The wave of coronavirus infections swamping Indian River County senior care facilities appeared to have crested this past week.
Three nursing homes that consistently rank at the bottom of Medicare’s Star ratings – Sea Breeze Rehabilitation and Nursing Center, Consulate Health Care and Palm Garden – as of Monday reported a combined total of 60 patients and 32 staff members currently infected with COVID-19.
The largest publicly reported outbreak in the county was at Sea Breeze, which peaked on Friday with 39 active cases among residents and 18 infected staff members. Five of those infected at Sea Breeze died.
“We have opened up a COVID unit so we can take care of our patients here, and we are setting up something with Cleveland Clinic when people are getting sick enough that we can’t manage them,” said Sea Breeze’s director of nursing, Steven Pendleton.
“It’s going to be the new normal around here,” said Pendleton, an RN for the past 37 years who joined the staff of Sea Breeze only recently. “None of us have ever dealt with this before. We’re doing the best we can to take care of our patients.”
Asked to confirm if a staff member brought the virus in, Pendleton said only that “they should have stayed home like they were supposed to.”
While the numbers at Sea Breeze were down a bit on Monday, Consulate of Vero rose to 17 positive residents and 11 staff members. Palm Garden had 12 positive residents and 10 staff.
In all, 167 people connected to 19 of the county’s 25 senior-care facilities have tested positive for the coronavirus. That includes 76 infected residents currently in the facilities, 29 residents transferred out, and 62 positive staff members, a significant portion of the long-term care workforce.
More than half of the COVID-19 related deaths in Indian River County – 19 out of 35 – are connected to senior-care facilities. Along with five deaths at Sea Breeze, there were five deaths at HarborChase in April and four deaths at Rosewood Manor in late June and early July.
Over the weekend, the families of affected residents were frantically expressing worries on social media about loved ones they have not seen since March. One post by the daughter of a positive resident at Sea Breeze drew more than 450 comments.
Suddenly, ailments ranging from hallucinations to headaches took on frightening significance to families of patients the facility called asymptomatic, believed to comprise most of the positive cases.
At the same time, families were burying loved ones, all suffering through the macabre restrictions COVID-19 imposes. One son, Tom Aspromonte, was told he couldn’t bury his mother Carmella in the favorite outfit she had picked out. So he and his wife Cindy asked the funeral director to lay the clothes – including her favorite gold slip-on shoes – next to her in the coffin.
Cindy Aspromonte said her 89-year-old mother-in-law, who went by Millie, had gone to Sea Breeze at the end of May to recover from a medical procedure. Twice she was tested for COVID-19 and twice she was negative.
She was slated to move to HarborChase, an assisted living facility, on Monday, July 13. But that weekend, Sea Breeze sent her to the hospital with nausea and difficulty breathing. By Thursday, Millie was well enough to go back to Sea Breeze. But by Friday evening, she was back at the hospital.
The couple rushed to the hospital themselves. “I asked the nurse where’s our mom?” recalled Cindy. “She said, ‘She’s behind you in that room.’ I looked, and she was lying there staring at the ceiling.” Millie was near death, the nurse told her. She would not let Cindy in the room.
Prior to those final moments, the only time they had seen Millie was through the window of her room at Sea Breeze, just a couple of weeks before her death.
Millie had called that day, upset with the food, upset with her care, and missing her grandchildren. Cindy piled the kids in the car and called Sea Breeze to arrange for a nurse to wheel Millie to her window.
There, the kids pressed their hands to the cobwebbed screen while Millie from the inside pressed her hand to the glass.
“All we could do is look at her crying,” Cindy recalled. “This is real,” she said in an imploring tone aimed at COVID-19 skeptics. “This is not political.”
Melissa Schwanke said last week her mother, who tested positive for COVID-19, hadn’t been bathed in three weeks, presumably due to the shortage of nurse’s aides. She and other positive residents are confined to one wing within Sea Breeze, blinds drawn and doors closed. Even housekeeping has stayed away, Schwanke said, apart from changing sheets.
Last week, her mom went for days without ice in her water glass because staff couldn’t take ice into the COVID wing. Her mom won’t drink water without ice, she said.
As frantic as she and her sister are over their mother’s diagnosis, they are frustrated beyond measure to not be able to check on her in person. Instead they rely on phone calls to decipher how she is doing, demanding answers from staff as to why she has not been hospitalized.
“How can they say she’s asymptomatic? I can hear her coughing on the phone. Her diaphragm hurts from coughing,” said Melissa. “She begged me for cough drops last week, before we even knew she was positive.”
Schwanke called the VNA, hoping to get an outside nurse to get past the facility lockdown and examine her mother in person. The VNA has nurses trained to do just that for COVID-19 patients and some facilities welcome them. But Schwanke was told Sea Breeze would not let their nurses in, she said.
“It’s been a challenge,” said VNA CEO Lundy Fields. “There’s no coordinated approach to facilities from the state level.”
Friday night, Schwanke dialed the non-emergency number at the police department and told them her concerns. They forwarded her call to the sheriff’s office which offered to send an ambulance to take her mother to the hospital. But when it arrived at Sea Breeze, employees turned the ambulance away, Schwanke said.
“How could he know it wasn’t an emergency since no one has looked at her or given her an X-ray?” she said.
For Judy Rigsby, there was no tip-off that something was wrong with her mom. She got a call at 1 a.m. Sunday that Annie Rowe, 88, had left Sea Breeze by ambulance with what the medical examiner’s report would later call a “decreased level of consciousness.”
Tested for COVID-19 in the Cleveland Clinic Indian River emergency room, the retired packing house worker of 40 years was found to be positive. For Rigsby, another test was equally alarming. “The doctor told me her sodium level was the highest he’s ever seen, and that she probably hadn’t had anything to drink for four days,” she said. By 5 a.m. the next day, her mother had died.
Rigsby had been taken aback when a nurse at the ER told her Sea Breeze “didn’t know much about your mother,” Rigsby said. “She said they said she was new. She was there over two years, and they didn’t know her?”
Rigsby strongly believes it was a mistake to ban family from elder-care facilities.
“I’m sure it’s been difficult to staff up for something like this at a facility,” said Rigsby. “But when you work at a place like a nursing home and you don’t have family members come in and check, do you become lax about the care you give? Were they really looking in on my mother to make sure she had something to drink?
“No one has even called back to say, ‘Hey, how is your mom doing?’ OK, so she was nothing to you? She lived there for two years.”
No one has called from Sea Breeze to extend sympathy, or to ask what to do with Rowe’s belongings – family photos and a bible.
Wendy Rhyant didn’t get a sympathy call either. She had been caregiver for 10 years to Norvell Gaynor, 82, a retired St. Lucie County parks department worker. Rhyant stays in close contact with Gaynor’s daughter, who lives in the U.K.
Gaynor died July 16 after being taken to the hospital by ambulance from Sea Breeze on July 11, the same day as two other residents. Like those residents, he too tested positive for COVID-19 at the hospital ER, apparently triggering the widespread testing of fellow residents that revealed the true extent of the outbreak.
Rhyant said a hospital nurse set up a call to the U.K. so relatives could say goodbye. Rhyant’s husband, Gaynor’s pastor, helped her stage a graveside service for Gaynor last Friday. The only family member in attendance was a cousin who drove down from Ocoee, north of Orlando.
Rhyant had tried unsuccessfully to see Gaynor in the hospital. That failure still troubles her.
“You think about how the patients die alone,” Rhyant said. “That’s what puzzles me. What were they thinking at the time of their transition? It’s not a good thing. It’s not a good thing to take your last breath, and you don’t have one person standing by? Not a thank you? Nobody?”
