How My Father Died
Note: This is a non-A.D.D. related post about the recent death of my father.
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Before I explain how my father died, it is important that we first do our "amens" and "hallelujahs."
This is the greatest country in the world. Now you say "Amen."
Americans are the smartest people on Earth. Again, you say "Amen."
We have the best health care system in the world. Let me hear you say "Hallelujah!"
Now…let the story begin.
On January 4, 2008, my father was admitted to a nursing home in Florida. Some time during the previous month he had a small stroke1 that made it impossible for him to walk ("shuffle" is a more apt description). The nursing home stay was meant to be rehabilitative so that he could learn how to walk again. The first week he was making enormous progress and then things starting to go wrong. One day he had a large gash on his nose. Another day it seemed that he was given his day medications at night which kept him awake all night long. Another time his new sneakers suddenly disappeared.
By the second week at the nursing home something was terribly wrong and he was rushed to the hospital. The doctors gave him 48 hours to live. His kidneys had stopped functioning. He had a fever and a urinary tract infection. They determined he was completely dehydrated. The hospital administered an IV drip and antibiotics. I was in constant phone contact with my brother down in Florida (I live in New York) who told me that all the funeral arrangements had been made and now they are just waiting for him to die. I made arrangements to fly down as soon as possible. By the time I got down to Florida (about 72 hours after he was admitted into the hospital) his kidneys were functioning and he was like a chatterbox, talk with everyone in the room and making jokes.
As I later found out, the nursing home had failed to keep him hydrated. Since most stroke victims have trouble swallowing2 a thickening agent is added to liquids because the stroke victim has a better chance controlling the flow of the thickened liquid so that it flows into the esophagus. At the nursing home they did not care how much thickening agent they added to the liquid. It turns out, they added so much thickening agent that my father could not drink at all. (Oh…did I forget to mention? A lot of stroke victims drink using a straw.) The gash on his nose was a result of him falling out of his wheelchair. (Ooops…someone forgot to strap him in.) Though he was diabetic, they gave him lots of orange juice (a no-no for diabetics because of its high sugar content).
After several days in Florida I flew back to New York thinking that a crisis had been averted. My father was sent to a different nursing home for rehabilitation. About a week later he was back at the hospital. His body was riddled with infections and his kidneys shut down again. The hospital put him on antibiotics and, even though he was fully hydrated, his kidneys were not functioning. It was determined that his body could not handle the stress of a dialysis machine. A DNR was signed, he was placed on a morphine drip and, after eight days, he died in his sleep around 10:40pm on the evening of February 12, 2008.
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As news of my father's death started to become common knowledge among the doctors that had known him, they were startled to hear of his death. He had a very strong heart and his kidneys had always worked fine. In fact, prior to being admitted to the nursing the first time around, he had just completed a blood test which showed that he was slightly anemic and nothing more.
My mother has been gathering up copies of all his medical records from the nursing homes and the hospital. She's contemplating a lawsuit against the first nursing home. I will leave it up to her as to whether she should or should not pursue it. I'm not sure what I would do. On the one hand you have to go on with your life, on the other you want to see some justice in an unjust world.
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To complete the circle we must end this post the way it started. Let's say our our "amens" and "hallelujahs."
This is the greatest country in the world. Now you say "Amen."
Americans are the smartest people on Earth. Again, you say "Amen."
We have the best health care system in the world. Let me hear you say "Hallelujah!"
- He's had a series of strokes over the past five years. [↩]
- The epiglottis does not function normally, thereby potentially allowing food or liquid to enter the lungs which can become a source of bacterial growth and lead to aspiration pneumonia. See: Dysphagia. See also this abstract about a study of swallowing abnormalities after a stroke. [↩]
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(On Mar 9th, 2008 at 12:35 am)
Even if you plant armed guards in every nursing home in the country, you will not solve the quality problem as long as nurses aides can make more money working with fresh vegetables and soda pop at a Taco Bell than they can make working in blood and feces at a nursing home. Get real!
The truth is that the nursing home industry provides an extraordinarily high level of compassionate, professional care for a huge number of mostly Medicaid residents in spite of the welfare program’s grossly inadequate levels of reimbursement. If nursing homes sometimes fall below that standard, the responsibility–indeed the guilt–lies principally with public policy. However well-intentioned that policy may have been, it created the quality problem by crowding out private financing of long-term care and trapping most people in institutional care inadequately financed by Medicaid.
(On Mar 9th, 2008 at 5:41 am)
First, I should state that this post was meant as a warning to others who’s parents may not yet be at the “nursing home” stage.
Second, it would seem to me that if long-term care is part of the profit-driven world, you would want to pay your labor - care-givers - as little as possible in order to maximize profit.
Interestingly we can probably agree that health care (and I include long-term care) is a “good” that all should have access to but how to deliver that good…ay, there’s the rub.
(On Mar 9th, 2008 at 4:43 am)
Wow, this is so scary. The problems in the news with MRSA infections, and with nurses using dirty syringes in hospitals, and with how bad the veterans’ health care system is, have made me really lose faith in our country’s ability to properly provide and regulate health care.
Of course it’s your Mom’s decision, but I think people in this situation should sue, because that’s the only way that the institutions will take financial hits and bad publicity and maybe clean up their acts.
I’m so sorry to hear you had to go through this….
(On Mar 9th, 2008 at 7:23 pm)
And to think we have the “best” health care system in the world…or so we are told. I have more horror stories. My father’s youngest brother went in for an operation for kidney cancer. The doctors opened him up and accidentally dropped the cancerous cells into his body cavity. They went back in and nicked his colon. He never really recovered from that one.
(On Mar 9th, 2008 at 8:42 am)
Jeff: My father died in a nursing home on May 1. He died alone. He was 83 years old. Here’s a man who came from Italy, raised a family, served in the U.S. military, paid his taxes, and never took advantage of a soul. And he died alone. He went to a nursing home in Jan. 08, and then I transferred him to a better one in New Jersey–far from the troubles of Philadelphia and its environs. Though he had a cardiac problem, it took the nursing homes only 4 months to make sure we wouldn’t have to deal with it again. How many times did he fall in those places?? I got call after call. Don’t they watch them a little bit? In the first nursing home, I mainly found the staff watching “American Idol” at night, or laughing and joking at the nurses station, or ordering food. They NEVER interacted with the patients in the compassionate, professional way that Mr. Schafer (above) claims they do. NEVER. I have been to my father’s homes 3 to 4 times a week since Jan–never less than 3 times a week. I was so mistrustful. The second nursing home wasn’t as bad. Still he died there–and quickly. In part, it was his time. In part, these places are hell holes. And incidentally, I don’t give a blow about people on medicaid. My father WASN’T on medicaid, and still got mediocre care, at best. For him, I can’t see what the nursing homes were doing that was worth $8,000 a month. The care was basically custodial. As for the people who can make more at Tacobell, that’s where they should work. Most are not going to be doing anything else in life anyway–not from what I’ve seen. The self-absorption, rudeness, loudness and other questionable behaviors (at least at the city nursing home and occasionallly in the other) were not exactly going to move these people into nice desk jobs. Maybe if people disciplined themselves to do right where they are, they could move up a little. Clearly, Mr. Schafer hasn’t had a dutiful parent die in a nursing home like a piece of refuse. His detached response about public policy is the one you usually get when people have not been in the trenches. I could go on and on about this issue. If I hadn’t been the sole caregiver, if I wasn’t also caring for a more functional mother who suffers from Alzheimer’s Disease, believe me, my father would never have lived his last days under the “compassionate, professional” care provided in nursing homes. I hope I died at the hand of a terrorist rather than in one of those places. Thanks.
(On Mar 9th, 2008 at 1:37 pm)
I realize that mine is an angry entry, and I am angry. I also wish to extend my condolences for your loss, Jeff. It’s a sad, sad end for your father, as for mine. I hope your family sues.
(On Mar 9th, 2008 at 10:01 pm)
Sandra,
Thank you for sharing that story. I understand, quite well, the depth of your anger. We can hope that, when it is our turn, we get better care than our parents did. At the minimum we will be aware of the danger signs of neglect.
And I extend my condolences to you too. I truly understand and feel your pain.