To think in this day and age nobody should have “dehydration” as a cause of death.

[Whiskyinajar]

Devastated and upset.

In January this year my 77yr old auntie was independent, car driving, walked long distances and was healthy.

In February she started feeling tired and started staying in bed lots. She and my Uncle spoke to the doctor who said she was depressed and would feel better if she got out of bed. .

My auntie has never been depressed in her life, nor was she ever someone who just laid in bed. She was in bed as she was exhausted and had weaker muscles.

She was admitted to hospital sho said she had a low sodium level and said this was causing her symptoms. They tried to address this and I have no complaints about their care at this stage. They identified an issue and gave treatment, my auntie went home. However her symptoms continued to get worse and she started to display neurological symptoms, unsteady on her feet, lurching to one side and needing a walking stick. She began to look like an old lady...and by that I mean like her late Mum when she was 94.

Symptoms got worse, she got more and more confused. She’s been in and out of hospital where they have blamed in no particular order...a urine infection, her tablets, the low sodium level and getting older.

In the last month it got so bad that she became more and more confused and sleepy. Eventually my Uncle who is registered blind had to say he couldn’t care for her any longer . She was in and out of hospital and finally went from hospital to a nursing home last week. By this point she didn’t know where she was ..she thought she was home.

By Tuesday they’d phoned my Uncle to say she was on “end of life” care.
They still had no answers as to what was causing all the symptoms.

By Wednesday she deteriorated and died.

The death certificate has been produced today.

She died from “Dehydration” , “old age” and “dementia”.

I am fuming....this woman was still driving in January and whatever has happened has left her dead and no fucker can tell us what has happened to her.

My Uncle is devastated and really upset about the death certificate, He’s contesting the death certificate and the nursing home are now saying they had no hand over so have no access to her previous records.

Can my Uncle insist on a post mortem. ...we just want some answers but it feels like there are none. How does someone go from fully independent with all their faculties to dead in nine months with no answer about why Their health has deteriorated.

If you’ve read all through thank you, I’m aware I’m ranting but I am so upset.

I bet you are. That sounds really awful. I hope you get some answers.

Dehydration is the cause of death from end of life care/liverpool pathway.

They withdraw food and water, it's legal to not provide fluids once they cannot drink but illegal to euthanise directly.

@Whiskyinajar That is awful, I'm so sorry for your loss and I hope you get answers.

It was a similar situation with my SiL. She had a fall and broke her arm and was admitted to hospital. She died 10 days later. The hospital launched an internal investigation and she was found to have been severely dehydrated. She was only 65. We were appalled.

Presume she had COVID tests? COVID has been presenting as delerium in some older patients. I'm sorry for your loss. You are entirely within your rights to want answers and to question her care. Alongside that, do grieve and remember and look after yourselves too. You can't change the outcome but you can gain understanding.

Op I’m so sorry for your loss, it all sounds very swift. No wonder you are all left shell shocked. Did anyone explain to your uncle what end of life care was?

Sadly Elsewhyre has it right sounds like Liverpool pathway

Thank you @Elsewyre

No nobody explained it to my Uncle. I’m just sat reeling a bit as we still have no answers for her rapid decline,

Tbh the nursing home did the best they could in the few days they had her and once it was obvious she was dying they bent over backwards to ensure relatives could come and spend time with her.

The doctor who certified her death had only seen her once the day before. Had never met her prior to this ...that’s not her fault as my aunt only arrived there on Monday.

Oh that's sounds awful, it does sound like theres grounds for a post mortem, I hope you get some answers

Hi @Whiskyinajar I'm really sorry for your loss.
In answer to your question yes you can insist on a postmortem and an inquest (we had to for my uncle) but it can be difficult (lots of forms,emails and phone calls) i would advise you to speak to a solicitor who can help you with it. If they have already done 1 you can get a 2nd but you would have to hire a pathologist and pay for any tests etc

@Whiskyinajar really sorry for your loss 💐

Please pursue it with the authorities! You will never forgive yourself if you don’t! 💐💐💐

How awful. I’m so sorry

What is listed that she died of is actually things that is is possible she died of, legally i am not sure if he can insist on a post mortem and if one was conducted it may just confirm what is already known

No advise OP but that sounds horrible to have been through, really hope you get an answer soon

I don’t know where you live but the Liverpool Care Pathway is outdated and frankly considered barbaric in most trusts.

Your aunt may have had vascular dementia if dementia is mentioned on death certificate. The decline from that can be shockingly quick. If your uncle isn’t happy he should absolutely take it further and the sooner the better.

Sorry for your loss OP

They identified an issue and gave treatment, my auntie went home. However her symptoms continued to get worse and she started to display neurological symptoms, unsteady on her feet, lurching to one side and needing a walking stick.

It sounds as if she developed dementia which progressed rapidly and ultimately ended in her no longer having a drive to eat of drink. It's a cruel illness that progresses quickly sometimes.

How does someone go from fully independent with all their faculties to dead in nine months with no answer about why Their health has deteriorated.

I think you should start by investing whether dementia, as entered on the death certificate, is the answer. Dementia affects all body systems, it is not just forgetfulness etc.

I am so sorry to hear of your loss. This does not sound right at all and I think a post mortem is needed.
Her symptoms sound very very similar to my father who passed 7 weeks ago. He had a Glioblastoma brain tumour. One minute he was gardening and doing DIY and the next he was falling over and could barely speak. 4 weeks after diagnosis we lost him. He was in his early 70s
Please ensure they investigate properly as care during covid has been shocking!

The decline you describe is almost exactly what happened with my Mum but she was admitted to hospital after she just couldn’t get up one morning. She’d been weak and tired for a couple of months but prior to that was unbelievably energetic and lived a full, fun life. She’d been given antidepressants by her GP and told she had muscle spasms. After hospital admission, she was diagnosed with Stage 4 kidney cancer within 24 hours and died two weeks later. Get the post-mortem if you can.

@Elsewyre

Dehydration is the cause of death from end of life care/liverpool pathway.

They withdraw food and water, it's legal to not provide fluids once they cannot drink but illegal to euthanise directly.

That sounds awful. Is that with patient/next of kin consent? Surely it's kinder to give extra painkillers rather than depriving of food and water?

@Whiskyinajar I'm so sorry about your loss.
It might be worth trying to speak to a patient advocate. They may be able to offer support.Try these people. If they don't cover your area, they'll tell you which organisation to contact.
www.theadvocacypeople.org.uk/

Low sodium can cause all of the symptoms you describe. My MIL died this year after collapsing at home. She was eventually diagnosed with lung cancer which was causing her sodium to drop. despite our best efforts we never managed to get her sodium completely back to normal and she died in a confused state. It was heartbreaking.

Sorry you’ve had such a terrible experience. Was the dementia mentioned before she died? As pp have said it can be very rapid and have significant secondary physical effects. It’s hard to watch someone you live decline so quickly, however if she was end of life rather than sudden death you may find the post mortem does not come up with any new answers, and can be a traumatic waiting period, and also delays being able to have a funeral usually which again can affect the way you are able to grieve. It sounds like she was a very loved lady, may she RIP.

My mum passed away 12 years ago when the liverpool plan started. She unfortunately had alzheimers, my mum was left in agony as the medical team withdrew her drip.

From experience, it can be a real headache getting people with dementia to drink enough fluids.

Also, when someone is nearing the end anyway they may often refuse food and drink - in any case their bodies are probably unable to process them any more. An aunt of mine who was nearing the end was regularly offered food and drink but she’d just close her mouth and turn her head away. I sat with her a lot in her last days so I saw this several times.

As a doctor once put it, ‘They are not dying because they are not eating and drinking. They are not eating and drinking because they are dying.’

It might be that in hopspital she has had brain scans that show rapid onset dementia, I wonder if they investigated conditions such as CJD. seems like the hospital have not communicated well with the relatives.

Some dementias are very rapid, I'm afraid, this might explain your sad experience.

< www.choosecomforthome.com/the-facts-of-rapid-onset-dementia-life-expectancy/>

There are so many horrors in the world, and how we treat the aged is one of them.
Awful. I'm sorry this happened.
You are right to look for answers.