On Monday March 16th, just after 4 am, I received a call from the high-care seniors’ residence where my 91 year old father was living letting me know that he had died. I had last seen him on the previous Friday. He had been struggling with physical and cognitive challenges that had been tentatively diagnosed two years earlier as Lewy Body Dementia, and during my visit he was very tired and at a low level of awareness of me and his surroundings. He had his teeth cleaned by the visiting hygienist, and I gave him a shave with his electric razor, both of which he enjoyed. But he was too tired to go for even a short walk with his walker, and was quickly asleep after the flurry of attention. We exchanged few words, but it was not without meaning for either of us.
As it turned out, the timing of my visit was very fortuitous. The next day, the facility was put into full lockdown in the face of the pandemic threat, and no visitors have been permitted since. I spoke to him briefly on the phone the next day, but he remained very tired and not very communicative. The next morning I was advised that he was running a fever and further down in terms of his level of consciousness. Despite the fever, he was not tested for Covid-19, because the predominant secondary symptom was more gastrointestinal than respiratory, and at that time that was not considered to be indicative of Covid-19, even with fever.
By early afternoon, his fever was down somewhat with Tylenol and ice packs, but his level of consciousness and breathing were continuing to decline. He was then at the point that the protocol would have been to transfer to hospital unless the Power of Attorney, who was me, indicated otherwise. I did indicate otherwise, and they quickly forwarded an updated direction for me to sign to confirm that, which I did.
They then transferred my father to a hospital bed (until then he and his wife still shared a normal Queen-size bed) to make it easier to provide him with the care he needed. The last view I had of my father alive was a 10 second video showing him resting comfortably and peacefully in that bed with supplementary oxygen flowing to his nose. He died less than 12 hours later.
Shortly after his death, the residence reported positive diagnoses of Covid-19 among staff, and later among a number of residents, including my father’s widow. Since that time, two residents have died, but Irene is hanging in, although the shock of losing her spouse of 35 years and the ravages of the illness have exacerbated her Alzheimer’s to bring her own level of consciousness and communication very low. More than two weeks into the infection, she is by no means out of the woods.
The level of care that can be offered in the facility is demonstrably less attentive than was available to my father earlier in the crisis. Not only are there many more sick residents, the others are restricted to their rooms, and meals and other care has to be delivered in compliance with strict infection control protocols. And the staff available to provide the care has been decimated by those that have become infected themselves, including those mildly ill but precluded from coming to work by their positive infection status.
It is a tragic and difficult scenario for everyone, and especially so for families. I know what they are feeling. My own father died without me being there, and although I comfort myself with the certainty that his level of consciousness was at a point that my absence did not register with him, I know that I would have felt better to have seen him off. I begrudge the virus for that, but not for taking my father. He was in his final days, and something was going to take him. We carefully chose the facility that we last moved him to (there had been two prior moves as his dementia progressed) not because we had any thought that they would forestall his last breath as long as possible. We chose it because we felt it was a place that would offer him the opportunity to continue to interact with people at the level that he was capable and continue to do so as that capability continued to decline. And that he could stay there until the end and be spared the confusion, futility and fear of dying in a stretcher in the hallway of an overburdened hospital.
And that is what happened. I am not sure that the system, the care home, my family or I could promise and deliver anything more than that.
Rest in peace, Stu.
