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Question
Posted by: Liz | 2008/01/15

Triage and neglect

Good Morning, Cyber Doc. My father who lives in England alone (age 84) had a fall in his flat and was only found 3 days later by which time he was chronically dehydrated and the police had to break the door down to get to him. He was taken to Emergency where he became part of the triage system and it was seven and a half hours before he was admitted to the ward. Blood tests revealed a urinary tract infection but nothing else. He had no broken bones and they did a scan to make sure he hadn't suffered any bleeds to the brain. He was extremely confused which they put down to dehydration. Since being admitted two and a half months ago, he has deteriorated and is now incontinent, has no mobility and almost doesn't recognise his own daughters voice ~ the cognitive damage is horrendous. During his first week in hospital I spoke to him 3 times and he was very lucid even though confused. Why has he deteriorated so quickly? Why have they not found anything wrong with him and have no answers for me? Is it possible that he was neglected in the triage system? My father was fine and now he is not. We have such a close relationship (he phoned me every Monday and I emailed him every Wed and visited once a year). He was independent and strong and his mental faculties were amazing. Apart from being devastated and battling emotionally to cope with me being here and him there alone, I am angry and looking for answers. I can't think of anything else except this. Please could you help me? I am a realist and accept that our parents get old and die and that it is difficult for "geriatrics" to recover from trauma but something is just not sitting right with me. I would appreciate your comments.

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Our expert says:
Expert ImageCyberDoc

Dear Liz
Especially babies and old people are at risk of stroke when dehydrated severely. It is difficult for me to guess why he deteriorated, he may have had mini strokes, or suffered renal damage causing abnormal electrolytes in the blood that can cause disorientation ( presenting as dementia or delirium). This can also be caused by medications as side effects.
see http://www.nlm.nih.gov/medlineplus/ency/article/000740.htm
Is it possible to speak to the doctor that treats him at the moment?
dr Bets

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