The Morning Call

Cri­sis unveils nurs­ing home fail­ures

Ad­vo­cates: Virus bat­tle re­sults in res­i­dents’ ne­glect

- By Matt Se­den­sky and Bernard Con­don

As more than 90,000 of the na­tion’s long-term care res­i­dents have died in the coro­n­avirus pan­demic, ad­vo­cates for the el­derly say a tan­dem wave of fa­tal­i­ties is qui­etly claim­ing tens of thou­sands more who are suc­cumb­ing not to the virus but to ne­glect by over­whelmed staffs and slow de­clines from iso­la­tion.

Nurs­ing home watch­dogs are be­ing flooded with re­ports of res­i­dents kept in soiled di­a­pers so long their skin peeled off, left with bed­sores to the bone, and al­lowed to wither away in star­va­tion or thirst.

Be­yond that are swelling num­bers of less clear-cut deaths that doc­tors be­lieve have been fu­eled by de­spair and des­per­a­tion from be­ing cut off from loved ones, listed on some death cer­tifi­cates as “fail­ure to thrive.”

“What the pan­demic did was un­cover what was re­ally go­ing on in these fa­cil­i­ties,” said June Lin­nertz, whose fa­ther died in June af­ter she found him in what she said were pu­trid con­di­tions at his Ply­mouth, Min­nesota, as­sisted liv­ing fa­cil­ity.

Nurs­ing home ex­pert Stephen Kaye, a pro­fes­sor at the In­sti­tute on Health and Ag­ing at the Univer­sity of Cal­i­for­nia, San Francisco, an­a­lyzed data from 15,000 fa­cil­i­ties for The As­so­ci­ated Press, find­ing that for every two COVID-19 vic­tims in longterm care, there is another who died pre­ma­turely of other causes. Those “ex­cess deaths” be­yond the nor­mal rate of fa­tal­i­ties in nurs­ing homes could to­tal more than 40,000 since March.

The more the virus spread through a home, Kaye found, the greater the level of deaths recorded for other rea­sons. This sug­gested care suf­fered as work­ers were con­sumed with at­tend­ing to COVID-19 patients or were left short-handed as the pan­demic in­fected em­ploy­ees.

“The health care sys­tem op­er­ates kind of on the edge, just on the mar­gin, so that if there’s a cri­sis, we can’t cope,” Kaye said.

Dr. David Gif­ford, chief med­i­cal of­fi­cer of the Amer­i­can Health Care As­so­ci­a­tion, which rep­re­sents nurs­ing homes, dis­puted that there has been a wide­spread in­abil­ity of staff to care for res­i­dents and dis­missed es­ti­mates of tens of thou­sands of non-COVID-19 deaths as “spec­u­la­tion.”

Fam­i­lies around the coun­try, though, say their loved ones didn’t have to die.

In Birm­ing­ham, Alabama, Don­ald Wal­lace was one of the lucky few to avoid in­fec­tion as COVID-19 tore through West Hill Health and Re­hab.

But the 75-year-old re­tired truck driver be­came so mal­nour­ished and de­hy­drated that he dropped to 98 pounds. Sep­tic shock sug­gested an un­treated uri­nary in­fec­tion, E. coli in his body from his own fe­ces hinted at poor hy­giene, and as­pi­ra­tion pneu­mo­nia in­di­cated Wal­lace, who needed help with meals, had likely choked on his food.

“They stopped tak­ing care of him,” said his son, Kevin Amer­son, who pro­vided med­i­cal files doc­u­ment­ing the con­di­tions he de­scribed. “They aban­doned him.”

West Hill Health said Wal­lace was “cared for with the ut­most compassion, ded­i­ca­tion and respect.”

Ch­eryl Hen­nen, Min­nesota’s long-term care om­buds­man, is among the ad­vo­cates who’ve seen com­plaints pour in for bed­sores, de­hy­dra­tion and other ex­am­ples of ne­glect, such as a man who choked to death while un­su­per­vised dur­ing meal­time. She fears many more sto­ries of abuse and ne­glect will emerge as her staff and fam­i­lies are able to re­turn to homes.

“If we can’t get in there, how do we know what’s re­ally hap­pen­ing?” she asked.

When the lock­down be­gan at Gur­win Jewish Nurs­ing Home on New York’s Long Is­land, Dawn Best was con­fi­dent her 83-year-old mother would con­tinue re­ceiv­ing the dot­ing care she’d grown used to. But as the virus spread, Best sensed the staff couldn’t han­dle the hand it had been dealt.

Her mother never con­tracted COVID-19 but died af­ter suf­fer­ing de­hy­dra­tion, Best said, pro­vid­ing med­i­cal doc­u­ments de­tail­ing the di­ag­no­sis.

“My mom went from be­ing un­be­liev­ably cared for to dead in three weeks,” said Best.

Rep­re­sen­ta­tives for Gur­win said they could not com­ment on Best’s case but that its staff “has been do­ing heroic work.”

“Fail­ure to thrive” was among the causes listed for Max­ine Schwartz, a 92-year-old for­mer cake dec­o­ra­tor who lived at Ab­so­lut Care of Aurora Park in up­state New York.

Schwartz’s daugh­ter, Dorothy Ann Car­lone, paid daily vis­its to her mother in which she’d coax her to eat, a rou­tine that was halted in March by the fa­cil­ity’s COVID-19 re­stric­tions.

Car­lone, as her daugh­ter feared, stopped eat­ing and within weeks was dead.

Dawn Harsch, a spokes­woman for the com­pany that owns Ab­so­lut Care, noted a state in­ves­ti­ga­tion found no wrong­do­ing and that “the nat­u­ral pro­gres­sion of a pa­tient like Mrs. Schwartz ex­pe­ri­enc­ing ad­vanced de­men­tia is a re­fusal to eat.”

But Car­lone won­ders what her mother thought when she no longer ap­peared each day: “That I didn’t love her any­more? That I aban­doned her?” That I was dead?”

She thinks the pain of it all played a role in her mother’s death.

“I think she gave up,” she said.

 ?? FRANK FRANKLIN II/AP ?? Dawn Best holds a photo of her mother, Carolyn Best, who went from “un­be­liev­ably cared for to dead in three weeks” at a New York nurs­ing home.
FRANK FRANKLIN II/AP Dawn Best holds a photo of her mother, Carolyn Best, who went from “un­be­liev­ably cared for to dead in three weeks” at a New York nurs­ing home.

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