My dad was staying with us until his new assisted living apartment was ready. He's had some weakness in his right leg for months now but did ok with his walker.
Suddenly last Thursday, he couldn't lift his leg at all. We took him to the ER. They admitted him, and at ran some blood tests. His White Blood Cell count was up, so they looked for an infection.
But then I stopped hearing from any doctors. I would go to hospital to see him and no one would be there to talk with me. I left my cell phone number but no one would call.
They ran more tests and came across an enzyme elevated, saying he had a heart attack. But I literally took him to cardiologist five days ago, he had an echocardiogram, and they said everything looked good with his heart. Hospital ran repeat echo and EKG, everything is normal. I asked if there could be another cause of elevated Isopropin? Yes, they said, but it's not typical. So they put him in cardio unit on statins and drugs for high blood pressure.
My dad consistently has lower blood pressure, so I protested to no avail. Latest blood tests show anemia.
Finally, today I insisted on talking to doctor. He sits down with me and says to me:
"Your dad is 88-years old, he's circling the drain. What do you want me to do? It's not worth it to try and treat him."
I was horrified.
I asked to speak to Social Case Worker and she said "this is above my pay grade." I asked if we could transfer him to different hospital. She says no. She says the only way they'll release him is to go to Skilled Nursing, aka Nursing home.
What can I do?
I want to be an advocate for my dad. He still enjoys life, has some memory loss, but doc said mild cognitive impairment for his age, not Alzheimer's.
I am so upset about this, I could just cry.
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If you know anything about prednisone, you can not stop it cold Turkey. It can cause huge problems with your adrenal glands, your blood sugar and yes, your heart.
I found out today that they did not give him his prednisone the last five days. I also found out that in fact he had no heart issues when we brought him in because they tested the tropinin at the ER and it was negative. It was only after two days with no prednisone, he had the heart attack.
I could cry that I ever took him there. Not only did they not help him at all, they actually harmed him.
It’s awful. And unfortunately often, hospitals do such things: not giving the medicine; other negligent things. It’s such a risk to go to the hospital. Sometimes they just don’t care enough, even when the records are clear: you MUST give this medicine.
I hope your Dad will be OK.
The most common evidence, however, for elevation is, they are correct, a heart attack.
You have a hard time believing that because your Dad had recent exam with no evidence of heart problems. But, sadly, the truth is that you can have a PERFECT EXAM, walk out the door 5 minutes later, and suffer a heart attack.
So let us assume the doctors are correct. There is a heart attack. The EKG is looking OK so there are no rhythm abnormalities. There is no good science for indication that an 88 year old have invasive procedures such as cardiac catheterization, because if there are blockages, the surgery to correct them could be very dangerous for an elder of this age. Expect them to do an ultrasound of the heart for indications of possible blockages.
As the doctors said to my own Dad at 92 when his anemia showed up "Would you treat any leukemias or lymphomas we might find if we ran further tests?" My father said he would not. Further tests were not done. He lived for another four years after that.
I find it interesting that you found in one hospital a doctor rude enough to use the phrase "circling the drain" and a Social Worker who said "above my pay grade", but you have perhaps stumbled upon Rude General Hospital here. And sadly, the truth is that your father has had a heart attack. Hospitals do not put patients on blood pressure meds to lower pressure in someone with already low pressure, so know that Dad's pressure is being constantly monitored now, and perhaps something is misunderstood in all of that.
I am certain, as they are sharing information with you, that you are MPOA? The thing now is that your father IS being treated with medication, rest and monitoring. This IS the treatment for a heart attack. He is being watched. He is, as was observed so rudely, of an age. This fact means he is more at risk, and that even TREATMENTS may be deadly for him.
If you are Medical POA you need to be aware that anything might happen and you may need to decide whether you wish heroic measures done or not. I hope that the advance directive has been done and is in the record.
So now you are in the land of wait-and-see. That is where you would be with a much younger man with these conditions as well. And contrary to common supposition, a VERY young man with a heart attack is much more likely to die than an elder, for he has not yet had years to grow a periphery of vascular routes to carry blood in the case of injury to the heart from a heart attack.
If you want further testing done to try to ascertain the reason for anemia then do tell the doctor that. I would also tell the doctor that due to his inappropriate rudeness you would like to record him as you speak. Pull out your phone, set for record, and do record his responses. If you are afraid to say that, then tell him you need to record it because you are distressed and finding your anxiety makes it difficult to hear, and you would like to go back to listen later.
I am sorry you are receiving rude treatment, but your father is receiving treatment, monitoring and care and rest and watching, it sounds to me.
You should, once your father is released and you are able to gather yourself, write to the hospital administration regarding the rude remarks directed at you when you are quite naturally and rightly in dire distress over your father's illness.
Do know that I, as an RN, when I had cancer, chose the rudest doctor in our hospital to do my mastectomy. That's because I knew him to be the best. I hope your rude doc is a great physician as well.
I wish you and your Dad the very very best. Holding him in my heart and hoping for his healing. Hoping against hope that the RNs are kind and helpful to you.
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I'm with IsThisRealyReal; raise the roof in that hospital w/o using foul language. Make SURE your father is treated and that a complaint is filed at the highest level, and both the doctor and the SW are reported for their inappropriate behavior. Once a complaint is filed, action MUST be taken on the part of the hospital administration, I found out when I filed a complaint myself on behalf of my DH who was almost killed by an ER doc who refused to do a heart catheter on him.
These days especially, if Covid isn't involved and the hospital can't get $100K for killing the patient and putting down the cause of death as Covid, they want the patient OUT the door asap, especially if they're elderly. My Uncle George is 102 soon; what if your dad's doc told HIM he was 'circling the drain' 14 years ago when he was in the hospital?
I'm sorry you're going through such a bad experience at this horrible hospital, and hope you get a resolution that helps both you and your dad IMMEDIATELY.
If you know the entire prognosis, is it something that he can recover from, and if he does recover, will he have the quality of life he wants?
I say all this as I had a similar situation with my Dad, but when the hospital discussed the treatment, I knew it was something he wouldn't want to do. To treat him would have meant very invasive actions and he would have never recovered with any quality of life.
It was a very hard decision, but I moved him to hospice so all of us could be out of the hospital and in a more caring environment.
I don't know your situation, but I think the first step is totally understanding the issues, what treatment may be available, and the outcome. If he has health directives, I would follow them.
in ops case, I thought that maybe the dad might have a lymphoma or leukemia given the blood derangements. Treatment remains a viable option for many in their 80s.
The problem is not that doctors are saying treatment is futile, what they are implying is that diagnosis is futile. SO, op, I suggest you ask this hospital for a referral and a transfer to the closest teaching hospital to facilitate the diagnosis.
I have been told twice in the past 2 years that my mother is likely to die imminently. This was in the hospital. She was released to palliative care at SN. Then she was removed from it. She is not in great shape but she defies the odds.
I am sorry you were spoken to in that manner. We all have our unique scenarios. To be perfectly honest there are many residents at the SN facility my mother is in that make one or at least me question the purpose of life at the stage they are in. I hope you find the care your father and you search for and need.
They oversee Quality of Care concerns for Medicare recipients. You can file a complaint with them and they reach out to the hospital and/or doctor's office and give them a set timeline to respond. I think their complaints factor in to a hospital's funding, so it definitely raises the alarms with the admin staff there.
I came across this article while looking for information. It can give you more information on how to go about it than I know. Best of luck!
https://health.usnews.com/health-care/patient-advice/articles/where-do-you-turn-when-you-want-a-hospital-transfer
I had a horse's azz hospitalist basically wash his hands on my dad and I went straight to the administrators office with the biggest attitude you have ever seen. They had like 12 people in his room finding out what was going on and how to settle me down. I made it clear I would sue every individual and the hospital and their board of directors if my dad wasn't treated.
They would have let him die if I hadn't went straight to the top. I did give them 3 days to prove they were actually treating him before I went over everyone's head though, because I couldn't believe that they would not do their jobs but, they proved me wrong.
Keep your temper in check, it's okay to appear upset, you just can't yell or use vile language. Be firm and persistent with demanding to speak to the head honcho, NOW! Because you will be doing everything in your power to protect your dad and others from this type of medical neglect.
Call the hospital you want him transferred to and find out how to move him. You can absolutely do this and a good hospital will help you move him.
Then get stomping mad, phone that Hospital & ask for the most senior staff on Dad's ward, keep working your way up until you are heard. Transfer to another hospital sounds like a good plan.
Let us know how you get on.