​Don't let this happen to your loved ones: Monitor nursing home care, and plan decisions in advance

My big brother Jay embraced life on every level. He had very strong interests and opinions, which he put into practice no matter what others thought. I always admired this about him. He could be the only person in the room who felt a certain way, but he was steadfast, some would say stubborn, sometimes rankling. But you had to hand it to him. He was real. You didn't have to agree with him, but if he found something that he liked, he would let you know it. And although he didn't have a large circle of friends like many of us do, if he was your friend, he would be the best and most loyal friend you ever had.

Jay was a man's man. He loved sports, antique cars, always wore muscle shirts. Growing up, he would befriend older male relatives and become their closest companions. He was very hardworking -- at any given time, he would not only be working full time at my father's printing supplies business, but at several other part-time jobs as well; many might have lacked prestige, but he made them his own. He learned air conditioner repair from a friend of my parents, and set up a side business doing that. He repaired cars too, of course. And he drove a cab around Boston doing late night shifts.

During my '80s clubbing era (well that has not totally ended, lol), I would often be exiting Lansdowne Street clubs at closing time when more than once, a friend would say to me, "Was that your effing brother in that cab?" (Knowing Jay, it could easily also have been because he wanted to keep an eye out.)

Jay made his own decisions about every facet of life, and was not doctrinaire. He would support Republican candidates, but also listen to former California governor Jerry Brown all the time on the radio and had a great love for the Kennedys, even creating a museum devoted to them (and sports) in his basement. Nobody could pigeonhole Jay, and no one attempted to.

Jay loved Boston, especially the North Station area where his cherished Boston Bruins played. My grandfather Sam Abrams was a bartender at the Iron Horse in Boston Garden and would get me tickets to concerts, and games for Jay. He even ended up living at 150 Staniford Street nearby until he met his wife, got married and returned to buy a house and later to raise their son in our childhood town of Randolph. Jay never wanted to leave there. (It was also convenient for him, although married, to stop by my mother's house for a meal at any time.)

You could not keep Jay down. However, about 15 years ago, it became noticeable that he was walking stiffly, and it was not long before he was diagnosed with Parkinson's disease, which sadly, progressed fairly quickly. Despite cortisone shots and other treatments, Jay could soon no longer live at home, and entered Hebrew Rehabilitation Center in Roslindale. This began a new cycle of meeting there every Sunday as well as any other day that family members could get there. He was quite conversational for many years, but over the past few, became less so. He was pretty much okay, however, and still ate voraciously.

He was also contracting infections. Most nursing homes, of course, could not escape the COVID-19 pandemic, and this one was no exception. Jay must have gotten it several times. And then this past year, he also contracted norovirus and RSV. He became quieter and upon arrival, I would often find him on the floor crawling around. I myself, and my companion helped get him up into his chair a couple of times. While most nursing homes are understaffed, his seemed particularly so. I was not happy that they let him crawl around on the floor, because unsurprisingly, he would get cuts and bruises from that, and who knew if his abrasions were being properly treated?

Added to this was the curious (not in a good way) fact that none of the aides wore gloves or masks. The cleanliness and hygiene there had been a concern for some time. I had made a suggestion that Jay be moved to a smaller facility in Randolph, but it wasn't up to me to make that decision. So, I hoped for the best and continued to visit.

In early October, Jay contracted three serious infections: COVID (again), pneumonia and MRSA, a dreaded superbug. I still don't know if his vaccinations were kept up, especially for the pneumonia. From what I was told, the nursing home staff asked his wife if he should be sent to the hospital. It was very disconcerting that the staff had not assessed this on their own and sent him there sooner.

A few days after his admission, I learned that his nutritional support and Parkinson's medication lines had been disconnected on his second day there, and I had not been consulted. I was told that he was so sick when admitted that it was an “act of love.” However, most patients are quite sick when they are first admitted, and not everyone is my brother.

According to Jewish law life is sacred and sanctified, and this was very wrong. I immediately went to Patient Services and also spoke with the attending physician. Both said that there was nothing that could be done, and the physician (rather starkly) added, "he's going to pass away."

My beloved brother was a fighter. Indeed, he became COVID negative in a few days. I played him his favorites, Chicago ("Terry Kath's guitar solo on '25 or 6 to 4' was perfect," a friend consoled me. "There's nothing better to pass to the next world with.") and The Beach Boys, and could see that he reacted. I also saw him struggling, and had to go out to the nursing station a few times because it was not what I considered comfort care. Amazingly, he lingered for 9 days with no sustenance and no Parkinson's medications, basically just morphine and oxygen, before passing away on October 8.

I will always believe that Jay would have lived, had he been given that opportunity. “Jewish law differentiates between terminating care and withholding care,” states Rabbi Micha Cohn in a July, 2024 Aish article on this topic. (https://aish.com/a-long-life-or-a-good-life-end-of-life-care-in-jewish-law)“If a patient is connected to a life sustaining machine, like a ventilator, and removing it will result in their immediate demise, it is forbidden. Removing the device, often referred to as ‘pulling the plug,’ according to Jewish law, is an act of terminating life and not allowed."

Cohn also cites Rabbi Shlomo Zalman Aurbach (Minchas Shlomo 1:91.24): “He reasoned that just as we are not allowed to starve a dying patient, we cannot withhold basic necessities like oxygen, nourishment and fluids. However, aggressive medical treatments may not be required.”But I was not asking for aggressive medical treatments. I was only asking for sustenance for my brother, and a chance. He was never given that chance, and no one was given the opportunity to weigh in on this ultimate decision.

Jay's funeral was, perhaps appropriately, held during the October 13 morning nor'easter (kudos to Rabbi Evan Sheinhait of Temple Tiferet Shalom for delivering a meaningful eulogy in the wind and rain). Despite the many supportive people there who told me that they agreed with me 100 percent, the experience, needless to say, was as dismal as the weather.

I am writing this because I don't want any other families to go through anything like this. I will miss my beloved brother every minute of every day for the rest of my life. And I will also feel that I was not able to help him.

I would urge every reader of this story to make certain that plans are in place so that all members of a family will participate in any such decision, if that time unfortunately arrives.

I would also strongly advise that families be proactive regarding the care that their loved ones are receiving, should they be admitted to nursing facilities. Although the Stanetsky-Hymanson obituary suggests donations be made to the American Parkinson's Disease Association, certainly a worthy cause, my brother did not die from Parkinson's disease. His Parkinson's was relatively stable. The causes on his death certificate are the infections that he contracted at the nursing home.

In his memory, I ask that the highest oversight of care be taken, as well as strong decisionmaking protocol be enacted, to protect all patients and their loved ones. May you only know comfort, and the knowledge that you did all you could do.