I put her in what is called a "good'' assisted living. Mom, 95, in-out dementia, incontinent, not eating right and just seemed to be suffering. I tried to assist her staying home-she always said she wanted to die in the house I grew up in with my father. He died from cancer in 2000. My mom was also falling over once a week at least the last few months. She was difficult to lift-even at her age a sturdy-tough woman. Hired aide services say they will not assist in picking elders up off the floor. I put Mom in ALF the end of Feb 2020. She was not happy being there but was at least cared for. I visited twice a week until locked out first week of March. Then on an aide supervisor called or emailed with an update on her condition. The last update was the end of March with a pic of Mom looking okay-as I had last seen her. Here is where I am both angry and feeling guilty. The first week of April went by and no update. Ten days into April I emailed the aide supervisor to get back to me. Friday April 17 2020 a phone msg-call the ALF. They say Mom has some bleeding and their doctor and staff are monitoring it. Friday night a call Mom to Emergency. Saturday night April 18-Mom dead. Doctor said low fluids, high white count, incoherent and possible virus. That is all the info I can get. I suspect the hospital put her to the side to die from Friday to Saturday night. Turns out the supervisor I had relied on went out "sick with a cold" the two weeks I expected an update. Today,April 23 I picked up my Mom's belongings packed up by this person back at the ALF. Then in the mail is a general info letter dated the day my Mom died to all families that they have found two staff tested + with the virus. My question- should I have removed Mom when the virus first came to area? Is the ALF responsible or negligent? Did I help kill my Mom? Thanks all, best wishes.
I'm so sorry for your loss, my friend. Wishing you peace as you move through your grief process.
I think your question is two-fold.
First is dealing with your guilt. You were no longer able to take care of your mother's needs, so you made the responsible choice to place her in a facility that had the ability to provide care. That was the responsible thing to do. It was the compassionate thing to do. Could you have guaranteed her safety if she had remained with you? Could you have guaranteed there would be no chance of her being exposed to this virus had she stayed in your house? Could you have guaranteed that her falling would not have caused her injury that would have necessitated at least a visit to the ER, if not admission to the hospital? I'm sure you went over all the scenarios in detail before you placed her. I'm also going to assume that you were in contact with her doctors, who green-lighted your decision, and I will assume (because this has to happen in NY before you can be admitted to a nursing facility) that your mom was evaluated by a health professional before entry into the ALF, and the results of that evaluation were that she needed care beyond your capability. So let me assure you, you have nothing to feel guilty about. Guilt is an insidious little bugger, though, and doesn't respond to logic, so you have to keep reminding yourself - you made the best decision with the information you had at hand at that time. 20/20 hindsight is a useless exercise, and is the handmaiden to guilt.
Now onto the question "is the ALF responsible or negligent?"- unfortunately, this virus is particularly hard on the elderly. There are a lot of nursing home residents who haven't/will not survive. It's not fail. It sucks. It's heart-wrenching. It's a terrible blow to the family members left behind. That doesn't mean it's anyone's fault! Not yours, and not the facility's. I believe, unless it's unquestionably negligence or carelessness (ie.: I'm allergic to penicillin. I tell the medicos I'm allergic to penicillin. They ignore me, give me penicillin and I die from my allergic reaction), it's not really moral for people to sue because they feel "cheated" somehow out of time they feel they were owed. In the end, the only guarantees we have are death and taxes.
Only you can make the determination if you feel your mother was so wrongly treated that you need to hold her facility responsible. But if this is a way to try and somehow alleviate the guilt you feel, that's really not fair to the facility - who I am sure are doing the absolute best they can in these extraordinary circumstances.
Caveat: the following was the situation when I worked in medical malpractice ("med mal") law firms decades ago. It may or may not have changed. With that qualifier, when a medical situation is analyzed for purposes of assessing liability and potential negligence, a critical factor is the standard of care for the condition in the geographic area.
Given the current pandemic, I anticipate that med mal attorneys are already creatively attempting to expand, or establish, new criteria for treating people in close situations such as rehab, AL, IL, etc. I also anticipate that new standards may in fact arise from the lawsuits to be filed.
For you, the question probably would focus on whether the AL had established standards for addressing and coping with the pandemic, what those standards were, whether they factored in various aspects known at the time.
I.e., did they do what other AL facilities in the geographic area also did, such as quarantine infected people, provide as much protective equipment as they could to the staff, and residents, if appropriate? Did they specifically omit or fail to do something or take action that could have prevented her death?
You could if you want to spend the money to order a copy of their medical records, but it will cost you a lot of money, and probably won't be on their priority list. And there's no guarantee that the records would provide any more information to satisfy your concerns.
A med mal attorney would have the records reviewed either by a doctor in a related field, or by a nurse, sometimes on staff (at least they used to be). Their determination would guide whether or not liability existed, and whether the AL might have been responsible or negligent.
There's another factor and that's the decline that some people face when confined, in a building not their home, in unfamiliar surroundings, w/o the freedom they have at home, etc. It's also possible that her having learned of acceleration of the outbreak frightened her and changed what I've interpreted as an adaptable attitude. Anyone would be frightened; the pandemic scares a lot of us!
You raise the issue of bleeding, or was this actually hemorrhaging? There's a big difference. I think high white count indicates infection (medical people here, correct me if I'm wrong). Also cited were incoherence and possible virus. I won't even try to guess what other conditions would reflect these symptoms, but perhaps some of the medical people can offer some insight.
For liability to attach, you'd have to prove through medical records and consistent diagnosis by another medical practitioner in the area that the AL treatment did not meet standards of care.
Personally, I think this: you mentioned she was suffering for a variety of reasons when she went in. Being away from your own home is depressing, lonely and sometimes frightening. Add to that mix the fear created in a pandemic, inability to contact her loved ones, and so many people, so vulnerable, all in one facility.
I don't think her removal from AL and back to home would have been helpful b/c you wouldn't have had the benefit of medical examination other than going to the hospital. And both of you might have been more exposed together at home.
As to negligence or responsibility? Again, it turns on the criteria above, and in a drastically changing scenario, I'm not sure that can really be established. If questioned as to what else could have been done, I think the only alternative was what they did do: take her to the ER.
Please don't feel that you helped her die. I think that's an assumption a lot of us make, w/o justification, and it unsettles us, creates guilt and anxiety.
Know that you did the best you could under the circumstances.
Please, don't feel guilty. She lived a long life and seemed to be loved. I think as things are going now, you can not blame anyone.
I just want you to look at what you wrote.
"...in-out dementia, incontinent, not eating right and just seemed to be suffering."
"...falling over once a week at least the last few months."
Well, something was doing this to your sturdy, healthy 95 year old mother, and it wasn't Covid-19.
I'm still really sorry for what's happened because it means that instead of your being able to spend time with her, making her feel cared for and loved at the end of her life, you were kept away not knowing what was going on. It's dreadful. You were robbed.
I know it isn't any consolation but so many families are experiencing this. I don't know, though - does that help? To remember that you're not alone in what you're going through?
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