Michael Archibald was already worried about his mother, Annie, whose social life at The Enclave of Scarborough gradually shut down over the last several weeks to prevent a COVID-19 outbreak.

“Everything has been canceled,” said Annie Archibald, 82, a retired telephone company employee. She hasn’t left the senior living community off Black Point Road in weeks. She misses going to church, sharing meals in the dining room, attending happy hour performances and, most of all, watching movies with friends in The Enclave’s theater.

Then on Saturday, The Enclave notified residents and their family members that a resident had tested positive for the coronavirus. The announcement made the threat all the more real for the Archibalds, who for a month have been sharing brief weekly visits wearing masks, sitting outdoors and spaced at least 6 feet apart.

“It’s difficult,” Michael Archibald said. “I could hear it in her voice when I called this morning. This is going to make things a lot more challenging for a lot of people.”

Senior congregate care facilities across Maine have heightened efforts to stave off COVID-19 outbreaks as five long-term care facilities reported dozens of cases among residents and employees. Older people with underlying health issues are considered especially vulnerable; 399 of 888 confirmed cases in Maine – 45 percent – have been among people age 60 and older.

Among the five facilities with outbreaks – defined as three or more confirmed cases – 120 residents have tested positive and 16 have died, according to the Maine Center for Disease Control and Prevention. That’s 44 percent of the 36 Mainers who have died after contracting COVID-19. Those numbers don’t include OceanView at Falmouth, a retirement community where 12 residents have contracted the virus and an undisclosed number have died.

But efforts to protect seniors in congregate settings from COVID-19 have downsides that can also impact residents’ physical and mental health. With gyms and dining rooms closed and exercise classes and bridge club meetings canceled, many sit isolated and alone in their rooms or apartments.

Limited contact with family members and friends and lack of physical activity can cause or worsen heart, lung and blood pressure problems, arthritis, diabetes, depression and other health issues.

“If people aren’t moving and connecting with others, the physical and mental effects could be detrimental,” said Marilyn Gugliucci, professor and director of geriatrics research at the University of New England’s medical school.

Residents and their family members find they have few options when considering what they might do if an outbreak happens where their loved ones live.

In Washington state, when COVID-19 outbreaks spread through several nursing homes in early March, some news agencies reported that family members wanted to remove loved ones before they got sick as well. Experts say that’s definitely not the answer.

“On the stress scale, moving is right up there at any age, right after dealing with the death of a spouse,” Gugliucci said.

Gugliucci said residents in senior congregate settings have adapted to their environments and established relationships with staff members and other residents, as people do at any age. Studies have shown that moving frail elderly people can precipitate illness and even death.

“Pulling them out of that environment is going to put them at greater risk,” Gugliucci said. “You may think you’re doing what’s best for them, but it’s generally not in their best interests.”

Family members also must remember that residents of assisted-living facilities or nursing homes are there for a reason, said Dr. Jabbar Fazeli, who oversees medical care at three long-term care facilities in southern Maine and is spokesman for the Maine Medical Directors Association.

They usually have physical or cognitive disabilities that make living alone difficult if not dangerous, and family members often were unable to care for them without assistance from home health workers, Fazeli said. Removing seniors from congregate settings now would put them at greater risk of contracting COVID-19 in the wider community.

“If you take them home and they fall or have some other medical emergency, they could wind up in an ER with even more contact with the coronavirus,” Fazeli said.

Gugliucci said most nursing homes and assisted-living facilities are mindful of their residents’ physical and mental well-being, and many are doing what they can to maintain social connections and activities through staff members and online efforts.

At the South Portland Nursing Home, where residents haven’t been able to receive visitors since late February, staff members have increased their social interactions with residents while wearing masks and keeping a safe distance, said director Jeff Ketchum. They’re also offering frequent opportunities for phone calls, online chats and window visits with family members.

On the porch steps of her house in Buxton, Mary Altenbern waves to her husband, Charlie Altenbern, while using FaceTime on her iPhone on Tuesday. Altenbern’s husband has Alzheimer’s and she used to visit him at the South Portland Nursing Home daily. Because of the coronavirus, she has not seen him in person since Feb. 28. Gregory Rec/Staff Photographer

For Mary Altenbern, being separated from her husband, Charlie, has been excruciating. He’s a former electronics engineer who has Alzheimer’s disease. She usually drives daily from Buxton to the South Portland Nursing Home to spend four hours with him at lunchtime.

Now, they have virtual online visits a few days each week. Her spirits lift when their eyes meet, but she misses his hugs.

“He’s my soulmate and I don’t know when I’ll get to see him again in person,” Altenbern said. “But I know my husband is getting the best care possible, and I know I cannot care for him better than they can care for him.”

Altenbern said she has witnessed how disruptive and harmful moving can be for nursing home residents, and she wouldn’t consider removing her husband if there were a COVID-19 outbreak where he lives.

“I’ve seen it happen when they just move someone to another room,” Altenbern said. “My husband is in the safest place he can be.”

Michael Archibald of Portland visits with his mother, Annie Archibald, outside at The Enclave of Scarborough on Monday. Despite a confirmed coronavirus case at The Enclave, “She feels safe there, he said, “especially because they’re taking so many precautions.”  Gregory Rec/Staff Photographer

Michael Archibald and his mother feel the same about her situation at The Enclave of Scarborough.

“She feels safe there, especially because they’re taking so many precautions,” Michael Archibald said. “I also feel it would be worse if she left. My mother is pretty independent and healthy right now, as long as she’s being safe.”

Archibald said he was heartened to learn from an Enclave administrator that the resident who tested positive for COVID-19 was a newcomer to the senior living community who was tested before entering and has been isolated from other residents ever since. Archibald said he also was told the person wasn’t showing symptoms when tested.

Caitlin Marsanskis, executive director of The Enclave, said she was unable to provide specific information about an individual resident because of federal health privacy laws.

“However, I am able to confirm that our policy requires new residents to be held under strict isolation protocols for 14 days or until they test negative for COVID-19,” Marsanskis said in an email.

Marsanskis said The Enclave is providing individual activities to engage residents of the 81-apartment community and daily access to Zoom, FaceTime and other technology so they can connect with friends and loved ones.

For Annie Archibald, an admitted film buff, being able to watch movies via Netflix on her digital viewer has been a blessing.

“I thank God for my Kindle every day,” she said. “I feel safe except for that one resident. My son is so good about checking on me and making sure I have sanitizer and everything I need. I’m taking it one day at at time. That’s how I’ve always lived my life.”