wants to go back at that point, it is very possible that she will not be allowed to by the nursing home staff, administration, or on general medical advice.
Another consideration: You probably know that nursing homes and care facilities of that type are, unfortunately, prime breeding grounds for COVID-19. If you've been following local news you probably know that something like 85 Massachusetts nursing homes & care facilities have reported clusters of cases. That is about half of all such facilities in Massachusetts. And that is only the facilities that have reported cases. I'll wager 100% of such facilities either have outbreaks now or will have them within a week or two.
Which brings me to my final point: Personally I would think that the "come home for a few days and go back" plan is the worst of all possible worlds.
But the "come home and stay home until this CV19 thing is over" plan is potentially not a bad plan at all.
There is a good chance grandma will be safer living at home with you and your parents than she will be in the nursing home.
There is a good chance she will be a lot happier living with you as well.
Personally if I were 90 years old I would be much, much happier living at home among family members, even if there is a certain risk of CV19 in moving there and in living there, than living completely alone and isolated in a nursing home, in some combination of terror and boredom, and not even able to visit or see my closest family.
AND on top of all that, in a nursing home environment, which is one of the highest-risk environments for large CV19 outbreaks.
So, that is something to think about.
posted by flug at 9:22 PM on April 5, 2020 [12 favorites]
She might be able to go back right after passover OK. But also it might be a month before she can go back, or two months, or six months, or a year or maybe never.
Again, even if she wants to go back at that point, it is very possible that she will not be allowed to by the nursing home staff, administration, or on general medical advice.
Another consideration: You probably know that nursing homes and care facilities of that type are, unfortunately, prime breeding grounds for COVID-19. If you've been following local news you probably know that something like 85 Massachusetts nursing homes & care facilities have reported clusters of cases. That is about half of all such facilities in Massachusetts. And that is only the facilities that have reported cases. I'll wager 100% of such facilities either have outbreaks now or will have them within a week or two.
Which brings me to my final point: Personally I would think that the "come home for a few days and go back" plan is the worst of all possible worlds.
But the "come home and stay home until this CV19 thing is over" plan is potentially not a bad plan at all.
There is a good chance grandma will be safer living at home with you and your parents than she will be in the nursing home.
There is a good chance she will be a lot happier living with you as well.
Personally if I were 90 years old I would be much, much happier living at home among family members, even if there is a certain risk of CV19 in moving there and in living there, than living completely alone and isolated in a nursing home, in some combination of terror and boredom, and not even able to visit or see my closest family.
AND on top of all that, in a nursing home environment, which is one of the highest-risk environments for large CV19 outbreaks.
So, that is something to think about.
posted by flug at 9:22 PM on April 5, 2020 [12 favorites]
The OU has updated their guidance here:
Everyone must plan to celebrate Pesach where they are currently. Travel to other cities, or visits with family even within your city, should be cancelled. This applies to the entirety of Pesach, including Chol HaMoed and the last days.
posted by damayanti at 10:31 AM on April 7, 2020 [5 favorites]
Everyone must plan to celebrate Pesach where they are currently. Travel to other cities, or visits with family even within your city, should be cancelled. This applies to the entirety of Pesach, including Chol HaMoed and the last days.
posted by damayanti at 10:31 AM on April 7, 2020 [5 favorites]
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I understand my opinion is not a popular one but I would not want to be a 90 year old Orthodox Jewish woman isolated for Passover, and even knowing the risks, would probably choose to absorb them because I could be dead next Passover anyway.
And while yes, young people are dying of Covid, you are at the least risk (and able to absent yourself), so I think you get the least weighted vote.
posted by DarlingBri at 11:18 AM on April 5, 2020 [33 favorites]