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The Crisis July 2, 2020

Residents at Risk

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By Cynthia Yeldell Anderson

As the coronavirus continues to ravage long-term care facilities, it also wreaks havoc among family members who are anxious and concerned about the mental and physical health of loved ones who are isolated inside.

For the family of Doris Edmond, that anxiety quickly spiraled into a rush for her three daughters to say their final goodbyes when they learned that she had contracted the virus at the St. Louis-area nursing home where she resided and that she had about an hour to live. The daughters, who live in three separate states, suddenly found themselves navigating the odd new reality of how to shape their final moments with their 74-year-old mother.

"I received a call from her doctor with my sisters on the line that she had been diagnosed with COVID-19, the coronavirus, and they weren't expecting her to make it through the hour, so we have this very panicked and rushed effort to try and get a video chat going, and that was not good," said Sandra Braham, Edmond's middle child.

A homemaker, Edmond loved to cook and enjoyed shopping for purses and things that sparkle. Diagnosed with a brain tumor, she entered the long-term care facility in January when a hospice bed became available. Family members prided themselves on taking excellent care of Edmond. Visiting frequently, they read her stories, gave massages, and did their own physical therapy with her to help exercise her limbs. Their issues began in late March when they received a call that there were five patients with coronavirus at the facility, but that their mother was fine.

"The next time that we heard anything, I guess that was maybe seven to 10 days later, was that we've got 22 cases and your mom is one of them and she's not going to make it through the next hour," Braham said.

That call on April 2 was the beginning of the family's challenge to find a way to say goodbye by video call or video conference. With the nursing home able to make only one call, and the three daughters located in Missouri, Florida, and Alabama, the sisters had little time to make a decision on who would have what was thought to be the last opportunity to talk with their mother.

"You get into, you can do this format if you have an iPhone, you can have that format if you have an Android, you can have this format if you are on a laptop with webinar access, but the hospitals (long-term care facilities) are not trying to figure that out because they are dealing with so many issues and they don't have time," Braham said. "My youngest sister and I agreed that we should basically reserve that one phone call for my older sister."

The sisters waited through the night and fortunately, their mother lived several more days. This gave Braham an opportunity to communicate with her mom through FaceTime — two days after doctors said she wouldn't make it through the night. Edmond had no awareness of what coronavirus was or why she'd suddenly experienced its symptoms. But family members say she did know that she always had a ton of visitors — brothers, nieces, and her daughters and other extended family — and then suddenly she had none.

"There is nothing to substitute for the human touch," Braham said. "You may have touches from nurses, and you have comfort, but there is nothing like the touch and comfort from a loving family."

Residents at Risk

According to the Centers for Disease Control and Prevention, nursing home populations are at the highest risk of being affected by COVID-19, given their close living quarters and population of older adults with underlying chronic medical conditions.

The Associated Press reported in May that a third of the nation's coronavirus deaths are attributed to nursing home outbreaks. One of the few efforts at counting the number of African American nursing home coronavirus cases was conducted by The New York Times, which took a measure of the 22 hardest-hit coronavirus states and the District of Columbia. Facilities with large numbers of people of color are twice as likely to be struck than those who are at facilities that are overwhelmingly white.

The report noted that in more than 60 percent of nursing homes where at least a quarter of the residents are Black or Latino there was at least one coronavirus case. That is double the rate of homes where Black and Latino people are less than 5 percent of the population. Nursing homes are largely segregated.

Risks associated with having a loved one living in a long-term care facility during the COVID-19 outbreak leave family members such as Andre M. Johnson on edge. Johnson has a 70-year-old mother in a rehab facility in Prince George's County, Md., the county with the highest number of COVID-19 cases in the state."Even though her facility has zero cases of COVID-19, I'm scared every day that will change," Johnson said.

Johnson hasn't seen his mother since the coronavirus outbreak began, which he said has created a significant amount of anxiety for him. "Even if I go up there, they won't even let me in the door," said Johnson, who has tried to communicate with his mother through Zoom, but the facility didn't have a strong enough connection. Phone calls are his only option.

"It takes a lot of prayer, perseverance, staying confident, and putting it in God's hands," he said.

Don Hamilton's 93-year-old father, Oscar Hamilton, is in a nursing home in Wayne, Mich., about 25 miles outside Detroit. Though he misses seeing his father daily, Hamilton understands why the restrictions are necessary and believes his father is safe.

"Knowing the facility he is in is very good, I'm O.K.," Hamilton said. "He's answering the phone, and he calls me sometimes."

For Some, Phone Calls Are Not An Option

The phone is not an option for Robert Turner, whose sister, Mary Alice Harris, is bedridden and unable to speak.

Turner, who hasn't seen or heard from his sister since the outbreak began, said the situation is disturbing. Prior to the outbreak, Turner visited his sister at least twice a week in her long-term care facility near Union Springs, Ala., and at each visit sang her favorite song, "One Day Religion Won't Do." He worries about his sister's state of mind."She recognizes us with her eyes," Turner said. "I know she is having a hard time because she can't see us."

In the Washington area, Sir Jamison calls his mother's rehab facility daily, only to be transferred to the nursing station, where no one answers."I'm trying my best to call at least two to three times a day: morning, evening, and afternoon," Jamison said. After more than a month of not speaking with his 80-year-old mother, Alice Murray Jamison, who has a doctorate in psychology, he learned she had tested positive for the coronavirus. Jamison finds some comfort in knowing that his mother is not showing any symptoms, but she was moved to a different area of the rehab center for a two-week isolation."I've been nervous and afraid, I'm trying to be strong as best I can," Jamison said. "It's hard because my mom is my rock, my everything."

Saying Goodbye While Social Distancing

For Edmond's daughters, being unable to lay their eyes on their mother was devastating."They closed down the homes to protect the residents and the residents still were not protected because they still ended up getting sick from someone on the inside," Lorie Williams, Edmond's oldest daughter, said. "It was a false sense of safety for the residents who, in fact, had no safety after all." Williams said the no-visitor policies take a toll not only on the family but on the resident's mental health. It's common for people living in community settings that are not allowing visitors to feel socially isolated during this time, according to the CDC.

"It could make the resident sad, depressed, and give them a sense of hopelessness that their family doesn't care when, in fact, they actually do and want to be present," Williams said. Edmond passed away on April 8.

Because of the coronavirus and social distancing restrictions, many members of her large close-knit family weren't able to be present during her final sendoff. Her three daughters were among a small group of family members present for the intimate service inside Layne Renaissance Chapel in St. Louis. They wore face masks and sat spaced apart at the service as it was live-streamed for those who couldn't come inside.

"It's not but a few of us here and we can't touch each other, but I know somebody who can touch us, for He's not affected by the virus. He has control over everything," said Edmond's brother, the Rev. David Rice Sr., who preached his sister's eulogy. Each daughter made remarks, and Williams recited an original poem entitled, Mother."Mom, ever so sweet and kind, a friend throughout all times, always by her children's side," she read.

People around the country tuned in and listened to the hymns and heartfelt testimonies of Edmond's love of God and devotion to being a mother. About 20 cars of family members watched the service on their mobile phones while parked in the parking lot of the chapel."Though they stayed in their cars, it was lovely," Braham said. "I don't think we are going to be the same, any of us, after this as a country," Braham continued. "I wouldn't wish an e-funeral on anyone."

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