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Marguerite Todd has been a resident at Apple Grove Alzheimer’s and Dementia Residence in southeast Memphis for five years.

Family members of the 88-year-old were notified March 12 that all non-medically necessary visits to the facility were suspended until further notice because of the growing coronavirus threat. Key fobs that visitors used to enter Apple Grove were deactivated.

Todd’s daughter, Diane Pace, a nurse practitioner, was thrilled.

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“That may seem harsh to people. ‘What do you mean you’ve disengaged my fob?’ It’s because you just don’t know,” she said. “And these are medically fragile individuals, not just the Alzheimer’s and dementia (residents). They have all kinds of secondary diseases – diabetes, high blood pressure – that make them more vulnerable.”

Facilities like Apple Grove are taking extra precautions to protect some of the most susceptible to the coronavirus – the elderly.

Pace’s mother is no longer able to speak for herself, making her even more defenseless.

“My mother cannot have a conversation. She can’t tell me when she doesn’t feel well,” Pace said.

Pace presumes most nursing homes and care facilities are taking similar precautions to protect the residents and staff, and she approves of it all.

“That’s the nurse. That’s the daughter. That’s all parts of me,” Pace said.

The Village at Germantown also has amended its policies to protect its residents.

The Village has about 350 people living in its suburban retirement community.

Skilled-nursing facilities, assisted living and memory care are what people tend to associate with accommodations caring for the elderly, according to Mike Craft, chief executive officer.

“These areas are where we are most strict because (residents in the areas) are most vulnerable,” Craft said.

The Centers for Medicare and Medicaid put out new guidelines twice last week. Each time, Craft said they were immediately enforced. 

“At first, they limited visitors,” he said. “Now they’ve restricted them.”

Craft said family may not visit residents in those areas. Few exceptions are made for residents who have special needs or are nearing the end of life.

The Village is helping its residents stay connected with families by coordinating FaceTime visits.

Residents take pleasure in communal dining or having a visitor join them for a meal, but those activities have been put on hold for now.

“It’s sort of disruptive to the residents,” Craft said.

Any normal day, residents would sit at a table chatting with friends as they enjoyed their meal.

Normally, Craft said, residents can eat alone at a table or in the dining room but at this time, food can also be taken to rooms without an added fee. The large tables were taken out of the dining room to discourage eating with others.

Various programming opportunities are available for the residents but those likely to draw a crowd were canceled.

Small-group activities like exercise are continuing as well as one-on-one healthcare activities that provide “intellectual stimulation.”

“Independent living is not as highly regulated,” Craft said, noting stricter guidelines are in place in other parts of the property.

Outside visitors are strictly regulated, but two family members may visit at a time.

They must enter through the main entrance and are screened with a series of questions about their travel history and health. The guests also have their temperature taken and must visit residents in their apartment or villa instead of the various meeting areas on campus. 

“We are really pushing hygienic guidelines,” Craft said, noting hand washing, sneezing and coughing into tissues.

He is trying to teach residents about the importance of social distancing.

“They are slow to pick up on it because they really like to visit with their friends,” he said. “(Social distancing) is a huge culture shift for anybody.”

Some of those in independent living still work. Others have medical visits they may need to take. 

“If you absolutely must leave, take extra precautions,” he tells residents. “If they do leave and come back, they get screened.”

Staff is being allocated to cleaning high-traffic areas.

“There’s not a whole lot of working from home (our employees) can do,” he said due to the nature of the facility.

The Village is affiliated with Methodist Le Bonheur Healthcare.

Tennessee Health Care Association has 22 facilities in the Memphis area. The Tennessee branch is following guidelines published by the American Health Care Association.

Employees, visitors, new residents, government officials and healthcare professionals must be screened before entering the building. A series of questions will be asked, including if they have been in a setting with a confirmed COVID-19 case or traveled internationally in the previous 14 days. Screening questions will also ask about respiratory issues.

Access will be limited and granted to employees and contractors who must enter facilities to keep them operating. Government officials with health care roles will be allowed. Family and friend visits will be limited but allowed for time-sensitive issues such as hospice visits. Entry will be limited especially when there is a confirmed case in the community, and reasons for visitor entry will be taken into consideration. Those entering the building must wash their hands.

The facilities are also encouraged to help residents and others connect remotely with others.

Events that could expose residents to sickness will be restricted. Events that take residents from facilities into the community are canceled with an exception for medical visits. Tours of facilities for prospective residents are being limited.

Reporter Linda Moore contributed to this story.