Increasing number of deaths stretches coroner's office thin

An uptick in deaths in recent years spurred commissioners to bring on a fourth deputy coroner in the county.

The unanimous Jan. 12 vote came after County Coroner Steven Schnackenberg told commissioners that deaths handled by his office increased dramatically in the past two years. In 2019, the coroner reported an average of 230 calls a year. In 2020, he handled 282 deaths and in 2021 that number shot up to 315.

“That’s quite an increase in calls,” said County Commissioner Brent Teske after reviewing the figures.

Schnackenberg cited the county’s demographic shift as a primary reason for the uptick. According to the latest Census data, about 27.7 percent of the county’s population is age 65 or older. That’s compared to 19.5 percent of the state as a whole.

“The age change in the residents of the county is really a huge deal,” Schnackenberg said in a follow-up interview. “One percent of the population is supposed to die every year. Because we have had so many young people move out of the county looking for work and so many older people move in, it has moved us way ahead of the demographics.”

Although the uptick in deaths coincides with the emergence of COVID-19, Schnackenberg said the pandemic played a small role in the increase. He said he saw few cases where the disease, which is caused by the coronavirus, was listed as the main cause of death.

County health department officials attribute 12 deaths to COVID-19 in 2020. In 2021, by contrast, the county saw 61 COVID-19 deaths. Two people have died of the disease thus far in 2022. Deaths from COVID-19 surged starting in the summer, with 55 fatalities recorded between July and December.

In November, the state Department of Public Health and Human Services released a report citing COVID-19 as the third leading cause of death in the state. Officials cautioned that the report is considered provisional and would be finalized in 2022. Two-thirds of Montana’s COVID-19 deaths occurred in individuals with an underlying condition, namely cardiovascular disease, diabetes and respiratory diseases.

“In elderly people, it just pushes them over the edge,” Schnackenberg said of COVID-19. “It is not the main cause [of death]. If COVID-19 is listed, it’s way down the list.”

He turned again to the region’s demographics. As long as the county population keeps growing older, the upward trend of deaths will continue.

“We are a retirement county; we just see more deaths,” Schnackenberg said.

In the short term, the increase in work has stretched the department thin, he told commissioners earlier this month. Service calls for a coroner comprise those deaths that occur outside of a care facility and include individuals hospitalized for less than 24 hours, according to a letter Schnackenberg provided county commissioners.

While hospice deaths do not count toward the coroner’s figures, increasingly more people are choosing to die at home, he wrote. Occasionally, they are still looking for hospice care when they die. Others opt against it altogether, the letter reads.

Schnackenberg pitched bringing on a funeral home employee as the county’s fourth deputy coroner. The candidate is a licensed practical nurse and holds a bachelor’s degree in criminal justice.

“He also was employed by the Libby Care Center for the last two years,” Schnackenberg wrote in the letter. “He is well versed in death and dying. He is also very familiar with medications and their effect on the human body. He is a perfect fit.”

County commissioners saw little reason to quibble with Schnackenberg’s assessment.

“I don’t see any issue [with it],” said Jerry Bennett (D-2). “It’s one of the needs that has to be met whether we like it or not.”

Teske made the motion to expand the coroner’s office. It earned a second from County Commissioner Josh Letcher (D-3). The trio indicated that the position would be effective as of Feb. 1.

“Unfortunate that it’s necessary, but it is,” Teske said following the unanimous vote.