Death in a Nursing Home Manuel Melgoza’s family comes to terms with the ravages of COVID-19

Galinda and Manuel Melgoza | Provided photo

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By Joe Livernois

The Melgoza family gathered at the Garden of Memories in Salinas earlier this month to bury their patriarch, Manuel Melgoza Montejano. Only 10 people attended the graveside service and the earlier funeral at Cristo Rey Church, but there could have been many more. The Melgoza clan is large, with sons and daughters and grandchildren spread between the Salinas Valley, Bakersfield and Illinois.

But COVID-19 and the resulting shelter-in-place protocols kept most of the family from paying their proper respects. There had been some family discussion in the days after their abuelo died about who should be there. The priest at Cristo Rey suggested live-streaming, so a local relative streamed the ceremonies while about 40 others watched from afar.

“It was definitely super hard,” said Brenda Melgoza, a granddaughter who lives in Gonzales.

Manuel Melgoza was 89 when he died on May 2 at Windsor The Ridge Rehabilitation Center, a skilled nursing facility in Salinas. He had been at Windsor for about a year after slipping into dementia. He died eight days after the family was told he had tested positive for COVID-19.

The death certificate shows Melgoza’s “immediate” cause of death as cardiac respiratory arrest, but it also listed COVID-19 and Alzheimer/Dementia as contributing factors.

Manuel Melgoza was a resident of a skilled nursing facilities to have died after a COVID-19 diagnosis. There could be more; state health officials are not specific about the number of deaths at any facility unless the number exceeds 11, while Monterey County’s health officials and Windsor administrators will not release numbers.

As of Saturday morning, the state Department of Public Health reported that 40 percent of the fatal victims of COVID-19 in the state — 1,434 people — had contracted the virus while living in similar facilities throughout California. The cumulative list includes people who died in a nursing facility or who were transferred to another medical facility for care and died within 14 days after being moved.

The statewide numbers indicate that the incidence of death among residents of skilled nursing facilities who are infected with COVID-19 — more than 18 percent — is significantly higher than the rate among the rest of the population. Overall, the death rate in California is about 4 percent.

Eight Monterey County residents have died from complications related to COVID-19 since late January, when county health officials first started recording cases. All of the fatalities were adults with pre-existing conditions, according to Dr. Edward Moreno, Monterey County’s public health officer.

Losing their abuelo hurt, Brenda Melgoza said. The Melgozas are a close-knit family. Though Manuel Melgoza was older and suffering from dementia, his death “really broke us, especially under the circumstances,” she said. The family says they are also disappointed that their abuelo apparently contracted COVID-19 from staff or another patient at Windsor. They also say they were mostly in the dark about infections reported at the skilled nursing facility.

“It’s so disheartening that people aren’t careful,” Brenda told Voices of Monterey Bay. “He should’ve never passed away like this and alone. We never had the opportunity to hug him one last time or say goodbye. We want to know what he went through. We don’t want to sue anybody, we just want them held accountable and we want them to improve their communications with families.

“We don’t blame the staff, not at all. They’re doing the best they can.”

But the main thing, she said, is that people should be aware that the virus is deadly. Because health officials steadfastly refuse to release information about victims, the dead are only numbers and statistics for those who have not been directly impacted by COVID-19.

“I feel as though some people don’t take it as seriously as they should, but it could be their grandparent or any other relative next,” Brenda Melgoza said.

Manuel Melgoza was from San Antonio Ocampo, a village two hours northwest of the Michoacan capital of Morelia. He and his wife Galdina raised a family of eight that mostly gravitated to the United States while he tended a small store from his home. “The family was very poor, but he was very encouraging,” said Brenda. “He encouraged my dad to go to university.” When he couldn’t, and without other options in the village, he immigrated to the United States. Five other brothers and sisters also came to the U.S.

While he was in Michoacan, the entire family visited every year, usually during the winter. It was the family home. Manuel and Galdina and a daughter moved to Illinois when he was in his 70s, as his health started to fail. They later moved to the Salinas Valley to live with their son’s family.

“He was a very sweet man,” said Brenda Melgoza. “More than anything, he loved his family.”

Shortly before county health protocols were established to keep people from visiting most patients in hospitals and nursing homes in March, Brenda dropped in on her abuelito. She said she doesn’t know if he recognized her as a relative. But she remembers that he smiled, held her hand and tried to comfort her because she looked sad. It was the last time she saw him.

“He kept telling me he was sorry,” she said. “He kept saying, ‘lo siento.’ That’s the way he was. He had a beautiful heart.”

In early April, the family caught an item on KSBW Action 8 News about a case of COVID-19 at Windsor, according to Brenda Melgoza. They were alarmed, worried that it might have been their abuelo and concerned that they only heard about the case on TV. Brenda said they received a written notice the day after they learned about it on KSBW. They started calling again after seeing another KSBW item not long after that at least three residents at Windsor had tested positive for COVID-19. Melgoza said a Windsor representative told the family on April 23 that Manuel was okay, that he was in isolation and that he would continue to be tested regularly.

“A day later they called and said he tested positive,” Brenda Melgoza said.

She said the family knew her grandfather’s health condition was compromised and they understood that his chances were probably not good. But when they checked in with staff, they were told he was stable, that his fever was down. “He was giving us hope,” Brenda Melgoza said.

Following protocol, Windsor would not allow visitations. They told the family they could set up live-streaming visits on one of their tablets. But getting through on their electronic devices was a problem. Windsor blamed the failed attempts on “connectivity” problems. One family member did manage to get through, but other scheduled live-streaming visitations with more family members failed. On May 1, the family gathered at 6:30 p.m. for a “visitation” that Windsor staff had scheduled. The connection couldn’t be made and no one from Windsor answered the phone to explain what was happening. The family gave up around 9 p.m.

They got a phone call the next day. Manuel Melgoza had died. A hospice nurse told them he died peacefully in his sleep, Brenda Melgoza said.

An employee from Windsor told Voices of Monterey Bay that calls were made to family members of all residents after the first coronavirus was discovered in early April. She said Windsor officials would have a more formal response to Voices’ inquiries soon, but no administrator has responded to inquiries made since Monday.

Residents and staff at skilled nursing facilities are perhaps most vulnerable to COVID-19. Residents live in closed quarters and are often unable to care for themselves. Staff is required to tend to the personal needs of residents who do not always understand the nature or the threat of viral diseases.

Because of that, public health officials have been communicating with administrators at skilled nursing facilities regularly, according to Moreno, the county public health officer.

When a resident or an employee at a skilled nursing facility tests positive for COVID-19, “we spend additional time with that particular skilled nursing facility to make sure they are properly implementing infection control prevention strategies,” Moreno said.

Containing the spread of COVID-19 has proven difficult in hundreds of facilities throughout the United States. In the state of Washington, for instance, the first large outbreak in the U.S. was reported from a nursing facility in Kirkland in February. Thirty-four residents died there, and the state is still grappling with infections in nursing homes. In Los Angeles County, at least 134 nursing home facilities have reported at least one death, and several have reported more than a dozen fatalities.

The Windsor facility is the only skilled nursing facility in Monterey County with a known cases of COVID-19, according to the state Department of Public Health. The agency had reported earlier this week that a resident from Forest Hill Manor Health Center in Pacific Grove had died, but the agency reporting site removed that death on Saturday without explanation.

While the state agency lists that cases and deaths have occurred at facilities, it is vague about numbers. For instance, in its listing for Windsor The Ridge it only says that there were fewer than 11 cases reported, and fewer than 11 deaths. Monterey County’s public health officials say the state doesn’t publish the actual number of cases at each site if the total is less than 11 to “protect the privacy of patients.” Moreno likewise avoids specifics when discussing deaths, also citing patient privacy.

At the time KSBW reported the first cases at Windsor, officials at the Salinas facility issued a written response to say that three of their residents had tested positive and were in isolation.

“Rest assured, since the onset of this pandemic, Windsor’s clinical team has been collaborating closely with local, state and federal authorities, as well as the facility’s medical director,” according to the statement. It said that employees are screened at the start of each shift for symptoms of COVID-19 in a procedure that includes daily temperature checks and completion of a Centers for Disease Control screening questionnaire.

“Employees who show signs of illness are asked to leave immediately and isolate at home. Nothing is more important to us than providing a safe environment for our residents and team members.”

Editor’s note: The story has been amended to reflect that a possible death of a resident at a Pacific Grove nursing facility has been removed from the state Public Health Department’s website.

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Joe Livernois

About Joe Livernois

Joe Livernois has been a reporter, editor and columnist in Monterey County for 35 years.

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