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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.

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I agree with LoopyLoo in that the ALF didn't 'give' your mother anything. At 95 years old, she's lived a good long life. My mother is 93 and living in a Memory Care ALF. If it's her time to go now, then she'll either contract COVID19 or God will take her while she sleeps. At this point, there's not much anyone can do for the very aged. You haven't done anything wrong here either, so please let yourself off the hook, okay?

I'm so sorry for your loss, my friend. Wishing you peace as you move through your grief process.
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george11694 Apr 2020
Thanks much.Stay safe.
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The ALF didn’t “give” her Coronavirus. More than likely it was simply her time.
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george11694 Apr 2020
Well they assisted her time but certainly not intentionally,true.As with any ALF/Nursing Home,except the few that have their 'wits' about them and possibly walk too,most are put in babysitting groups to watch tv,talk or veg until next meal or bed.Sad but true and as another mentioned you can't beat death and taxes and I'd add aging too.I've been expecting her time for a few years now.It was just helped quickly by the virus.Thanks.
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First, please accept my deepest condolences on the death of your mother.

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.
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george11694 Apr 2020
Good points and I have thought and dealt with them all.The exception is the virus.My mother's hous was nearby in more open coastal community of NYC.There is room for distancing and I have been outside maybe 6 hours in 5 weeks.Falls and quality of life were the issues.Yes she would likely die in the not so distant future but not from the virus.I do agree there is no 'intentional' negligence.The ALF workers are stressed like everybody else.Thanks for your comments.
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George, I just want to supplement the issue of responsibility and potential negligence.

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.
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cherokeegrrl54 Apr 2020
Thank you for such an honest forthright answer for george...stay safe
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george, I'm very sorry for the passing of your mom. No, you didn't "help kill" your mom. Please...you did your best. Also no to pursuing legal action for negligence. People are getting the virus in spite of wearing all the PPE and quarantining themselves, so it's extremely difficult to not transmit it. It would be cruel to sue them and may cause good people who were taking risks to care for LOs to lose their jobs. If she would have died of the "normal" flu would you be thinking of suing them? I doubt it. May you have peace in your heart that everyone did their best. May you be comforted by her loving memory.
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lealonnie1 Apr 2020
I agree........I cannot tell you the precautions my mother's ALF is taking right now to keep the residents safe. It qualifies as superhuman efforts, really. In a sue-happy society such as we live in, it would be cruel to go after ALFs after this crisis is over for something that NOBODY could possibly prevent. This virus is SO highly contagious and unfortunately, does affect the elders and those with pre existing conditions. It is what it is.
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Agree that the facility did NOT give your mom covid. Please do not second guess yourself. It was obviously time for to be taken care of in a facility. People do not live forever, which of course you know, and something was going to end her 95 year run eventually. While her care may not have been "perfect", I'm sure they did their best. I suggest taking a deep breath and letting go of guilt and blame. Grieve your mom and then try to move on.
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george11694 Apr 2020
Thanks much.Trying to do just that.It is hard since she relied on me and I had no choice but to rely on others.Yes,for the last few years,when she did not answer her phone to visit,I'd give it another day and no answer.I then expected to find her dead but she usually just did not hear the phone or re-seat it properly.Anyway,thanks for the response.
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Was your mother on hospice? It sounds from your description like she had a lot of health issues, plus, she was 95 years old....IDk. If you feel something is improper, I'd keep notes and seek a consult with an attorney in the area. With this new type of situation, there will likely be cases that arise from LTC resident's family members.
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Your Mom had numerous health problems. She may not have survived a cold. If it was my Mom, who passed at 89, I would have been happy that she wasn't suffering anymore. The person u knew has been gone for a while. I never promised my parents anything. I have promised my husband nothing. I cared for Mom until it was too much. I will do the same for my DH.

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.
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george11694 Apr 2020
Yes JoAnne,I expected her to die there but she was still fairly sturdy lady when I saw her last.Thanks for your advise.
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I am so sorry for the loss of your mother. Please know that you did not kill her. Also, the assisted living facility did not kill her either. This corona virus is deadly and unfortunately the elderly are the most susceptible to it. Please do not sue the assisted living facility. They did the best they could.
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george11694 Apr 2020
Thanks Elaine.Had I kept her in her house as I did until the end of February she would be alive though her dementia obviously only getting worse .It was getting harder to care for her and falls were increasing.The problem I have is the staff infected her.I know likely not intentional but she died from personnel there infecting her.I don't,nor am I seeking lawsuits but I guess I am mad at them for not protecting her.They did not take hospital type precautions dealing with their elderly.A letter to the public from the ALF says they have at least two aides tested positive.It is dated the day my mother died.I'll keep your reply in mind,thanks!
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George, I'm so sorry for what's happened.

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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