Does the hospital have any responsibility when dealing with a dementia patient?

The first thing you do when you take someone with dementia into a hospital is put that notice on their charting with the triage nurse. Then show them your medical power of attorney. The hospital will still not correctly access the patient especially when the nurses come in and ask how they are feeling. My husband always says, "Fine", then when I arrive he tells me the real story. Beware of hospitals, yes even the ones with awards who want to do all kinds of testing and keep the patient in. I have removed my husband twice and he is still alive and nothing untoward happened to him when I removed him "AMA". They know I'm a nurse and just had me sign several papers stating I knew I was taking him out. Of course I knew it!

In my experience, hospitals, even highly rated hospitals that win national awards, have zero to very little understanding of how to deal with dementia patients.

The hospital has now locked the barn after the horses are out. That is good. But you are wondering about legal action against the mistakes of not hooking up the bed alarm and giving therapy without knowing the nature of the injury. I am not generally in favor of suing over every mistake any business makes. But the total lack of dementia understanding drives me nuts. If a stream of letter of lawyers would get their attention, I'm in favor of it. I don't know if you'd have a case -- a lawyer could tell you that -- but if you do decide to proceed, keep us informed about how it goes.

Besides putting someone in her room, what did the admin and investigator say?

My mother has dementia and had to be taken to the hospital via ambulance after she fell in her home. She was x-rayed and no broken bones or tears were found. A bed alarm was put in her bed at the hospital. My brother stayed with my mom overnight and alerted the nurse that he was leaving to go put up our dad and ring him back to the hospital, and asked the nurse to watch out for our mother. I got a call 6:30 am saying my mom had fallen on the floor. The nurse forgot to put the bed alarm in the bed. X-rays and a ct scan was taken again. They showed nothing. I had been asking for an MRI to be done since she arrived in the hospital. My mother was in even more pain after she fell in the hospital. Finally, 9 days later the MRI done and revealed she had a broken collar bone and a torn rotator cuff. The hospital had been giving her therapy on her arm and did not know the extent of the damage. I met with the hospital investigator and administrators, and they have now put a nurse tech in her room.I do not have POA. What should I do about this situation? Should I get a lawyer? We live in the state of VA. Thank you.

When Reagan was in office, he closed the mental hospitals
--which meant lots of inmates became homeless--street-people.
It has not changed much since.
Facilities play the "hot potato" game, trying to empty beds as fast as possible, and dump any patients who cannot pay or have no discernible insurance. Happens all the time.
Those patients who are confused, either from dementias of some sort, or from illness, are easy targets.
Laws get made to try to prevent it, but it still happens.
Facilities LIE on charting, to cover themselves--from leaving out notes about the actual condition, changing vital signs that indicate a problem, ignoring adverse reactions to medications, mistakes made, etc. .
Not much can be done about that, as far as I know.

Newer charting has removed as much descriptive charting as possible
--only charting vital signs and tests, and assigning scales for pain, awareness, etc.
30 years ago, nurses sometimes got asked to change charting--do-overs--
if the Charge nurse thot the charting reflected badly on the hospital, they'd demand the nurse on one shift re-chart notes to make things look better for the hospital [Kaiser Hospitals]--to the extreme of having a 24-hour/3 shifts all change their notes.
Big Corporations have gotten laws passed to protect themselves from litigation--they do not want to pay restitution or damages--these newer laws protect them, not people.
Our regulatory agencies [EPA, FDA, etc.] have chemical company execs placed onto their governance, which means, those "protection agencies", formed to protect consumers, now are run by the very corporations we need protected from.
It is up to all of us to be the very best advocates we can possibly be, and train our kids to do so, too.
Otherwise, we might as well "go sit on the iceberg & wait for the polar bear to get us"--oh. wait....those are all melting, & polar bears are threatened with extinction...darn--might have to go out and wait for a grizzly bear to get us..!

Chimonger, that was aweful. They try to do my dad that way last year n y'all had told me that they cannot just release him on his own with alcohol dementia. I was in Fl at the time n I threaten to call the local news people if I saw my dad out in the rain from being release without a family member. I guess because he had no insurance but Medicare A n at the time they didn't know if he had that either for we didn't know us children. Us children had to stand up against them n the stupid social worker at the hospital. We finally got the sw to help find a rehab center for him for he couldn't walk on his own for being too weak! Finally, the sw guided us to apply for Medicaid for him n she found a rehab not to far away. However, if we didn't stand up n make threats, I think my dad would be out on the street somewhere today. Sad how this can be allowed to happen n not be notice by the government or whomever suppose to check for the safety of the people.

My husband, who has dementia and Parkinsonism, has been hospitalized 4 times in the last 2 years, twice for neurosurgery and twice for the effects of a UTI. Each time, a 1:1 aide was ordered by the doctor in order to ensure that my husband would not get up on his own and fall. However, if it weren't for the fact that he has a Parkinson's gait and is therefore at high risk for falls (with their concern about their own liability), I don't think they would have ordered this service (which Medicare paid for).

YES!
The hospital does have responsibility to care for patient, not just shove them out the door to make room.
Turning a patient out the door like that, comes under the "patient abandonmeent" laws.
UNfortunately, this happens frequently, not only to patients who are mentally compromised, but those who are just darn sick, and the hospital needs a bed.

One client I had, was ambulanced to ER, sent home on her own unbalanced devices, then the hospital, instead of contacting family [they knew them], to bring her back in [hosp. had failed to check med levels properly],
the hosp. sent 2nd ambulance to bring her back into the ER.
There was no need to use 2nd ambulance.
AND, they tried to bill her for it later.
Then, they wanted to make Medicare pay for it, even though it was the hospital's screw ups in several ways.
All I managed to assure, was the patient didn't have to pay that 2nd bill.
The hospital in Centralia, WA is notorious for strange treatment of patients.
IMHO, I wouldn't send a dog to that place--major mess-ups have happened far too often in the last 10+ years, to consider them safe to even put on a bandaid.

I agree with Ferris for it was the hospital staff era and they should had notify someone before just dumping her off without her having any supervision knowing she has AD. You are so lucky that she didn't walk out the door n got loss or try to cook something. I really would check those attorney notes n some! Thankfully, she is alright.

It is unbelievable but so true what is going on with our sick loved ones. I too have experienced some grave errors done with my father that I could fill this room with. You must stay on top of things as some will take advantage of a patient when they are at their weakest moment. It is unreal what I have seen in the last few months. I stand tall for my father and I say cut the chase with all the BS and get right down to bare facts. Use a tape recorder if you have to in the doctors visit. You can ask if they do not mind. There you will have proof of what was said and done. I can not believe they would send anyone home to an empty house in this situation and yes I would consult with legal counsel about this. I also understand doctors, hospitals and nurses are overwhelmed but they also take an oath to do what is right by their patients. After reading some of these things I know I am not alone with my own story. It is sad too. What has happened to the compassion for our elders and the care that was there many years ago? It makes me stop and think for a minute about all of this. Know you are not alone and you talk to the patient advocate and make sure you take your notes and it is documented what happened. This should never have happened. I wish the best for all of you and stay on top of things. Without family around it makes you wonder what goes on behind closed doors.....I am a fighter when it comes to the care that my father is getting and while I do not make any idle threats I know who to go to and I will do just that. You have to protect them at all times and at all cost. You are doing the right thing! God Bless.

thank you ferris1... that's what i was looking for... risk management. thank you so much!

Not knowing all the facts, but it sounds like hospital staff erred. Whenever there is a court-appointed attorney, patient has dementia, and it was told to staff, then a documentation of such provisions should have been charted. Call risk management at the hospital and demand to see the nurse's chart notes as to what the attorney's instructions were about releasing your mother. In any event, I am glad your mom made it home all right, but she should not be on her own. In the future, attorney for her should not leave her alone so this cannot happen again.

My mother has dementia but it's been awhile coming. Whenever she was hospitalized, I stayed overnight and supervised that she was getting the right kind of attention. Luckily, the hospital she stayed at was accommodating in everything and also honored the POA that I have. I still have my job, however, so far my employers have been understanding with it when I had to come in later in the day. I do find that night shifts don't give the same attention because they are more prone to believing that the patient is sleeping most of the time. But patients with dementia don't think about this when they get up at night to go to the bathroom even if the patient is able to get about.

First, I'd make sure the POA knows that he's to avoid hospitals in the future. Flu-like symptoms should be treated in a doctor's office if at all possible. We are so conditions to the 'test and treat' mentality that I think we lose sight of the forest for the trees. As 'Braida' points out, "hospitals are not safe places for our dementia loved ones." I'd go a step further; they're not only not safe, they are harmful. Palliative care (which is what is needed for a person with advanced dementia) is the opposite of what hospitals are all about, so enter with extreme caution and question the long range goal of any tests or treatments.

Hi Quagmire. I really feel for you going through a nightmare situation of trying to care for and protect someone who thinks of you as the enemy!! I take it she is like this with everyone....even her attorney?? How terrible, and what on earth will happen when she can't live alone anymore, and needs more help to survive? Sounds like you describe it.....a nightmare. What the hospital did in releasing her on her own is outrageous. Like many of the posts said, many of the hospitals just don't care much about the elderly person w/ dementia. They're a burden to the staff, and they want them out of there ASAP. Not only do they have to tend to the physical needs, but struggle with the patient's constant confustion, and inability to understand what's happening. I find it to be extremely aggravating. Even taking my Mom to for her opthamology appointments every month for injections to control macular degeneration is an ordeal. The staff/assistants are very impatient and abrupt with my Mom. They treat her like she's a moron, and speak curtly to her, telling her to do what they want her to do....like she should know and understand. It infuriates me, but it's the only place in town to take her for these injections. Anyway, I just wanted to say, best of luck to you now, and down the road, with the hurdles that lie in front of all of us!! But even moreso with you, I think, with your Mom's particular kind of dementia. With others, they can be with the parent, 24/7, in a hospital stay or even with scheduled test appointments. (which is absolutely necessary, otherwise it would be like leaving a two year old to fend for himself.) Believe me, no matter what you tell the hospital staff, they are too understaffed and quite honestly don't really care enough....it's NOT their loved one, and their job isn't to watch over people who can't think. So unless you hire someone to sit with your loved one all the time if you or a family member can't be there....God only knows what can occur. Sad, but totally true. Hospitals are not safe places for our dementia loved ones, but they're a necessary evil. :-/

my mother has been fully conserved, both person and estate, and has a court appointed attorney to serve in that capacity. while EvaLynn Pearl's advice is very good it is not practical in our case, and the mere sight of anyone in the family sends her into an uncontrollable rage. sounds dramatic but it is true. her attorney has done many of the things listed, but my mother lives alone and when left to her own devices, hides everything she gets her hands on because of the paranoia. frontotemporal dementia is a rare form of dementia with some unique characteristics, it took 3 years to get her diagnosed. she can be very convincing that she is a victim one moment, and a raging wild person the next.
again, that you for your suggestions.

It is sad to say and to think of all the thousands of elderly people who don't have a person to be their Care Giver or POA. My mother is going through the 2nd stage of dementia, at times she finds it hard to say words that she is thinking. At this time she is still very capable of living in an apartment by herself and to take care of herself. The 1st and 3rd Wednesday of each month I take her to do her errands. My husband and I three years ago hired a "Health Care Whisperer" for my mother.
Your loved one's PCP should of had your name and information on file for contacting you. What I would also like to suggest is that make you badge for your loved one with all the important contact information including meds that cause an elergic reaction. This badge should be worn at all times and one should be kept by the entry door to their home or apartment. When it comes to my mother receiving proper care in the hospital, everyone in the hospital including my mother's PCP knows we mean business. When you have a loved one regardless of their age, it is extremely important that you have legal documents stating you are that individual's POA. It is also extremely important that you have a complete list of all meds and times they are to be taking by that person. It is a general rule that a hospital will not allow a patient to provide their own meds during a stay in a hospital. It is also extremely important, if you can do so, to stay with the person 7/24 while that individual is in the hospital. When you are assigned as the POA, you do have the power to say and do what needs to be done for that patient. All the Drs., nurses, and employees don't have the right to say, "We don't have time to give your individual loved one time and care that they need. We have too many other patients who need our attention too." Nope! If you are the POA, you have every right to make sure your loved one receives proper care. Because there are so many elderly people in our world today, most businesses have become very understanding about an employee needing time off to take care of a person in the hospital. If a person doesn't have a car to take them to the hospital on emergency basis either for themself or to go to a loved one, make a phone call and have a taxi pick you up and take you there. It is a general rule that before a person checks into a hospital for medical care, the question is always asked, "Will a person be taking the patient home and staying with them during the recovery period?". Normally a hospital will not release a patient if they don't have a person to take care of them during this time. If the hospital and your loved one's PCP had all the important information to contact you or a member of the family, both of them are at fault for allowing this unfortunate situation to happen. If you covered all your steps in this matter, you do have your rights. Please take my information to heart. I take great concern for all the elderly people in our world. I hope this situation never happens to you or your loved one again. God, please help take care of this person and help guide her through the rest of her life. I speak on your behalf as a professional Care Giver for the elderly. Thank you.

Yes, the hospital does have a responsibility and what they did was terrible. My husband has dementia and Parkinsonism. I was told that I had to stay with him in the ER while he waited for a room to be available (for 20 hours!) because the ER staff did not feel that they could ensure his safety. Once on the floor, I requested a 1:1 aide since my husband is likely to get out of bed and fall if he isn't watched constantly. The hospital was reluctant until I made it clear that they would be held legally liable if he got up and hurt himself after they had been warned of the risk. I have POA but have found that the only way to get the hospital to behave responsibly is to make it clear that I will hold them liable if they do not do everything necessary to ensure my husband's safety.

I feel ya quagmire. My MIL broke her hip last week and we had such a struggle with the hospital regarding her being an incapacitated person. We went to admitting -sealed guardianship in hand- and carefully explained that MIL was incapacitated and could not sign ANYTHING. Sure, sure, sure. They made a copy.

This meant nothing to anyone. We had to explain over and over to all parties that she could not sign ANYTHING. Still they tried to get her to sign the release for surgery when my husband went for coffee and I was in the rest room!

After surgery the floor charge nurse refused to give us information on MIL's potassium and creatinine numbers. Told us we didn't have POA! Can you believe it? My husband had to explain to her that his guardianship carried more weight.

You could tell she didn't believe him and she explained back to him what he really needed was MPOA.

We couldn't leave her for a moment as no one understood the meaning of incapacitated or guardianship.

I am not looking to sue anyone, I am trying to understand how this could happen. My mother has completely alienated herself for the entire family, and has built an elaborate story in her head that my husband and i are trying to kill her, steal from her, want to poison her, etc. The mere sight of us sets her off on an uncontrollable tantrum which makes it difficult when dealing with any kind of medical situation. We have since learned from a neighbor, that she was sent home with medication and instructions as well. It's very disturbing to think that doing this can be permissible. Thank you for your responses. I am very happy to find this forum, as we have been dealing with this for the past 8 years with little or not help from local authorities, state authorities, medical arena, APS, or the police. It is a living nightmare.

We recently had a similar experience. My mother-in-law who is eighty-four, legally blind with dementia was in need of a test in the hospital. As we entered the hospital, the wheelchairs were in disrepair. My husband (POA) escorted her to the test and was asked to wait in a specific waiting room and the test would only take 20 minutes. Well, an hour 1/2 later, he went to check and the technician said they had to take her for an additional test (without his knowledge); at this point he was okay with the additional test, however, once again he stayed longer than anticipated. When he asked the 2nd time, he was told they left her in the waiting room which was totally different. She was frightened, confused and truly distraught over the entire ordeal which was told would only take 25 minutes.

Solution for us was to write the hospital with a letter of our dissatisfaction and they replied with a letter of apology and solutions to this problem. One solution was to properly name the waiting rooms and two to repair the wheel chairs. It is not in our nature to sue someone for a misunderstanding, however, a professional response was in order. We were satisfied in knowing that hopefully we have improved a process for future patients.

In Wisconsin they have to be deemed incomptetant by 2 Dr.'s before the family can get power of attorney. At least that is what our experience is. They have rights that prevent you from helping them. Good luck. And yes prsimon is right about asking your atty that question.

Ask your attorney that question. What is morally and socially appropriate and expected may not always be legally required.

yes they do, I would sue, my mom with dementia was taken by ambulence after a fall and admitted to the hospital, I am her daughter and poa, I did not go this time as I do not drive and could not find anyone to bring me home, after she arrived back home, I recevied a bill for 1500 dollars for meds after i had sent all her meds with her, they said they could not give her own as that would cause them liabily, i told them i would not pay that bill, i got the runaround, they said she signed that it was ok, i told them she had dementia and they knew it and knew as they had a copy of the poa, I threatned with law suit as her signature was not legal do to the dementia, so after gettting the runaround, i finally won and they wrote off the bill