The time of that risk calculation ended abruptly.  When I arrived at the apartment one afternoon, David told me that he had gone for a walk and suffered an episode of weakness so sudden and severe that he’d barely made it to the front door of the building.  He couldn’t get the door open with his key fob.  From that point, the report got murky.  Someone had helped him, or hadn’t, and he couldn’t tell me how he’d entered the building and returned to his apartment.  He couldn’t tell me when this had happened.  Judging from his account, it was in the evening.  I’d been at the apartment in the morning, and he hadn’t said anything about a walk; recounting this experience now, in the afternoon, he was panicky and distressed.  Upsetting dreams sometimes surfaced as remembered events, so it wasn’t clear whether this had happened or whether he’d fallen asleep during the day and dreamed the whole episode.  I called the administrator and reported the account David had given me.  He may have had a particularly vivid dream, I told her, but I had no way to determine with certainty whether this episode had happened. 

Around the same time, the administrator called one afternoon and asked me to come as soon as I could get there.  She had found David wandering the halls, pants undone and sagging low, looking for his phone and keys.  She helped him adjust his pants and search his pockets, where he found both the phone and keys.  When I arrived, David seemed to know nothing about the encounter; the next day, however, he mentioned “that humiliating incident” with the administrator.  I asked a few questions.  David told me that she had put him in a cart and rolled him down the halls. 

 Fiona and I talked and talked.  What should we do?  The administrator had cautioned us that other incidents like this one would mean that David had to move to another facility.  We already knew that he needed to move to another facility; the question was which facility?  We had to get it right, insofar as there was a right place in that time of chaotic nursing home COVID lockdown.  

How many families faced this dilemma – then and years later?  How many vulnerable people go on living in precarious or dangerous situations because staffing shortages and unreasonable admission protocols mean that they have no better options? 

After much consultation, the administrator proposed a general safety and cognitive-function evaluation and scheduled a session with the nurse who consulted with families about placement in the “continuum of care.”  At last someone with expertise would be evaluating David.