FARGO — Irene Kjellberg’s family learned that their mother’s organs were shutting down as the coronavirus ravaged her frail body.
The 77-year-old Menahga, Minn., woman had been flown by air ambulance the night of Wednesday, Nov. 11, to Fargo for treatment, but her doctors soon determined that therapies wouldn’t be able to halt her rapid deterioration.
The doctors offered to give her convalescent plasma therapy, but her daughters didn’t want to put their mother, who suffered from dementia, through any more torment because her organs already were shutting down. They didn’t believe she’d want extraordinary measures to be taken, given her condition.
The mother who raised them was a vibrant woman who loved to dance and had the grit to raise five children, mostly as a divorced mother, who earned a living as an upholsterer.
“We all raced to Fargo to be with her for the comfort measures,” her daughter Jada Jacob said.
Jacob and her sister Cally Kjellberg-Nelson drove in from the Twin Cities, while another sister, Kitty Jacob, drove from Williston, N.D., where she was working.
Once gathered on Thursday, Nov. 12, the treating physician told the sisters that they would keep their mother on a ventilator but would stop giving three medications that kept her weakened heart beating. Without the support, they were told, their mother would live at most a matter of hours.
The doctor and nurse in charge of their mother’s care in the COVID-19 unit at Sanford Broadway Medical Center said it was OK for the three daughters to be at their mother’s bedside. They started their vigil, staring grimly at the monitor showing her heart rate and blood pressure beginning to plunge.
Another nursing shift had started, and a different nurse entered the room, upset that the three of them were present. They would have to leave immediately, she said, as they were watching their mother slip away.
“She just started screaming at me at the foot of the bed,” Cally Kjellberg-Nelson said.
The first signs of Irene Kjellberg’s dementia appeared seven years ago when she began forgetting things.
Her Alzheimer’s disease progressed, and in October 2019 she entered a memory care center in Brainerd, Minn.
Then, when the coronavirus pandemic struck in March, she became disconnected from her family because of visitation restrictions.
Her daughters noticed her condition deteriorated more rapidly without the physical presence of her family. Window visits in the warmer months were allowed, but they weren’t very helpful because her mother found them confusing, Jada said.
“You could do the window, but they don’t understand that,” she said. Similarly, virtual visits also didn’t work well. Their mother would get distracted or stare blankly at the screen.
Kitty Jacob was able to visit a few times starting in late summer, outdoors, maintaining a distance of 6 feet. She was alarmed at how thin her mother had become, her eyes sunken, her shin bones like knife blades while in a nursing home in Park Rapids, Minn.
“She got to see us and recognized us at moments,” Kitty said. “She loved that. Her eyes lit up when she could see the family.”
Then, two months ago, their mother broke her hip and her condition began a downward spiral.
The nursing home in Park Rapids had a coronavirus outbreak. Irene tested positive on Nov. 3, and she showed no symptoms at all until days later. After aspirating on Nov. 11, she was flown to Fargo for treatment.
“She supposedly got the last bed in Fargo," Jada said.
'Her vitals are dropping'
After the three sisters gathered in their mother’s hospital room, staff entered and left. Nobody expressed any concerns about their presence, including the doctor who discussed how comfort measures would be taken, Jada and Cally said.
That abruptly changed when a nurse on the second shift told them that they would have to leave.
“She came in and it was a whole new thing,” Cally said. The nurse said she was concerned about the threat of infection to Cally, who is pregnant and therefore at higher risk.
After the medications were stopped, Irene's vitals quickly deteriorated, but the nurse insisted the sisters would have to pick only one of them to remain in the room.
The sisters pleaded to be allowed to stay with their mother. “Her vitals are dropping,” Jada said she told the nurse. “Can’t you just let us stay a little while longer?”
But the nurse said she also was worried that they could spread the virus to others. “None of you should even be here,” the nurse said, according to the sisters. The nurse announced she would summon security to escort them out, as the monitor showed their mother’s life slipping away.
“I told my mom goodbye,” Jada said. “I went out into the hall.”
Reluctantly, Cally also left the room. “I don’t even know if I was there in those last seconds, but I hope I was there.”
“Five minutes more” would have made the difference, Jada said. “It might seem silly to you, but it’s a lifetime to me. She had dementia. We already lost her once and we had to lose her again.”
Upset that they were forced to leave their dying mother’s bedside, Cally registered a complaint with Sanford. A nursing supervisor called to explain their actions and apologized profusely, she said.
Dr. Doug Griffin, vice president and chief medical officer for Sanford Fargo, provided a statement:
“Due to privacy laws, we’re unable to comment on this specific patient’s care,” he said. “These situations are extremely difficult for everyone involved. Our doctors and nurses are taking extraordinary efforts in unprecedented times to provide compassionate care while also keeping patients’ family and ultimately our community safe.
“We are allowing family visits at end-of-life but are doing so safely by limiting the size of gatherings in a room. These are extremely emotional, gut-wrenching decisions for our caregivers. Our heartfelt condolences go out to the family of this patient and to the loved ones of those lost during this pandemic.”
The sisters said they don’t want to blame Sanford, but can’t understand why they weren’t allowed to remain for those last crucial minutes — they’d already been in the room for several hours, so what more harm would a few minutes cause?
“I feel this has totally clouded my last moments with my mom,” Cally said. “I was sitting at the foot of my mom’s bed arguing with the nurse.”
Jada agrees that the altercation made for a stressful ending to what the family wanted to be a private, peaceful time.
“We were actually escorted out by security,” she said. “If we wouldn’t have left, they would have dragged us out. It was a real sad event. It was obviously a really hard time and this made it worse.”