How COVID Affected the Care and Death of the Elderly In My Family
When COVID began, I was already a caregiver for my mother and paternal grandmother. Mother lived on her own after father suddenly passed in 2016 and since father had done all the cooking, cleaning, housekeeping and driving, she was left in a lurch. It’s a bit ironic that mother really appreciated father after he died because while he was alive she yelled at him a lot in typical dragon woman fashion. Father also visited his 100 year old mother daily who lived in a nursing home with limited staff available to help their residents. The nursing home was fine for people who could walk and feed themselves. But once grandma was bedridden and had secondary strokes which made it harder to swallow, we were advised to help with feeding since staff could only feed her for ten minutes, but she needed up to four hours for a meal. We alternated feeding duties and hired a few personal support workers to help as well.
During COVID, I would deliver frozen meals I made to mother and whenever her friends offered to take her out, she would go. Sometimes she would be at restaurants everyday (she had just retired from her day job) to gossip with one of her many friends or teacher colleagues from the Saturday International Languages program she still ran as an Instructor-in-Charge (aka Principal). I was living with my husband and young child and not with her, so I did nothing to stop this. My husband was appalled at the risk she was taking to go out for dim sum regardless of how high the COVID infection numbers were and tried to talk to her, but she ignored him. “Death can happen anytime,” mother declared. “I might as well enjoy myself!” Mom believed in living life to the fullest.
One good thing that came out of COVID was the decision of moving in with mother which gave me more time to spend with her before she passed away abruptly in October 2021. After dad died, mother constantly asked us to move in with her, but my husband thought this would be too stressful given my mother and I didn’t see eye to eye sometimes. But after months of working from home, similar to the 64K Toronto residents making an exodus out of the city, my husband decided our apartment was too small and we should think about moving. Mother made us an offer: we can live in her house on the condition that we would take care of her for the rest of her life and never move her into a nursing home. My husband said this was only possible if she let go of thirty years worth of hoarding. For years I pleaded with mom to let go of stuff, but had been unsuccessful. Mother looked into the smiling face of her grandchild and said, “Everything can go!”
Thus, we embarked on a new adventure, spending all our weekends sorting and packing. There were trunks of clothes from the 1950s from my maternal grandparents which were never sorted, old restaurant equipment from dad’s long shut down burger restaurant, childhood stuff from me and my siblings along with lots of expired food. Admittedly, my husband did a lot of the work since he had no attachments to anything in the house. I had a much harder time sorting, I was still hurting from my father’s death and would cry as memories flooded back to me. Mother hired a renovator and the house was torn apart. We were in the midst of renovations when she died abruptly while washing dishes. An elderly uncle had fallen at the same moment and everyone went to check on him when she left us.
Because of COVID, doctors were doing phone consultations first and then seeing their patients in person after. My mother described her symptoms to her doctor on the phone and was told she could visit them in person a few days later. She died before the appointment date. I don’t want to point fingers, but I believe it is incredibly difficult to diagnosis a person on the phone with them describing the symptoms. Most people do not have the medical experience or terminology to paint an accurate picture of what is happening to their body on the phone. She should have gone to the ER, but the doctor surmised she had stomach flu and she wasn’t in a lot of pain. Then again, this is a stubborn woman who broke her arm and claimed nothing happened for two days afterwards. If she could have accessed healthcare sooner, she would have had more time to say goodbye. Death would have claimed her regardless since she had Stage Four cancer without knowing about it, but her surviving family would be in less shock about her passing. Why she hadn’t been diagnosed at all is another story. Many tell me this is a good thing, mom was never scared of dying since she didn’t know she was sick. As we planned mother’s funeral, we received a call that grandma would pass soon and we had to provide care for her because the nursing home staff would not (they said she was palliative = hands off care).
When COVID began, the nursing home staff restricted the number of visitors, so the personal support workers we hired quit since they could only work with one client at a time versus three or four. Before she died, mother walked to the nursing home daily to feed grandma two meals a day and one of the kids (me or another sibling) would feed her at night. Since entering the nursing home, grandma’s joy consisted of being taken out for dim sum every weekend. But after becoming bedridden, we started bringing the meals to her and gathering in her room. Once COVID hit, all family gatherings stopped because of restrictions and the people she wanted to see most of all, the great grandchildren, were not allowed to visit. After mother’s death, the only people left to care for grandma was me and my siblings (yes, there are other relatives but they have been MIA for the last twenty years), so I moved out of my family’s apartment to camp out in my mother’s half renovated house which was closer to the nursing home. Prior to all this, mother had tossed the dryer and stove, thinking she would buy new ones soon, which didn’t happen. I lived using an induction panel for cooking meals and my best friend’s laundry facilities. I was lucky that my husband was willing to let me move out to deal with grandmother while he became a single parent. I also credit my husband for not putting up a fuss and letting me pay for grandma’s expenses (the tab is split with my siblings) for many years such as the private room at the nursing home, meds, etc since her bank account dried up long ago.
Many nursing home residents passed away during COVID not from contracting COVID, but from other reasons. Mother suspected they may have starved to death after a lot of personal support workers quit. I speculate they may have died from loneliness because family members were banned from visiting during high COVID infection periods. We were only allowed to enter because we were considered “essential” to grandma’s care since the staff couldn’t care for her. Nursing homes are relatively joyless places to begin with and whenever a child is brought to visit, the room lights up. Banning children and visitors further isolated the residents from the world which they already feel discarded them and banished them to a building filled with strangers.
Grandma was hospitalized three times during COVID and we became experts at how to navigate the local hospital system. The nursing home would send her to the ER where she would wait by herself since no family members were allowed in. If she was given a bed, there was a 24–48 hour isolation period depending on the protocol at the time. The hospital would contact the person with the Power of Attorney only and it was up to this person to let others know about what was going on. There would be a call about the diagnosis and specific times to visit, one person at a time for an hour or two. We learned the hard way that we had to bring liquid thickening powder because the kitchen is not accessible and grandma could only drink thickened water. Meals were not fed to her if her eyes were closed at the moment when hospital staff delivered the food, so we brought in apple sauces and yoghurts because the meal tray may be missing by the time we visit. If she was on an IV, we were told not to worry about feeding her at all and any question about food was dismissed since the IV could keep her alive temporarily.
Since grandmother was over one hundred, her life was worthless. We knew she had multiple strokes, but there was no point wasting CT time to confirm this because there is no recommended treatment. She probably had cancer, but again, no point in scanning or treating. The hospital and nursing home pulled all her meds and said she was palliative, which meant staff didn’t have to do anything for her. As a family, my siblings and I rallied for her and asked for tests to ensure she could get some treatment for urinary treat infections or other illnesses. “Yes, we know she is dying! But can she die with less pain and suffering?” I pleaded every time with the hospital staff. I can not imagine what other people without family go through. I guess they just die without anyone caring.
Mom passed away in October 2021 and grandma in February 2022. Mom’s visitation and funerals had restrictions on attendance removed last minute but people had to be vaccinated. For grandma’s funeral there were restricted numbers since unvaccinated people were attending. If there were no restrictions, I would have invited everyone who wanted to come. Funerals are really for the living and the attendees are showing that they care about the survivors even if they didn’t know the deceased. In many ways, funerals are like weddings, it’s a big event to celebrate someone’s passing. Grandma lived her life and in the pictures it showed her progressive aging as she took part in numerous dim sum meals, weddings and a trip abroad to visit her relatives before becoming bedridden, surrounded by great grandkids. I have a harder time looking at my mother’s picture, her hair was still black and her next phase in life as a retiree had just begun when she passed. Both mom and dad died within one year of retiring from their full time job, which makes me quite bitter and angry that they never got a chance to enjoy their golden years. A doctor told my friend’s father that the two most dangerous days of a person’s life is the day of birth and day of retirement, for these major changes cause stress and disruption in the body.
Death happens everyday and sometimes I google new stories to see if anyone else’s dad, mom or grandma died. For some reason it makes me feel better. While growing up, my maternal grandmother always said that the Buddhist four noble truths of birth, aging, illness and death are things no one can escape. Unless you become a vampire or something supernatural of course, topics I love writing about because it’s a life that I can fantasize as being better than the current reality. I love my family members and my heart has been shattered multiple times. Resilience means growing scar tissue around the heart and drying up tears before they start. Dad’s death made me fall into a depression for many years and I needed a lot of help before I could function again. The deaths of mom and grandma were in some ways easier than dad’s because they had clear instructions that my goal after they leave is to take care of the next generation.
COVID makes visiting and caring for loved ones much harder than normal. If you are a caregiver, I’m rooting for you and please remember to make time for yourself. Similar to being on an airplane, caregivers need to put on the oxygen mask before taking care of others. Some have told me that I needed to live my life instead of taking care of the elderly, but I have no regrets taking the time caring for my parents and grandmother and I hope they are in a better place. By taking care of them, I am living my life to the fullest too.
