Monday would have been Nettie Cunningham's 80th birthday, but instead of throwing her an Elvis-themed party, her family is having to plan her funeral.
She died at Holland Lake and Nursing Rehab on Sunday of complications from COVID-19, according to her family. Cunningham tested positive for the coronavirus at the beginning of the month.
"She had regular conversations, she was very alert, you know, and had plenty of life left in her and then she got it (COVID-19)," said Carissa Manrique, Cunningham's granddaughter. "The first day or two wasn't too bad, and then by day three, it just went downhill, and she was barely conscious at the time."
She said her grandmother started to experience kidney issues, her blood pressure, and oxygen levels dropped and she was later hospitalized.
The family said once she was stable, Cunningham was released back to the nursing home but her health continued to decline.
So much so, they prepared to say their final goodbyes this past Saturday, but through a window.
"We were basically at a window and the nurse, he was great, his name is Mike and he had her phone, put it right here so she can hear. We literally sat out there for a long time but that's all we she got. She didn't get any family touch or love in her last moments at all," said Carla Smith, Cunningham's daughter.
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She said they requested to see her in person, but said it was denied because of the number of COVID-19 cases inside the facility.
But according to the leader of an advocacy group called Texas Caregiver for Compromise, recent state guidelines allow end-of-life visits.
"Knowing Saturday that they were nearing end of life, it sounds to me like this resident was probably entitled to some end of life visits from family members," said Mary Nichols, the creator of Texas Caregivers for Compromise.
She said according to Texas Health and Human Services, as of Oct. 19, nursing facilities are allowed to grant end-of-life visits, even with COVID-19.
"This is what we would call a compassionate care visit. This person had COVID-19, was declining rapidly, and they were entitled to a compassionate-care visit or an end-of-life visit. With these end-of-life visits, there's no limit to them, there's no limit to the length of time that's kind of up to the facility, but they (families) are entitled to them. And it doesn't matter whether that resident has COVID-19 or not, even a COVID-19 resident is entitled to an end-of-life visit with their family members," said Nichols.
The rules for visitations have changed over the last seven months as advocates, like Nichols, have pushed to get essential caregivers access inside nursing homes and long-term care facilities.
In September, the state relaxed restrictions and allowed essential caregivers, such as a family member, friend or someone else who helps take care of the individual permission to go in.
The state said under the new rules, residents can designate up to two essential family caregivers to go inside a facility for a scheduled visit. They must complete training about personal protective equipment and safety guidelines before entering. They also have to test negative for COVID-19 within 14 days of the scheduled visit.
Nichols said she believes thousands of people don't know about these changes along with end-of-life visits.
"I'm guessing a lot of people don't know all this, the rules are are complex, and they have changed frequently over the last several months, and Texas Health and Human Services has made every effort, in my opinion, to educate facilities," Nichols said. "I have seen the education efforts I've seen the countless webinars. I've seen their provider rules. I've seen the provider letters that have gone out. I feel like they're (HHS) making every effort to educate facilities, but I do feel like there are some facilities that still are either unaware of the rules or they're struggling to understand the rules."
NBC 5 reached out to Holland Lake and Nursing Rehab for a statement, but the facility declined to comment.
Texas Health and Human Services has a program called the Office of Long Term Care Ombudsman that assists with residents rights. If a family is in a similar situation, call 1-800-252-2412 or click here for more information.