'The Queen of Hanover Hill': The Human Toll of N.H.’s Nursing Home Outbreaks

May 6, 2020

In New Hampshire, nowhere has the coronavirus been more deadly than at long-term care facilitiesNewly released data shows a staggering three-quarters of all COVID-19 deaths in the state have happened at nursing homes or similar congregate living centers.

To most people, those deaths have been anonymous — just one of the many statistics listed off by state officials at each press conference. NHPR’s Jason Moon reports on the human story behind one of those numbers: a woman named Simonne Gagnon.

Simonne Gagnon moved to Merrimack, N.H., in the 1970s. She raised six kids there. She sewed custom outfits for their dolls out of the clothes they outgrew.

Simonne was diagnosed with Parkinson’s disease in 2008, when she was in her late 70s. By the time she reached her mid-80s, it was too hard for her husband, Roger, to take care of her at home. The family made the difficult choice to move Simonne to Hanover Hill, a nursing home in Manchester.

Simonne Gagnon on St. Patrick's Day, wearing a hat made by one of her daughters, Diane Giroux.
Credit Courtesy Sandra Gagnon

“She had been very, very frightened of it,” said Sandra Gagnon, Simonne's daughter. “She was very unhappy with the idea of going into a nursing home.”

Simonne remembered the kind of nursing home her parents had gone to. It didn’t seem fun.

But Sandra said her mother began to warm to Hanover Hill by just the second day. They had outdoor barbeques and live music; there were new friends to make.

“One of the things that really helped her to blossom was my mom always liked to dress up fancy, especially if anything had beading or sparkle to it," Sandra recalled. "And she liked to always wear a fancy hat to go with her outfit."

The staff at Hanover Hill would make a point of telling Simonne how lovely she looked. 

“Mom just ate all that up," Sandra said.

Before long, Simonne christened herself the "queen" of Hanover Hill. She and her fancy hats lived there for about five years.

Simonne Gagnon and Roger Gagnon at Hanover Hill nursing home in Manchester.
Credit Courtesy Sandra Gagnon

Then came news of the coronavirus. At Hanover Hill and similar facilities across New Hampshire, precautions were taken to try to stop it from getting in. As part of the new rules, Sandra wasn’t allowed to visit her mom anymore.

The virus got in anyway. By the start of April, Hanover Hill was sending notices to families like the Gagnons about its efforts to contain COVID-19. Initially, the scale of the outbreak wasn't clear, but on April 8 state officials reported that dozens of Hanover Hill residents and staff had been infected.

One of those infected early on was Simonne’s roommate. Soon, Simonne was tested too.

“It turned out to be positive,” Sandra said, "and even when mom heard that she still didn’t think that she had it, because she felt fine."

Within days, Simonne got so sick that she started to refuse food — and then, even her Parkinson’s medication. She started telling her daughters how much she missed her late husband, who died last summer.

"At one point, she said she doesn’t mind if she dies, cause she said she’ll be able to be with Dad again," Sandra said.

The Gagnon siblings, spread across the country, huddled over video calls and group text messages trying to figure out how to proceed. Was mom making a choice to die, they wondered? Was she just sick and confused? Should they transfer her to the local hospital? Was that worth the trauma it could cause? All the while, grappling with these questions, they still weren't able to see their mom in-person.

As Simonne's children confronted tough questions about COVID-19's impact on their family, a growing list of families across the state were finding themselves in a similar position. Within weeks of the news that the coronavirus had arrived at Hanover Hill, outbreaks were reported at additional facilities in Manchester, Dover, Nashua, Salem and elsewhere. As of May 4, the state said COVID-19 had infected at least 473 residents and 266 staff at 16 different long-term care institutions across New Hampshire. 

Many of those people were dying, becoming part of grim statistics in the almost daily press briefings from state public health officials. To date, 66 people — or more than 70 percent — of those who've died from COVID-19 in New Hampshire were associated with nursing homes or similar facilities, according to state data.

Simonne Gagnon was one of them. She died on April 13, the day after Easter. Sandra, her daughter, learned the news in a phone call early that morning.

“[They said] when they went into mom’s room to do a check-up on her, that mom was dead,” said Sandra. "Even when you know it’s coming, it’s hard.”

Simonne Gagnon was 89.
Credit Courtesy Sandra Gagnon

New Hampshire had plenty of warning, from Massachusetts and other states, that long-term care facilities would be vulnerable to COVID-19. But shortages in testing supplies, personal protective equipment and staffing — not to mention shifting state guidelines on who should be tested — have left public health authorities scrambling to blunt the impact of the virus in these facilities.

The day after Simonne died, state officials announced a new strategy aimed at preventing further spread at facilities like Hanover Hill: They would test more than 6,000 long-term care workers in Hillsborough and Rockingham counties, the two with the highest number of COVID-19 cases, and would roll out a new financial assistance program.

As recently as last Friday, state officials said they would only test for COVID-19 at long-term care facilities where someone is showing symptoms, for fear of introducing the virus. This is despite evidence that nursing home staff with no symptoms can spread the virus and the fact that other states have implemented universal testing programs for all nursing homes.

According to data collected by the Kaiser Family Foundation, the proportion of coronavirus deaths linked to long-term care facilities in New Hampshire — more than 70 percent — is among the highest of any state for which data is publicly available, and more than twice the national average of 31 percent.

Many families, including Simonne's, are unable to mourn at a traditional funeral.

“We could put it off until much later for the service," Sandra said, "but some of the siblings felt at that point it would just be too sad to go to the funeral home and have the service there."

Instead, Simonne's family will gather in New Hampshire when it’s safe to do so. They’ll go out for dinner, then they’ll get out old pictures of their parents and share their favorite stories.

For now, Sandra hopes her mother’s death can be a reminder of why we socially distance.

“I definitely would [like] everyone to please obey the stay-at-home orders,” she said. “The best thing they can do is to be thinking of others, and not only themselves and that’s the way everyone will benefit from slowing down the spread of this virus.”