Woman blames assisted-care facility when her mother dies of a stroke

[visionary123]

I read an article in the newspaper (StarTribune, March 12, 2013) tonight. The front page title caught my attention "FAMILIES WANT VOICE IN NURSING INQUIRIES". However, after reading the first couple paragraphs, I couldn't even figure out why they had chosen the introduction they did.

It begins like this:

"No evidence of neglect. Sheila Van Pelt couldn't believe it when she received the letter from the state health investigators in 2011. Her mother had suffered a stroke at an assisted-living facility and later died, and now she wondered: Did they even bother to seriously review the case? Investigators never formally interviewed her, Van Pelt says, even though she found her mother, with her legs twitching as she suffered convulsions from a severe stroke. No one was ever held accountable for the incident and she says, investigators didn't seem interested when she tried to bring information forward."

What is she talking about? Why should someone else have to be held accountable for her 'the incident' when her mother suffered a stroke, especially at an assisted-living facility and not a hospital? I don't get it - is it really that bad out there now that people don't expect their loved ones to ever die of natural causes? And when they do, it has to be someone else's fault?

Although I am an LPN, I still have very little experience. I continued in nursing school and am hoping to have my RN by the end of the summer. When I read articles like this, I feel discouraged before I even try. Why are people so unrealistic? We can't save every life, nor can we be there every time something is going wrong.

http://www.startribune.com/local/197250981.html

[loriangel14, RN]

Yes many people do indeed seem to expect a loved one to NEVER die.And if they do it is our fault. I recently had a patient dying of old age (94). One of her daughters tearfully told me that she never thought this would happen. I really wanted to say " really? You envisioned her living forever? ".

Yeah I don't get the point of the title of the article. It makes it sound like her death was from some nefarious actions on behalf of the staff.

[KelRN215, BSN, RN]

For those interested, here is the article:

Local

Some people need to blame someone for everything. An old person has a stroke and it's "unbelievable" that there was no evidence of neglect on the part of the assisted living facility? It's assisted living, not a hospital. And old people (and even young people) have strokes sometimes, it happens... last I checked, stroke was the 4th leading cause of death in the US and I've seen patients as young as 2 have strokes that didn't lead to state investigations. My grandmother had a stroke- at the age of 56- while at work in the 70s. No one ever blamed her work just because that was where it happened... she blew an aneurysm which could have happened anywhere. This article doesn't offer much, but I'm wondering why this woman thinks that someone IS accountable for her elderly mother's stroke.

[bebbercorn]

This is a prime example of why everyone is scared about getting sued.

[NRSKarenRN, BSN, RN]

The target of Van Pelt’s concerns is the state Health Department and its Office of Health Facility Complaints, which regulates more than 2,000 licensed health care businesses, including nursing homes, assisted-living facilities and home care agencies. It receives 12,000 complaints and self-reported incidents each year; about 1,000 are investigated and about one in four result in findings of maltreatment or other violations....

...Van Pelt scored a victory last month when state health officials acknowledged through a policy change that they need to ensure that families play a role in the agency’s investigations.

Yet some families and attorneys representing patients still think the agency holds information too closely, and are asking if the Health Department is sufficiently accountable to the public. Attorney Mark Kosieradzki, who represents patients in nursing home cases, said in the past year or two, investigations seem more cursory and the resulting reports provide less information.

The agency’s new policy requires investigators to interview a relative of a vulnerable adult in complaints involving nursing homes or other health facilities. The protocol also stresses the importance of communicating with families, returning phone calls and helping ensure that relatives get copies of completed investigative reports

[Fiona59]

I just want to know if people are so unhappy with the care their aged elder is receiving care facilities, why don't they take them home to care for them?

Assisted Living is basically check on them care. Can't these loving families be bothered?

Oh, wait, they don't want to deal with their cranky old people and would rather micromanage their care while some other human being is tortured by them.

[Nurse_]

It's a grieving family... they lost their loved-one all of a sudden and wanted to put a blame on someone to ease the pain or guilt they feel.

However, I do believe there's something we can advocate for older generations. The lack of autopsies in older populations are rampant, in all 51 states, unless the family pays for it. The coroners do not want to take the case, expecting it to be just another old person biting the dust. Is it always "died of natural causes"? We'll never truly know.

[Rose_Queen, BSN, MSN, RN]

However, I do believe there's something we can advocate for older generations. The lack of autopsies in older populations are rampant, in all 51 states, unless the family pays for it. The coroners do not want to take the case, expecting it to be just another old person biting the dust. Is it always "died of natural causes"? We'll never truly know.

Not sure how it works elsewhere, but in my area, the coroner gets called for every single death. He or one of his designees makes the determination whether or not the death becomes a coroner's case and if an autopsy is required. This is based on where the patient died, whether or not it was expected, and apparent cause of death. We have many cases that become coroner's cases but don't require an autopsy because we know how the person died. Example: patient who died following a fall with resulting large SDH, known as the cause of death but autopsy not needed to determine such. Examining the CTs, medical record, and surgical report are enough to determine cause of death.

P.S. 51 states? When did we get another one?

[Poochiewoochie]

However, I do believe there's something we can advocate for older generations. The lack of autopsies in older populations are rampant, in all 51 states, unless the family pays for it. The coroners do not want to take the case, expecting it to be just another old person biting the dust. Is it always "died of natural causes"? We'll never truly know.

My mother was a coroner's case because she had two accidents that resulted in broken bones before her death. Coroner's ruling-death was caused by complications of her hip fracture.

[jadelpn, LPN, EMT-B]

And as we all learned from the assisted living facility where the person didn't give a resident CPR, most are bound to just call the ambulance, and not render care. So not sure what the daughter expected anyone to do but call 911...

[Altra, BSN, RN]

I don't get it - is it really that bad out there now that people don't expect their loved ones to ever die of natural causes? And when they do, it has to be someone else's fault?

Yes, it is exactly that bad, in a minority of families. Fortunately, it is a minority ... though a distressingly large one.

On a regular basis I encounter people who have clearly never, ever given thought to the inevitable phases of life and passage of time. Their reality is simply an ever-present NOW. I have taken care of patients whose families were just *shocked* when told that the outlook was grim for their emaciated, dusky-colored grandmother covered in decubitii and with stridorous respirations.

And yes, this is exactly the type of person who looks for fault, because things don't go their way.

[Jsvp1234]

A year later, maybe this helps you folks figure it out....if you're providing appropriate care and following the law, there should be no problem with asking questions. In addition, this goes well beyond the elderly into anyone in any facility that requires 24/7 care. The assisted living facilities that aren't willing to provide answers via records, medication authorizations and questionable moves from nursing homes to assisted living with serious symptoms unresolved, need to be questioned ... By the way, the story goes well beyond this thread. Stay tuned.... Minnesota Woman Wants New State Law to Hold Doctors Accountable | KSTP TV - Minneapolis and St. Paul