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I have an Ombudsmans report due to making a complaint against…

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I have an Ombudsman's report...
I have an Ombudsman's report due to making a complaint against a hospital. Diagnosed our Dad with advanced vascular dementia left him undernoursihed and dehydrated. Admitted to second hospital from nursing home within 4 days undernourished and severly dehydrated. PEG tube inserted at second hospital and Dad treated successfully for infections. Been out of hospital in nursing home for 2 and a half years also had been on citalopram. I was put on citalopram made me feel sick could this be the reason why dad had not wanted to eat. Our Dad can't speak properly or swallow properly due to stroke on pureed diet not fed much through PEG understand everything we say and responds appropriately. Advanced vascular dementia I have grave doubts?
Submitted: 8 years ago.Category: Personal Injury Law
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Answered in 2 hours by:
6/20/2010
Personal Injury Lawyer: calii927,
 replied 8 years ago
calii927
Category: Personal Injury Law
Satisfied Customers: 1,436
Verified

HI jacustomer and thanks for writing JA

 

While I no longer treat geriatric clients I ran a program for Geriatric non-dementia clients for several years and worked as a geriatric consultant for a few years to several nursing homes in NYC>

 

Here is the thing and it is that it is so difficult to make a sure differential diagnosis in the elderly with people who have numerous medical conditions and are taking a great deal of medications.

 

It does sound in your Dad's case that there is some vascular dementia indicated. He had a stroke? This is a vascular event of the brain after all, so I would think?......

 

Now, he was put on an anti depressant for one of two possible reasons. One is that your fathers doctors and care providers may have been trying to rule out a Depressive Disorder and they are quite common status post strokes or they were trying to rule out a Depressive Disorder just in and of itself and the Citalopram is probably the best tolerated medicine for someone his age with fewest side effects.

 

So, I am going to say, No, it is unlikely that the citalopram caused what he experienced.

My guess, from what you have written?

It sounds as if your Dad became septic and dehydrated. This is so common in the elderly and then it sounds as if they righted whatever infection caused the sepsis.

 

As for advanced vascular dementia, well if you are certain he understands all you say to him, then I would say no to that as well. He might very well have vascular dementia, but advanced? hmmm. I would say not given what you have posted.

 

Having said that, the treatment for vascular dementia, be it mild or advanced is more about care than prevention so I can not imagine what to advise you on this.

 

You have an ombudsman looking into this for you so ask the ombudsman to inquire about the neurologists reports and if they are in order I am not sure that you have a misdiagnosis here at all.

Many people are diagnosed with Alzheimers disease but truthfully the only way to diagnose

Alzheimers disease is at autopsy. Another very similar dementia, Picks Disease, is almost exactly the same on clinical observation but only an autopsy of the brain can show the true diagnosis.

 

I caution all my clients about diagnoses and labels all the time. Be careful not to confuse a diagnosis with a treatment protocol as often treatment protocols are the same no matter what the diagnosis. Also, the focus needs to be on your Dad, or the person served, and not what his illness might be. If your providers treat him as your DAD and not a vascular dementia person he is getting great care. I never think of my clients as Mr. Alzheimers or Mrs. Vascular Dementia. Discuss this with the ombudsmans officer assigned to your case and let them help you work this out.

I know it is so frustrating and we wish to do our best in guiding the care of our aging parents, but I think so far there is nothing to suggest misdiagnosis.

Unless there are other things you have not shared, or do not know of, no evidence to suggest improper care.

You have all my best and warmest regards.

I hope your Dad has a good Fathers Day.

Cathy

 



Edited by cathy on 6/20/2010 at 4:38 PM EST
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Customer reply replied 8 years ago
Thankyou for your answer. Would it be worth getting an independent assessment by a private specialist because if the hospital has misdiagnosed our Father, this would be extremely serious. I only complained because I don't want bad care to happen to someone else.
Personal Injury Lawyer: calii927,
 replied 8 years ago

You know I hate to say this to you, but even if the hospital misdiagnosed your Dad it does seem that they did follow an appropriate and acceptable protocol so it would not be a case for malpractice or poor care, but you can, by all means hire a law firm to look into the matter for you?

 

I do not see malpractice here and a missed diagnosis is really not as serious as you would think in this case. Medicine is not so much science as art and you cannot say that your Dad does not have vascular dementia. All you can say is that he may not have advanced vascular dementia and since neither you or I have seen the ct scans we do not know anything for sure?

 

I would make a consultation at a law firm on this and speak with an attorney who is better versed in this than I and see what they think first?
If they think it is worth investigating they will tell you and if not they will also tell you. I find that most law firms do not take on cases they do not feel they can win, so lets leave it up to the legal eagles to review and allow them to help you with this decision.

If they think you have a case they will send in their own private investigators on this. Before you wind up dropping thousands of dollars on this, speak to an attorney?

I hope you have a wonderful weekend (that which is left of if anyway).

All my best.

Cathy

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Customer reply replied 8 years ago

I suppose what I am asking is do you think it is proper protocol for a hospital to choose to leave someone to dehydrate and starve almost to the point of death just because they have dementia. Who has the right to make that decision anyway?

Personal Injury Lawyer: calii927,
 replied 8 years ago

Hmm, no I do not think that is okay but I do not think either that is what happened. It is very very common for people who have had strokes and other severe injuries to become severely dehydrated especially when sepsis is present.

Okay let me reread your initial post-

 

Is this a typo or I am just misreading it? Was your father starved for weeks or not fed for a few days. I am sorry. I cannot tell what from your post. If he was not fed for four days he was not starved but if he was not fed for four weeks I apologize for not picking this up sooner. Starvation would mean not fed for several weeks? Again, sorry I missed this in our first go round.

 

Starvation would mean he was not fed for weeks on end. Dehydration can occur in a matter of a few hours. Are you saying they did not feel him for weeks? If so, then not only do you need an attorney you need to call your local papers and get this hell hole closed down.

 

I am serious. If you are saying that your Dad was not fed until the point of starvation that would mean he languished there for several weeks with no attention, then you have one heck of a lawsuit and a huge scandal.

Dehydration can happen in a matter of hours or less especially in an elderly person. So no case there.

Sorry I misread your earlier post. I somehow got that he was there for four days only. So sorry, yes by all means pursue ligitation.

I am just so sorry to understand this story now.

Four weeks? This is a tragedy.

Good Luck. Get an attorney right away.

Cathy

I am opting out and sending you over to legal on this now.



Edited by cathy on 6/20/2010 at 7:30 PM EST
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