Karla Abraham-Conley says her mother, Rosemary Abraham, used to be “a real spitfire.” “She was classy. She was funny. She wouldn’t walk out the door without looking like a rock star.”
As she got older and her hair thinned, she was never without a wig or lipstick. She’s been married for sixty years to Byron, but everybody calls him “Todd.”
Karla bought a duplex so that her parents could live next to her. Eventually, though, Rosemary had to go to a nursing home. She has Alzheimer’s disease.
Todd would go every day to feed her. Karla would too. Every single day.
“We’d still go out to lunch, to dinner, always home for the holidays,” her daughter said. “I would take her to get her nails done.”
She fell last December and broke her femur. Todd, Karla, and the family worked with her every day. That was before COVID.
“They told us she’s never going to walk again,” Karla now says.
The last time anyone was let in to see Rosemary was March 6. It’s been almost seven solid months that the nursing home has been on lockdown.
“If it weren’t for Facetime, she wouldn’t even remember who we are,” Rosemary said. “She can’t even talk anymore.”
“Something needs to be done, and it needs to be done now,” Senator Joseph Griffo insisted when I interviewed him last Tuesday.
We met six feet apart across the long conference table in his office. He was preparing for a press conference the next morning about proposed legislation addressing this problem. It’s called the Essential Caregivers Act. It would allow the family members of people in nursing homes to be designated as “essential caregivers,” thus giving them greater access to their loved ones, something that has been drastically curtailed since the beginning of the COVID-19 pandemic.
“We’re hearing from constituents who want to see changes and don’t understand why they can’t get in [to see their loved ones in nursing homes],” Sen Griffo explained. “I know we’re in a pandemic. I know there’s going to be certain protocols and guidances that will need to be followed, but we can figure it out.”
He describes himself as “disappointed” and “dismayed” that such a procedure to guarantee family members access to nursing homes has not been put into place seven months into the crisis.
“How would you feel if you were that person [in a nursing home] and you were isolated, and you didn’t have the opportunity to see your loved ones, to touch your loved ones, to interact with your loved ones?” he asked.
The Senator shook his head and described it as “mind-boggling.”
“Some of these people have not seen their loved ones more than a handful of times since March,” he said.
I asked Karla what kind of a toll this was taking on her elderly father.
“They were together every day for sixty years,” she said.
She has seen the toll the separation has taken on him. She sums it up as a “turn for the worse,” and says that he is “bitter,” “angry,” and a “timebomb waiting to explode.”
Senator Griffo’s approach considers the issue as having three main components; “accountability, visitation, and ultimately industry-wide reform.”
“There has to be accountability for actions that were taken during COVID by the Governor’s State Health Commission,” he says. “They made mistakes, and they need to own up to that.”
“What sorts of mistakes”?” I asked.
“You look back now and think, ‘how could you bring people who were infected from a hospital back into a nursing home?’” he said.
“Why did they?” I wondered.
“That’s the question we’re asking, but who wants to have ownership?” Sen. Griffo asked rhetorically. “But that’s a responsibility you [the Governor and State Dept. of Health] bear. They made mistakes, and they need to own up to that.”
The mistake to which he is referring stems from a March 25 one-page advisory the New York State Department of Health was sent to Nursing Home Administrators, Directors of Nursing, Directors of Social Work, and Hospital Discharge Planners.
It references an “urgent need to extend hospital capacity in New York State to meet the demand for patients with COVID-19 requiring acute care.”
The advisory directs “all [nursing homes] to comply with expedited receipt of residents returning from hospitals.” It says that those returning residents must be “medically stable,” and that, “No resident shall be denied re-admission or admission to the NH solely based on a confirmed or suspected diagnosis of COVID-19.”
On July 6, the New York State Department of Health examined the impact of the admission policy articulated in the March 25 advisory. It found that 6,326 COVID-positive residents were admitted to facilities between March 25 and May 8. Those numbers are supported by an independent analysis done by the Associated Press on May 22.
It concludes, however, that “an analysis of the timing of admissions versus fatalities shows that it [the March 25 advisory] could not be the driver of nursing home infections or fatalities.” It based this conclusion on “an individual nursing home-by-nursing home analysis of admissions versus fatalities [that] further supports this finding.”
My understanding of the July 6 memo is that the Department of Health is arguing that because the number of nursing home residents who died from COVID deaths occurred on April 8, but the peak of COVID-positive residents entering or reentering nursing homes happened one week later on April 14, the policy established on March 25 was not responsible.
Still, an Executive Order (No. 203.30) issued by the governor in May contains language that seems to reverse the earlier policy by stating that hospitals “shall not discharge a patient to a nursing home, without first performing a diagnostic test for COVID-19 and obtaining a negative result.”
Denis Nash, an epidemiologist at City University of New York School of Public Health, told Kaiser Health News that the Department of Health’s study was “pretty flawed.” He disagrees with the conclusion that the March 25 policy had nothing to do with the deaths.
Sen. Griffo isn’t convinced either. Further, he is dissatisfied that the only accountability by the State Department of Health so far is that self-assessment issued in early July.
He also criticized Dr. Howard Zucker, the commissioner for the New York State Health Department, for only attending one of the two bipartisan hearings help by the legislature.
Another problem that seems to have arisen from the March and May policies is that the “mistakes,” as Sen. Griffo characterizes them, have made the state unwilling to risk reopening the facilities in the way it has with stores, restaurants, health clubs, and schools. People in nursing homes and their families have been left behind and largely forgotten as everything else gradually reopens.
“Here we are at the end of September, and we’re still not in,” Karla says with exasperation. “I don’t understand why we are allowing it. They’re [denying us] our civil rights.”
“I’m going to continue to advocate and continue to call attention to what’s happening,” Senator Griffo promises. “The most important thing right now, the most pressing issue is visitation.”
I cut short my interview with Karla because she was on the phone with the nursing home trying to arrange for her mother to be sent to the hospital. Rosemary hasn’t wanted to eat or drink.
“What I fear,” Sen. Griffo told me, “is that we’re going to see people die from broken hearts because of the isolation.”
As I finish writing this column, Rosemary Abraham could be on her way to the hospital. If she does end up in the hospital, her husband and daughter might finally get the chance to visit her.
Ron Klopfanstein wants to hear your stories about how COVID-19 has affected you. Like him at Facebook.com/BeMoreWestmo and follow him at Twitter.com/RonKlopfanstein