Published in The MetroWest Daily News on May 1, 2020. By Jeannette Hinkle, The MetroWest Daily News. Photo: Courtesy
FRAMINGHAM – Natalie Caplan was a pistol. A driven, persistent woman who knew what she liked and what she didn’t.
“She was a lot a bit of a diva,” said her daughter, Debra.
Natalie got her nails done every two weeks, often in pink, her favorite color. If the salon was open, she would make her husband, Sidney, take her, even in a blizzard.
She was always well-dressed, taking time to select a coordinated outfit, along with earrings and lipstick, even for small trips out of St. Patrick’s Manor in Framingham, where she lived for the last four years of her life.
And if Natalie wanted lobster, her favorite food, Sidney, and later, after he died, Debra and her brother Dr. Arthur Caplan, would take her to Gloucester or Rockport or Scituate – sometimes even to Maine – to get it.
“She liked to crack the shell, not have it done for her,” Debra told the Daily News. “She was an expert with those lobster cracker tools.”
On one of their last outings together, before the pandemic began sweeping the state, Debra and Arthur took their mother to Legal Seafoods for her favorite meal.
“That was less than two weeks before visitors were banned at St. Patrick’s,” Debra said. “We were out frolicking and not even imagining what was to come.”
Natalie Caplan, a fiercely loyal wife and mother of three, died at St. Patrick’s Manor on Monday, after contracting the coronavirus. She was 96 years old.
Natalie is among 28 Framingham residents who have died from the coronavirus, as of Friday, and one of five residents to die at St. Patrick’s Manor, a nonprofit nursing home on Central Street where 32 employees and 81 of about 260 residents had tested positive for the virus as of Friday, according to the facility.
“We extend our sympathies to the families and friends of these residents and share in their grief,” Sister Maureen McDonough, administrator of St. Patrick’s Manor, said in a statement Thursday to the Daily News. “The sadness of this moment is no doubt compounded by the inability of families to share normal visits with their loved ones during the past several weeks. Our collective hearts break for every family member and resident who are missing the regular, in-person connections with their loved ones.”
‘There’s nothing you can do’
Natalie was told she had tested positive for the coronavirus on Saturday, April 18.
Staff at St. Patrick’s had been preparing Debra for that devastating possibility since April 10, when a social worker called to tell her that the building had three cases of the coronavirus, none of which was on her mother’s unit.
While Debra monitored local news for more information about the outbreak there, she tried to keep her mother grounded.
Before St. Patrick’s and nursing homes across the state barred visitors, Debra would visit Natalie six or seven times a week. They played cards together, usually Go Fish. They watched Ricky Martin’s ‘Livin’ La Vida Loca’ music video together (Natalie thought he was handsome). They talked and listened to songs from musicals like “West Side Story” and “Man of La Mancha.”
When Debra wasn’t there, Natalie played bingo and painted with other residents, activities she was never interested in until a kind and patient nun at St. Patrick’s convinced her to try them.
But when the facility locked down as the virus spread, Natalie was largely confined to her room.
“No family, no friends, no volunteers could come in, and I’m not against that, it’s just when that happened, people were thrown out of their routine and started to get confused and many of them declined, including my mother,” Debra said.
After the first week of lockdown, Natalie started to become disoriented. She began asking Debra what shows she liked to watch, what channels the shows were on, things she had remembered before. She asked when the lockdown would end.
She asked what day it was, a question that particularly bothered Debra, who had written the days of the week on cards that she would post on her mother’s wall each day.
“I stopped being able to do that, because I couldn’t go in,” Debra said.
As she watched her mother’s mental health decline, Debra also began hearing from friends who were losing loved ones in other skilled nursing facilities, including Mary Ann Morse Healthcare Center in Natick, where at least 20 people have died from the coronavirus.
“And it still hadn’t hit St. Pat’s yet, but I know that it’s probably coming and there’s nothing you can do,” Debra said. “That would be like trying to stand in front of a train and stop it with your bare hands.”
On Monday, Gov. Charlie Baker announced that more than half of all coronavirus deaths in Massachusetts – 56% – had occurred at long-term care facilities.
“With respect to nursing homes, Massachusetts has unfortunately evolved into a national hotspot for coronavirus,” Baker said during a news conference at the State House.
Baker said skilled nursing and long-term care facilities would be eligible for a new round of $130 million in funding to help with infection control, staffing and cleaning services. But in order to qualify, facilities must test all residents and staff, adhere to a 28-point infection control checklist and meet personal protective equipment requirements.
Access to rapid, system-wide testing and personal protective equipment have been near-universal challenges at nursing homes, including St. Patrick’s Manor.
As of April 30, St. Patrick’s had not tested all of its residents and staff, according to Framingham Public Health Director Sam Wong, who has encouraged all long-term care facilities in the city to conduct system-wide testing.
In a statement to the Daily News, McDonough said the facility is working with the state Department of Public Health to test all St. Patrick’s residents “as soon as practical.”
A final visit through the window
On April 13, St. Patrick’s Manor staff called to tell Debra that residents in her mother’s unit had tested positive for the virus.
Two days later, Natalie asked for Tylenol – she was feeling achy – so staff checked her temperature and found she had a fever. They wanted to test her for the coronavirus, but Natalie refused the swab. At the request of staff, Debra called her mother and convinced her to take the test.
Debra said Natalie never talked with her about the virus, so she isn’t sure how aware her mother was of the risks she faced in St. Patrick’s Manor. But she watched the news, Debra said, and she saw members of the National Guard walking through the halls.
“She knew more than she was talking about, but I wasn’t going to make her talk about it,” Debra said.
Debra had thought about taking her mother out of St. Patrick’s, but her apartment isn’t handicapped accessible and she didn’t have the ability to replicate the care that a team of medical professionals could provide, care Natalie needed.
When she was officially diagnosed with the coronavirus on April 18, Natalie’s health had already started to deteriorate. The next day, she told her daughter she had no appetite. A butterscotch pudding Debra delivered to St. Patrick’s, one of Natalie’s favorite foods, went uneaten.
“I knew she wouldn’t eat it, I just had to try anyway,” Debra said.
Debra was overcome by a gnawing, sinking feeling.
“I knew the virus was going to take her,” Debra said.
She thought of the rising death toll at the Holyoke Soldiers’ Home and at Mary Ann Morse.
“Why would my mother’s situation be any different?” she said. “She’s been through a lot. I didn’t think she had another miracle left in her.”
Last Sunday, Debra called the unit where her mother was being cared for. A nurse Debra didn’t know – “I don’t know where they found her, but she was great,” Debra said – answered and agreed to go to Natalie’s room to crack her first-floor window so that Debra could speak to her from outside.
Inside, Debra could see the nurse dabbing Natalie’s lips with water to keep them moist, something Debra knew meant her mother was nearing the end. Natalie told the nurse to give her a sip of juice.
“I said, ‘Mom, will you take a sip of juice?’” Debra remembered. “She was shaking, but I said to the nurse, ‘Put the straw in her mouth. She’ll take a sip. For me, she will.’ For me, my mother did.”
Debra, crying as she envisioned the scene, said she knew that visit through the window would be the last time she would see her mother alive. As Debra left, her mother asked the nurse to close the shades.
The next morning, a nurse called Debra to say that Natalie had gone through “a significant change.”
“They used that same wording with my dad when he passed,” she said. “That means it’s going to be any time now.”
At 8 p.m., Natalie died. A nurse at St. Patrick’s who had cared for Natalie for years was by her side.
“The fact that my mother did not have to die with a stranger holding her hand meant to me at least it was something familiar and hopefully comforting so that my mother could let go,” Debra said. “I know she was ready to join my father.”
Debra thanked the nurse for the “wonderful, wonderful” care she had given to Natalie.
“And she said, ‘It’s a privilege,’” Debra remembered, her voice cracking. “That may be her standard line, but it’s a good one.”
In her Thursday statement to the Daily News, McDonough commended her staff for providing compassionate care to residents during an unprecedented crisis that has rocked nursing homes across the country. Their work, she said, has been “nothing short of extraordinary.”
“Particularly for the residents who are at the end of life, they have been a gentle presence and constant support,” McDonough wrote. “For all families of St. Patrick’s residents, please know that we are caring for your loved ones as though they are our own family.”
‘We didn’t protect them’
As Debra’s father, Sidney, was dying, he gave her a directive that shaped the next years of her life. He told her, “Take care of my girl.”
Debra took him seriously, altering her days to ensure Natalie always had a companion who would take her to the nail salon, bring her Hershey’s Milk Chocolate with Almonds.
Debra was there when the hearse arrived at St. Patrick’s. She put her hand on the bag containing her mother’s body and said goodbye.
On Thursday, Natalie was buried at Sharon Memorial Cemetery. The ceremony was small, fewer than 10 people per state rules.
Amid sadness, Debra said she feels anger. For now, she said, her anger is directed at the virus.
But her brother, Arthur, a well-known medical ethicist at New York University, told WGBH this week that the government has failed to protect its most vulnerable citizens.
“We did let the elderly go, we didn’t protect them in nursing homes,” he said.