By: J Brian Ewing
News & Record – Greensboro, NC

Marty Walden took a walk with her children through her Guilford Hills neighborhood on a recent brisk evening, the stars bright in the night sky. As the chill set into her bones, a thought even colder set into her heart: “This is nothing like Mother felt.”

Edith Purvis was discovered just yards from a locked door at Loyalton of Greensboro on Lawndale Drive about 3:30 a.m. on Christmas Eve . She was wearing only her nightgown; hypothermia had set in. Purvis died a short while later at Moses Cone Hospital. She was 85.

State regulators swooped in to investigate and found that the assisted-living facility was not equipped to handle residents who might wander because of memory loss or confusion.

The state banned Loyalton from accepting new residents. The legal implications continue to unfold.

The tragic loss of their mother haunts Marty Walden and her brother Chuck Purvis every day.

“Because the facility didn’t take care of her,” Marty said, “I’m left with a picture of my mother lying on the ground frozen and her being alone and outside and confused.”
• • •

The Purvis family was like many in their day.

Marvin Purvis, the breadwinner, worked as a car salesman throughout much of his life. Edith worked as a secretary at a local orthodontist’s office and was active in her church. Marty said her parents were firm but loving.

In 2007 , when Edith and Marvin’s health worsened, the family decided to help them move into Evergreens nursing home in Greensboro.

Marty said seeing her parents’ move from their family home was an awful experience.

“There’s just no sense of the calm and privacy you get at your home,” she said. “It was tough. There were hard decisions we had to make, and it happened pretty quick.”

In 2009, after years of heart trouble, Marvin died at age 86. The loss was sudden and shocked Edith.

“She lived each day,” Marty said. “It was hard, but she survived and went on, but obviously there was a hole.”

While Edith’s health wasn’t the best — she suffered from heart problems and Parkinson’s disease — her mind remained sharp, so with her family’s help she decided to move into a home more suited to her.

Marty researched and visited Loyalton and liked the fact that it was smaller than many of the facilities she had considered. It would be easier, she thought, for her mother to get to know everyone.

Prior to Edith’s death, Loyalton had been cited only for minor infractions

And Loyalton was only about two miles from Marty’s house, which meant she could drop in to see her mom regularly.

Edith and Marty liked that her room was much larger than the one she and Marvin had shared at Evergreens. Edith could fit more of her furniture in the room to make it feel more like home. The staff were pleasant, and because her mother was still clear-minded, Marty knew she would speak up if there were any problems.

“As far as I knew, this was a decent place,” Marty said. “I felt like she was getting good care.”

Last October, Edith caught pneumonia and the family feared the worst. While she spent weeks in bed, Marty prepared herself for her mother’s death.

“She was so racked with the cough and so incredibly physically in pain, it was very hard to watch, and that’s when you want your loved one to get better or not be in pain any more,” she said. “It’s hard to watch someone you love in that much pain and not be able to do anything about it.”

Although Edith slowly rebounded physically, Marty noticed that her mother had become confused. Edith talked about people who were dead as though they were still living, especially her parents and Marvin. Edith once confused Marty for her sister, Brenda, who died in 2000.

“She wasn’t always oriented to a time or place,” Marty recalled.

Marty found humor in it sometimes, like when Edith reprimanded her for coming in after her high school curfew. But it also pained Marty to see her mother searching for lost loved ones like her father.

“You learn to lie to your parents to comfort them,” she said. “It sounds terrible, but that’s what you do to keep them from the pain.”

Marty understood that dementia could be an unfortunate but common problem of aging. She talked with a Loyalton nurse about it, she said, and the nurse told her they would re-evaluate Edith to see if she needed a higher level of care within the facility. Officials with Loyalton talked with Marty about end-of-life care for Edith.

“They told me they were perfectly equipped to handle that and that they would like for her to stay there where she would be comfortable,” Marty recalled.
• • •

Marty doesn’t remember much about Dec. 23, the last day she saw her mother alive. She’d dropped in to visit about 6:30 p.m. but didn’t really talk about the Christmas holiday with her mother. At the time, Edith thought it was spring.

Before she left, Marty prayed with Edith, just as she’d done with her mother and father when they lived at Evergreens.

Praying reminded Marty that she was leaving her parents in God’s hands, she said.

Marty sat on the edge of the bed, leaned over her mother and prayed.

“That God would comfort her and fill her with peace,” Marty said. “And I always prayed for the workers, that they would treat her with kindness and watch over her, and that she would sleep well and not feel any pain.”

Hours later, before sunrise on Christmas Eve, Marty awoke to a phone call from a Loyalton official who told her that Edith was in the hospital. The caller told her Edith had been found outside, but she was going to be OK.

By the time Marty got to Moses Cone about 4:30 a.m., her mother was dead.

“Once the chaplain came out,” she said, “you knew what was going on.”
• • •

Exactly what happened that night remains unclear. Loyalton staff reported seeing Edith about 11 p.m. and midnight. Staff told state investigators that Edith was noted as missing from her room about 2 a.m. but another staffer believed she’d gone home with family for the holiday.

A search began only after staff discovered Edith’s medications were still on hand. By that time it was nearly 2:30 a.m.

At 3:30 a.m. , they called 911. They had found Edith outside on the ground. She was moaning and her skin was changing colors.

The next day, Loyalton installed alarms on its exit doors, a minimum state requirement for facilities that care for residents who might wander because of dementia.

Loyalton maintained that it worked with families to relocate residents with such problems to nursing homes. However, investigators noted at least five residents there who fit the designation. They also were told by staff during confidential interviews that patients had wandered off from the building before.

Loyalton officials say they have addressed every issue that the state cited in its report.

As for Marty, none of that provides comfort on those cold evenings when the image of her mother, on the ground and dying, pains her.

“My heart breaks every time I think about it or have to deal with it,” she said. “There was no closure. I didn’t get to say goodbye to my mother.”