Families wrestle with moving loved ones from care facilities
They question where is safest for vulnerable relatives as virus spreads
G’Nai Blakemore was horrified. It was early April, and the coronavirus was spreading across Houston. But the personal care home where her aunt lived was sending residents to day groups again.
The 36-year-old public relations director couldn’t figure out what agency — if any — oversaw the facility. She desperately wanted help getting the owner to follow stricter protocol to prevent a coronavirus outbreak.
Her aunt, 62-year-old Vicki Brown, had moved into the care home two years earlier, after suffering a series of strokes. They had always been close. Blakemore began to wonder if she should move Brown into her one-bedroom Tanglewood apartment.
If her aunt stayed in the care home and got sick, Blakemore said, “I would never get over the guilt.”
The question of where vulnerable older relatives are safest has plagued countless families in recent weeks. Early on, state-regulated nursing homes and assistedliving facilities proved dangerous — roughly 2 of every 5 coronavirus-related deaths in Texas were linked to such facilities, even with added precautions.
An untold number more seniors, such as Blakemore’s aunt, live in group homes that were not uniformly regulated by the state and so not bound by the same
rules. Such homes, Blakemore was discovering, posed additional, untracked harm. Texas doesn’t release case data for individual regulated facilities, let alone unregulated ones.
The scant information, fear of the virus and lack of an oversight agency compounded an already difficult decision. Yet, the fact remained that a patient was typically placed in a care facility because family members could no longer meet that person’s needs, said George Taffet, a geriatrician at Baylor College of Medicine.
Moving someone into a facility can be challenging. Janet Marquis, 59, only got her 86-year-old dad, a truck driver, to move to a Katy-area nursing home with a court-order and transfer from a hospital. He had Parkinson’s and Alzehimer’s diseases, and, though she worried about the level of care, she felt she had no choice but to leave him there.
“If I could bring him home and have someone take care of him here, I would certainly do that, but my dad requires 24-hour care,” Marquis said. “I don’t have the resources for that and neither does he.”
Sue Ellen Davis tried for weeks to move her 89-year-old father, James Virgil Davis, from a League City assisted-living facility into her Angleton home. Davis planned to hire someone to help care for her dad, a former Dow Chemical employee, who had Alzheimer’s and was on hospice. She didn’t want him to die alone.
But before she could get him tested to be sure he didn’t have COVID-19, a worker tested positive, then some residents, then him. He was hospitalized and returned to the facility tired and weak. She still wanted to bring him home. On April 27, after she arrived for a daily window visit, staff found he had passed away. He tested negative that day for the virus.
Geriatricians such as Taffet caution family members to think carefully before removing a relative from a care facility, since the family will still have to meet the needs that overwhelmed them in the first place, and may have worsened. But Blakemore, working from home, felt she could support her aunt. She had to decide if she should.
Blakemore’s aunt, who worked on a Honeywell assembly line in the Dallas area, had nine strokes in late 2017. She went twice to a hospital, then to rehabilitation and then to a skilled nursing facility. But her insurance wouldn’t pay for her stay there long term.
Blakemore searched frantically for a place Brown could afford to live. Brown needed help with her meals and reminders to take her medication. But nursing homes were expensive and didn’t seem like the right fit since Brown was relatively young.
The facility she left arranged for her to move to the Alpha Personal Care Homes in Mission Bend. It allowed her more freedom and fit her budget, and Blakemore hadn’t been able to find another option. It took a while for Brown to settle in, to call her niece without crying.
Residents in the homes ranged in age, owner Alex Edohoukwa said. And they coped with a variety of issues, from mental illness to brain damage to dementia. Buses took them to various therapeutic programs during the day.
When the threat of coronavirus rose, Edohoukwa prohibited residents from attending their day groups. But he started to worry they would wind up in worse trouble since they could still come and go from the home. He checked that the day groups had procedures to protect against coronavirus, then decided residents could go again.
“I’m not putting them in harm’s way,” he said. “It’s more productive for them to have something to look forward to than just sitting at home getting depressed and looking for trouble to get into.”
Blakemore worried that returning to the day programs, with lots of other people, was a bad idea. The state had banned visitors and stopped group activities in nursing homes and assisted-living facilities in mid-March. When she learned residents were going back, she set off to figure out who oversaw personal care homes.
She didn’t get far. The Texas Health and Human Services Commission regulates group homes that are part of a Medicaid program for people with intellectual and developmental disabilities — which the Alpha Personal Care Homes location was not.
The commission investigated the home in 2018 to see if it was operating unlicensed as an assistedliving facility — defined as a place giving personal care or medication administration to four or more people — and determined it was not.
Fort Bend County, where the home was located, didn’t regulate such homes, either.
Blakemore had trouble getting someone on the phone to talk through any of this. She remained concerned. It would be a tight fit in her apartment, but her aunt could sleep on an air mattress or her couch. Blakemore could help her bathe and cook for her. She could get her a brain exercise workbook and let her watch TV while Blakemore worked.
And so, on April 7, Blakemore decided. Early before work, she drove to pack up Brown’s belongings and bring her home.
“If I could bring him home and have someone take care of him here, I would certainly do that, but my dad requires 24-hour care. I don’t have the resources for that and neither does he.”
Janet Marquis