This story by Rachel Chason of The Washington Post summarizes the heartbreaking reality that elderly people are dying of loneliness in care facilities. The COVID Pandemic has meant quarantines prevent family members from visiting. Of course, we all understand the reasons for taking such precautions, but that doesn’t make it any less heartbreaking. We witnessed a rapid decline in my 82-year-old Dad’s cognitive abilities and physical health once family visits were no longer allowed. While he didn’t die of COVID, it was certainly a big contributing factor.
Dad’s Decline
During the eight weeks between March 6th and May 10th when he died, Dad became unrecognizable. Social workers are typically the conduit between families and doctors allowing busy medical professionals to focus on resident care. But during COVID, social workers at my Dad’s facility were deemed non-essential and began working from home. This meant social workers weren’t laying eyes on patients making them less able to respond to our questions about how residents were faring. Family members were desperate to hear details of Dad’s days and frustrated when he stopped answering his phone. For some time, he would answer but it sounded like he had the phone upside down. We could hear him saying hello, but he couldn’t hear me shouting back “hi Dad, it’s Trish! How are you?!?!”. In frustration he would hang up. His voice sounded weaker and weaker as time passed. If we did happen to catch him by phone, he had little to say reporting “everything is the same”. Eventually, he stopped answering all together.
Video Chats
As a stop-gap measure, the facility started to arrange video chats so family members could see their loved ones and residents would have assistance with the technology. A nurse would provide me with a secure link and once connected, the nurse walked an iPad into Dad’s room. Most times he would stare blankly at the screen and often nod off. Nurses had to do a lot of prodding to help him understand what was happening. Calls were usually only minutes long and I’d walk away with a heavy heart because of how unlike himself he was. He was losing weight and his face was getting thinner. As a lung cancer survivor, his struggle to breath was getting more pronounced. Even speaking would take his breath away. This was such a sad time.
I Want To Go Home
In early April when the nurse was connecting me with Dad for a video chat, she warned that he was agitated and had been asking to go home. Sure enough, he told me the same. I’m not even sure what I said in response. This request was both confusing and heartbreaking. Did he understand that the pandemic was preventing us from visiting him? Was he saying he was lonely? Or was he saying he wanted to go home to die?
My siblings and I met with our social worker to discuss how seriously we should take this request. Apparently it’s not unusual to hear such requests from residents. But under COVID circumstances, it was heart wrenching because there was little we could do to comfort him. We knew Dad was declining, and his social worker assured us that they could administer palliative care when it was time.
We explored the option of taking Dad home and having hospice care come in to administer treatment. Unfortunately, due to demand and their strained resources due to COVID, we could only expect visits from hospice nurses 2 times per week. The rest of his care would be up to us. They advised he would really be better off where he was.
Video Message
Since communication with him was so difficult, Dad’s social worker suggested that we try sending a video so they could play it for him when he was most lucid. The video below is one that I made a few days before he died. I was trying to make sure he knew that we weren’t deliberately neglecting him. We were thinking of him and trying to stay safe while struggling with COVID on the outside too. I’m told that nurses played it for him several times.
End-of-Life Visit
Palliative care began in mid-April on an as-needed basis. Gradually his dosage became more regular as he struggled to breathe making him more anxious. I got a call on May 7th that an end of life visit was being granted and that I should arrange to get to New York soon. I left the next morning and was able to see Dad for two hours on May 8th. I believe he knew that my siblings and I were there, but he also seemed like he thought it was a dream. We did lots of hand holding but had to stay masked. We did tell a few stories but he was very groggy. We said our goodbyes and watched him nod off to sleep.
Dad died on May 10th around 7PM. Unfortunately, he was alone. His social worker told me that nurses were checking on him every 15 – 30 minutes but he had passed by the time they made their final check. I can’t tell you how.