Posted on 04/07/2005 2:59:57 AM PDT by schmelvin
http://www.merck.com/mrkshared/mm_geriatrics/sec5/ch40.jsp
Section 5. Delirium and Dementia
this section includes
Chapter 38. Mental Status Examination | Chapter 39. Delirium | Chapter 40. Dementia | Chapter 41. Behavior Disorders in Dementia (snip)
"The most common symptom in early dementia is diminished short-term memory. Patients repeatedly ask the same questions, often after only a few minutes, or forget where belongings were placed. The inability to locate belongings may lead to paranoia that they were stolen.
Word-finding becomes difficult; patients may forget a specific word and use elaborate circumlocution to compensate (eg, a necktie may be called "that thing around the collar"). Formerly mastered activities of daily living (eg, driving, handling finances, housekeeping) may also become difficult. A change in the level of functioning is key to diagnosis.
Other symptoms of early dementia include personality changes, emotional lability, and poor judgment. Family members may report that the patient is "not acting like himself" or is doing uncharacteristic things (eg, a miserly widower gives thousands of dollars to a questionable charity). Mood swings, including depression and euphoria, commonly occur. Although early dementia usually does not affect sociability, patients may become increasingly irritable, hostile, and agitated, especially in circumstances in which they are confronted with their cognitive impairment."
Miss Mae had a housekeeper who drove her to the beauty parlour, she understood her limitations. Her diagnosis of 'dementia' is suspect IMO, Miss Mae's misfortune was her heart condition, which is now being treated.
I have read the WMD documents that were linked here previously.
You are correct as far as what is stated on Pg 7. This is the initial Order which states that based on "review" of the petitioner's (G-daughter)petition, the Court finds that the ward, Ora Mae Magouirk is suffering from dementia,...etc. This is what Beth "claimed"; it wasn't a proven fact at the time of being submitted to the judge on April 1st.
The FINAL ORDER is on Pg 1 of that same document. In the last paragraph of the FINDINGS OF FACT, please note that Dr.Jones "examined" Mae, filed an Evaluator's Report with the Court...."proposed ward was incapacitated by reason of mental disability..." He does not say all the things that Beth claimed. The Court's FINAL ORDER, based on the "medical" facts presented, not heresay, was signed on April 4th.
Based on the FINAL ORDER, I accept "mental disability" over presumed dementia as to cause of Mae's medical condition.
I guess my question is, has Mae objected?
There have been alot of claims that Mae's lack of lucidy was only the result of the alleged hospice care. Too much morphine and not enough food and water. That has presumably been reversed at UAB and I anticipate a lucid Mae to emerge soon, if what those claimants say is true. The time of reckoning is near, one way or the other.
"mental dislability" sounds like a very convenient term that has absolutely no medical basis.
On has to admit that "the claimants" (and Ken) have been proven correct that Mae was not terminal. Three out of four doctors agree.
As to Mae's lucidity, a petition for guardianship wasn't filed until April 1, so we have to assume that Mae was lucid before she was admitted to the hospital on, I think, March 22. Otherwise Gaddy would have had cause to petition the court for guardianship sooner.
As between "terminal or not" and "lucidity," the question of terminal is the more important one.
The old woman is accusing me of stealing money from her checking account so therefor she must be crazy! LOL!
I wouldn't make that comment if I hadn't been through a similar family situation myself. My husband's father, aged 90, accused his eldest daughter of the same, he was in a nursing home, and after he died, the money in his bank account had totally disappeared. Yep, the old man was crazy all right. Crazy enough to realize he was being robbed.
I figure it's a broad term that may have any one of a number of underlying medical diagnoses. E.g., schizophrenia, delusional, dementia, etc. The idea being that some people aren't legally qualified to look after their own interests. Ironically, a person with suicidal tendencies might be mentally disabled. Stroke vicitims and head trauma victims likely fit in there too.
I agree. I think that Mae's condition at the time Dr. Jones examined her may have been due to her original weaken state at the time she was transfered from the hospital to hospice (she could have been medicated at the hospital).
Then there was probably further decrease in her ability to appear lucid and coherent after her 9 days at hospice; maybe more drugs and lack of nutrition/hydration. If it's true that her attending physican had the desire to just let her die, then she was probably not receiving substance; either by mouth or by tube. If she was only getting small quantities of jello and a few ice chips...her brain wasn't getting sufficient fuel to funciton properly. Just my opinion...to many things not yet provided as fact.
I wouldn't jump to that conclusion. The court order did not distinguish between terminal and receiving treatment. Many terminal cancer patients still go through intense treatments to prolong their life although the outcome is clear. It's just a matter of time and it may be the same for Mae.
I'll give you that there is time to try alternative treatments. If it keeps the flack off the doctors' backs, I'm sure they are all for it. Those doctors saw what happened in the Schiavo case, why get involved in all that?
And I've got a dozen stories of senile old geezers hiding money from themselves that they can't find. They claim it was stolen.
Mae's doctor said she was suffering from dementia, according to Gaddy. Ask him if he did or didn't say that.
Are you unhappy? Does life not seem worth living, not worth the struggle? Everything looks dark and gray? Can't be bothered to get up in the morning? How long have you felt this way? Six months! Good heavens, IT'S CHRONIC! You are Depressed! Depression is a Mental Illness! The mentally ill are not capable of controlling their own affairs, they need a court appointed guardian! Sign here. Who's next?
It ist VERBOTEN to be less than 'average' LOL!
No. But the doctors' diagnosis and prescribed treatment did. She wasn't terminal when admitted to hospice. Her dissection was not immediately life threatening.
Many terminal cancer patients still go through intense treatments to prolong their life although the outcome is clear. It's just a matter of time and it may be the same for Mae.
We're all gonna die!!!! Aieeeee!!!!!!
I'll give you that there is time to try alternative treatments. If it keeps the flack off the doctors' backs, I'm sure they are all for it. Those doctors saw what happened in the Schiavo case, why get involved in all that?
Yeah. If Ken had just kept this a quiet family matter, everything would have worked out sooner. At any rate, the doctors had to get involved. They were bound by a court order. They were not bound to find Mae's condition to be treatable. They could have found her terminal and vindicated Gaddy, Dr. Stoudt, and hospice.
Was doing some research on opinions and programs for "dying"
Once they can diagnose someone with dementia- the writing is on the wall. I am not a doctor, but I picture someone on lots of drugs responding much in the same way I picture someone suffering from dementia!
Here is a snip:
The team conducted a retrospective cohort study of patients with advanced dementia admitted to all Medicare- and Medicaid-certified nursing facilities in New York (derivation cohort, n = 6799) and Michigan (validation cohort, n = 4631) during 1994-1998 and 1998-2000, respectively.
A mortality risk score based on 12 MDS factors associated with 6-month mortality risk identified in the derivation cohort was evaluated in the validation cohort. Six categories of risk of mortality within 6 months were calculated. The authors provide within their report a score sheet for estimating 6-month prognosis and stratifying patients into levels of risk.
http://www.thehospice.org/phys.htm
This may be the key used by doctors. Diagnose dementia and boom- into Hospice you go!
Also- I found it interesting that the study was done at places funded by Medicaid and same type programs. I mean privatley paid care I am sure is better- so the results may be MUCH different. I will continue research on this....
also-- the Hospice where Terri died is funded (at least in part) by Medicaid:
How is Payment Provided for Medications?
Hospice receives a per diem fixed rate from Medicare, Medicaid or private insurance company to assume responsibility for providing related medications and all other services.
http://www.thehospice.org/phys06.htm
I guess we can't agree on what terminal is. You seem to think that it means that death is right around the corner. I was thinking it was closer to six months like the hospice guidelines dictate.
Being old and little forgetful is perfectly normal. The term 'senile old geezers' is offensive. Are you planning to live long enough to become one yourself?
Grow a skin. I am a senile old geezer...and I like it.
I think you have at least tried to be fair, level-headed, and honest on this thread. You've asked some reasonable questions and have refrained from getting ugly when you disagree with others.
Re: Your comment about this thread's title:
I took great care in selecting the title of this thread. I did not want to misrepresent the situation, but I also needed to get the right people to take notice. I needed to get this thread posted in the "Latest News on Terri Schiavo" section to keep it from being overlooked and getting buried. I also was careful to comment that I did not know if this was true or a hoax and then began investigating the allegations as soon as I could. Other FReepers joined in and immediately began investigating the matter as well.
It was not easy getting information regarding this case, especially in the beginning. We did what we could, with the information we had, the best way we knew how, and with the very best of intentions. Much more information has been coming out in the aftermath; information that we could've only known back then if we'd all had crystal balls that enabled us to see the future. Some people are now attempting to criticize us based on their interpretation of court documents that none of us had access to until recently.
Where were these critics during our early information gathering stage? If they knew so many concrete facts, why didn't they tell us? It's because they didn't know, and they didn't care enough to find out. Some voiced their early obections based on nothing but their own preconceived notions and willful ignorance, allowed others to do all the work and information gathering for them, and then came back later to play 20/20 hindsight gods of omniscience based on their biased interpretation of the facts we are all now privy to.
Here are some facts:
* Beth Gaddy knew that Mae's condition could be treated successfully at UAB, but fought tooth and nail to keep Mae in that hopice.
* Mae arrived at UAB severly dehydrated and malnourished.
* Beth Gaddy will not allow any family members to visit Mae at UAB.
* Beth Gaddy cannot be reached for comment.
Please, explain to me how any reasonable person can be expected to believe that Ken is the bad guy in this situation and Gaddy is the loving devoted granddaughter?
I read those court documents. This is not just a case of Ken's word against Beth's . Buddy and Lonnie's sworn statements back up everything that Ken is saying. It was Buddy and Lonnie who asked Ken to become involved after they became concerned that the doctors were dragging their feet while Mae was being denied proper medical care, adequate nutrition, and adequate hydration. How does this make Ken the bad guy?
If Ken had been a Republican instead of a Democrat, would he then be considered a good guy? Do petty politics now matter more to us than the principles we hold most dear? Should we ignore a desperate plea to save the life of an innocent woman, because that plea came from the mouth of an icky, icky Democrat? Is that what we've come to?
"Terminal" is always related to an underlying medical condition. It doesn't exist in isolation. Are you asserting that Mae has a medical condition with a prognosis of "terminal?"
You seem to think that it means that death is right around the corner. I was thinking it was closer to six months like the hospice guidelines dictate.
"Terminal" is always related to an underlying medical condition. The prognosis of terminal usually has a time component associated with it. Admission to hospice requires TWO things. A prognosis of terminal, and an estimated time to demise of 6 months or less.
"Like the hospice guidelines dictate"
Thanks but no thanks. I wouldn't want my doctor to admit me to a facility where my survival depended upon 'hospice guideline dictates'. Would you?
ROF (I think ??)
Do you think that with Mae's estate estimated at a value of over $200K, she might have had valid concerns about Beth dipping into the kitty. Could be why Beth wants gramma to go home to Jesus! Mae should rescind that POA like yesterday! And Ken should petition the Court to amend or set a "limit" on Beth's financial ability granted on that Final Order. She could wipe out Mae's assets before the family or Mae could stop her....just an opinion.
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