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I am very happy to hear that the CDC decided to prioritize health care workers and long-term care residents to be the first to receive the vaccine for the COVID-19 vaccine.  It is very personal to me as a health care worker and a daughter.

My mom was admitted to an assisted living/personal care home as the lockdown was hitting this past March.

Her health had been declining since September of 2019 with multiple hospitalizations.  We finally convinced her to move into an apartment building for seniors that offered meals and transportation around Christmas.  It was a very nice place, but it was too little, too late.  In late February, she was admitted to the hospital for the last time, and she was sent to a nursing home for a few weeks of physical rehabilitation.  The day before Pennsylvania went into lockdown, the therapist at her facility determined that she could not return to the apartment that we had finally convinced her to move into just a few weeks before.  She was scheduled to return to her independent living apartment the next day when the therapist deemed it an unsafe discharge plan.  Pennsylvania’s long-term care facilities allow 48 hours to find a new place.  We had 24.  The nursing facility did not work with us at all.  They were rushing to find placement for my mom and another female resident, and the person supposedly helping us find a new place confused this other patient and our mom.  The person “helping” us never got back to me, and with time slipping away and no new facility to go to, they went into my confused mother’s room and coerced her to write a check for another day’s stay.

We finally were able to find an assisted living place to accept my mom at the eleventh hour.  My sister helped my mom sign the papers, and that was the last time any of my mom’s six children were permitted in the facility.  It was a small facility – maybe twelve residents – but I’m not sure of that because most of my visits with my mom were through the glass. The isolation killed her.  My mom had a smartphone and was able to text.  We used to laugh because her texts were grammatically correct, with proper pronunciation, and always signed, “Love, Mom” or “Love, Grandma.”  She even used emojis.  The last coherent text I received from her was on March 17.  After that, she lost the ability to use her phone, which was her lifeline.  Some of the facility’s employees would help her if she asked them to, but they were too busy a lot of times, and sometimes they were mean.  One even told her it “wasn’t in their job description.”  This crushed her.  She could no longer count on the only way she had available to communicate with her children.  FaceTime calls helped a little, but we had to schedule them with the facility, and after a few weeks, the novelty wore off.  She wanted to know why no one visited her.  We would explain it was the virus, and she would answer, “Oh, that’s right.  I heard about that, but I bet they would let you in if you came.”  It was heartbreaking.

Soon after she was admitted, she was placed on hospice care.  Her hospice nurse, Clare, was wonderful with her but was only allowed in once a week by the facilities director.  A friend of mine had her mother in another facility, and because she was in hospice, her family was allowed to visit.  I was hopeful the rules would be the same at my mom’s facility, but apparently, each facility is allowed to make its own rules or enforce their own interpretation of the rules.  The director wouldn’t budge.  We were told we would be let in to spend time with my mom if death was imminent, and even then, it would only be one person at a time for thirty minutes.  There was one time when she told my brother that she wished she could kill herself.  I reported this, and they had to investigate it as a credible suicide threat.  I was happy that it enabled another person into the hospice team facility to check on her.

What was supposed to be a two-week lockdown lasted months.  In mid-April, my mother became confused, and her blood pressure dropped dangerously low.  It happened to be when Clare was present, and she called my sister and me to come right away. I really thought she was dying, and I thought they would relax the rules and make an exception due to the circumstances.  My sister was there, and when I arrived, she had to leave, and I was allowed at her bedside for half an hour.  My mom said a few words to me, including, “I love you.”  It was the last time I was able to hug my mom.  Ever. She recovered from that episode and did not remember that my sister or I were there.  No one from the family was ever allowed back into the facility by the Governor and the Secretary of Health in Pennsylvania. The only other visits I had with her were through the glass.  She was hard of hearing and had a very difficult time communicating through the glass.  It was frustrating to her and us.

My mom was a very social person and had to eat every meal in her room from the time she was admitted.  The week my mother passed away, my sister called and asked if they would rotate residents allowed to eat in the dining room.  They hadn’t thought of that but agreed to “look into it.”  My mom, who didn’t do anything wrong, was treated like a prisoner in the last months of her life.  The weather was beautiful, and my sister also asked if my mother could be taken outside to get some fresh air.  That phone call happened on a Monday.  My mom died on the following Thursday, June 18, 2020. She got up to go to the bathroom, said she wasn’t feeling well and laid down in her bed, and passed away.  Clare was called to pronounce her.  There was no opportunity for a family member to come and hold her hand.  There was no way to know that death was imminent.  She did not have a visitor, feel the touch of someone she loved and who loved her, go outside, or eat a meal with another person for three months without ever truly understanding what was happening.

In the meantime, the staff could go home, be with their families, and live their lives and return to work without any restriction that I was aware of.   I am a nurse.  I realize the importance of quarantine, social distancing, and common sense approaches such as mask-wearing and hand-washing.  I’m not saying that there should not have been restrictions on visitations, but the restrictive policy in place was cruel and contributed to my mother’s death.   No residents ever got sick while my mom was there, but there is no doubt in my mind that my mother died due to COVID-19.  After she died, I sent a message on Twitter to Pennsylvania’s Secretary of Health.  It read, “Please come up with a system by which families can see their loved ones in care facilities.  My mother died yesterday without hugging or even seeing her children in three months.  We are heartbroken, and she felt abandoned.”

I never received a reply.

Christine King is a nurse anesthetist.

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Source: KevinMD

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