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What Causes Aortic Dissection When Diagnosed With Dementia?
Question: Hello, two years ago my father was was diagnosed with dementia. He was was living alone and coping but his family doctor encouraged me to get CCAC involved. Dad would not hear of it he is a very independent man and was still coping on his own. Last January he collapsed with an aortic dissection and has been in North York Hospital since last January. He was in ICU for two days bleeding.
and cognitively weakened a bit I think due to the fall he was not out too long as my brother was on his way to take him out, At the hospital they also said he was too old to operate on. Dad has always been as healthy and stable have been wondering should i get a report to his Cardiologist Doctor XXXXXXX XXXX for another opinion.
Dad remains isolated in lockdown since as they say he is wandering still (very little last report). My father is in a lockdown ward there waiting for a home as we were told he could not return home.
He gets up every day shaves and sits in a chair and walks around this room as he knows better not to lie in bed.
I told him about the homes I had found and was impressed with Cedervale Terrace. He was accepted in April and the I was told 3-6 months wait. I was thrilled as it was reputable and connected to TGH where I had taken dad yearly him to for all his heart check ups with Doctor XXXX and had the aneurism measured to make sure we could fly to see his family in XXXXXXX Dad is still occasionally cognitive when we speak. Good days bad days.
He is slower to answer but does remember some recent conversations and still able to move around without assistance he is a very very low maintenance patient feeds himself ... dresses himself.
MY BIGGEST FEAR
I fear the longer he is in there he is giving up bit by bit. He no longer packs every day to leave and I feel he's losing hope. I would say depressed.
He is isolated while he is in hospital with ESBL no contact with other patients or any stimulation.
I would say anyone of us would be the same.
I am not sure where to meet again with CCAC as suggested recently which has given us so much varied info on the home wait times and the home I was hoping for just told could be a year now,
This after being told this would be the one he would likely go into first in the summer by the visiting doctor. But I've learned Central CCAC does have more accurate information.
My concern is is there a XXXXXXX alternative while he waits now? Should I be looking at an interim placement? Could this two transition be dangerous to aortic dissection still even though now stable
Will he still be isolated as it is not a home?
will he wait longer?
it will soon be a year will that make the tradition be more difficult?
Should I be looking at an interim location if will he still be isolated ... do they have lockdown?
Hospital CCAC answers are never the same to outside CCAC who do appear to have more accurate wait lists.
But I have been told people by CCAC people from the community will be bumped which can move him down the list. I was also told by two doctors he could not return to his apartment ... but I can't discharge him but is he ever going to get out because he could not go home to wait?
I was told early in the year the transition is very difficut I am also concerned as I see he is unhappy but seems to be resigned in his mind he is not leaving. He has stopped asking about the home.
He cries when I leave a there are a lot of patients on this ward who scream for there dead parents and wander into his isolated room lying on his bed touching handrails all things not to do while with the esbl is dangerous to dad. Some patients are violent too! My brother got a call to come up and told over the phone was kicked and punched in the face by a fellow patient. A few days later a nurse called to say same patient was in dads room with the door closed.
This was hard to hear and of course you have go go to check.
Here we did call patient relations as I went in often to see this patient sitting on dads bed and dad was sitting on the bed too trying to ignore him and saying this is not your room. I sat down between them so fed up till security was called and being told to leave that man was violent but I could see dad getting worked up at this point.
HERE I WOULD LIKE SOME ADVICE
I am seriously thinking should I go to another meeting with CCAC and her manager
will be fruitless just more names of shortlists around XXXXXXX and Finch and a few others I am sure we could get into fast but would not want them to be permanent and wait again ,,, as well as places places I cannot get to as I don't drive and there is no public transit, And I am sure they want the bed.
But perhaps speak with the the placement facilitator for North York. As I understand she is the person who decided in the hospital who goes where. Is that correct?
I want to know if he is going to be continually bumped or moved down.
THIS IS IMPORTANT I have just learnt that the hospital has no role in this application process, the person/SDM has the right to demand assistance from the placement coordinator, not a hospital employee. So would this be a better move at this point .... I know my dad he is sick but he would do better out of this situation.
Could that meeting include hospital ccac and her manager as well as the North York Hospital placement co-ordinator? I just want a sraight honest an answer after all this time,
Have also heard unfortunately, some placement coordinators have been refusing to accept applications or take any other steps unless the application is commenced by the hospital employee as is “usually” done. This has the effect of allowing the hospital employee to try to pressure the patient/SDM into complying with the hospital policy without involvement of the CCAC.
and cognitively weakened a bit I think due to the fall he was not out too long as my brother was on his way to take him out, At the hospital they also said he was too old to operate on. Dad has always been as healthy and stable have been wondering should i get a report to his Cardiologist Doctor XXXXXXX XXXX for another opinion.
Dad remains isolated in lockdown since as they say he is wandering still (very little last report). My father is in a lockdown ward there waiting for a home as we were told he could not return home.
He gets up every day shaves and sits in a chair and walks around this room as he knows better not to lie in bed.
I told him about the homes I had found and was impressed with Cedervale Terrace. He was accepted in April and the I was told 3-6 months wait. I was thrilled as it was reputable and connected to TGH where I had taken dad yearly him to for all his heart check ups with Doctor XXXX and had the aneurism measured to make sure we could fly to see his family in XXXXXXX Dad is still occasionally cognitive when we speak. Good days bad days.
He is slower to answer but does remember some recent conversations and still able to move around without assistance he is a very very low maintenance patient feeds himself ... dresses himself.
MY BIGGEST FEAR
I fear the longer he is in there he is giving up bit by bit. He no longer packs every day to leave and I feel he's losing hope. I would say depressed.
He is isolated while he is in hospital with ESBL no contact with other patients or any stimulation.
I would say anyone of us would be the same.
I am not sure where to meet again with CCAC as suggested recently which has given us so much varied info on the home wait times and the home I was hoping for just told could be a year now,
This after being told this would be the one he would likely go into first in the summer by the visiting doctor. But I've learned Central CCAC does have more accurate information.
My concern is is there a XXXXXXX alternative while he waits now? Should I be looking at an interim placement? Could this two transition be dangerous to aortic dissection still even though now stable
Will he still be isolated as it is not a home?
will he wait longer?
it will soon be a year will that make the tradition be more difficult?
Should I be looking at an interim location if will he still be isolated ... do they have lockdown?
Hospital CCAC answers are never the same to outside CCAC who do appear to have more accurate wait lists.
But I have been told people by CCAC people from the community will be bumped which can move him down the list. I was also told by two doctors he could not return to his apartment ... but I can't discharge him but is he ever going to get out because he could not go home to wait?
I was told early in the year the transition is very difficut I am also concerned as I see he is unhappy but seems to be resigned in his mind he is not leaving. He has stopped asking about the home.
He cries when I leave a there are a lot of patients on this ward who scream for there dead parents and wander into his isolated room lying on his bed touching handrails all things not to do while with the esbl is dangerous to dad. Some patients are violent too! My brother got a call to come up and told over the phone was kicked and punched in the face by a fellow patient. A few days later a nurse called to say same patient was in dads room with the door closed.
This was hard to hear and of course you have go go to check.
Here we did call patient relations as I went in often to see this patient sitting on dads bed and dad was sitting on the bed too trying to ignore him and saying this is not your room. I sat down between them so fed up till security was called and being told to leave that man was violent but I could see dad getting worked up at this point.
HERE I WOULD LIKE SOME ADVICE
I am seriously thinking should I go to another meeting with CCAC and her manager
will be fruitless just more names of shortlists around XXXXXXX and Finch and a few others I am sure we could get into fast but would not want them to be permanent and wait again ,,, as well as places places I cannot get to as I don't drive and there is no public transit, And I am sure they want the bed.
But perhaps speak with the the placement facilitator for North York. As I understand she is the person who decided in the hospital who goes where. Is that correct?
I want to know if he is going to be continually bumped or moved down.
THIS IS IMPORTANT I have just learnt that the hospital has no role in this application process, the person/SDM has the right to demand assistance from the placement coordinator, not a hospital employee. So would this be a better move at this point .... I know my dad he is sick but he would do better out of this situation.
Could that meeting include hospital ccac and her manager as well as the North York Hospital placement co-ordinator? I just want a sraight honest an answer after all this time,
Have also heard unfortunately, some placement coordinators have been refusing to accept applications or take any other steps unless the application is commenced by the hospital employee as is “usually” done. This has the effect of allowing the hospital employee to try to pressure the patient/SDM into complying with the hospital policy without involvement of the CCAC.
Brief Answer:
Read below
Detailed Answer:
I read your question carefully and I understand your concern. It is a difficult situation indeed.
Regarding the aortic dissection I do not think it should worry you right now. Whatever its progression it will not be affected by the moving or not. Actually since it was 10 months ago, if your father hasn’t had new symptoms it is probable for the dissection to have healed spontaneously over the months. Of course that should be confirmed by control imaging, but after so many months that may well be the case. You wonder whether you should ask a second opinion about surgery, but I do not believe surgery to be wise, the risks of the procedure surpass those of the dissection itself.
Regarding further steps to take I do not think an interim solution is advisable. Patients with dementia can have difficulty orienting themselves in new living environments, they lose the few referral points they have left, it might cause confusion and agitation. For that reason it would be advisable to switch arrangements more than once, better to wait a little more than having to move again in a couple of months.
I believe that you should go ahead and ask for a meeting with the placement coordinator as it is the one most enabled to establish connections and speed up the acceptance in an appropriate home which fulfills your needs. Afterwards if the coordinator will need information from the hospital will contact the hospital his/herself. I am sure the hospital will cooperate as it will be in its best interest to speed up the process as much as it can.
I remain at your disposal for other questions.
Read below
Detailed Answer:
I read your question carefully and I understand your concern. It is a difficult situation indeed.
Regarding the aortic dissection I do not think it should worry you right now. Whatever its progression it will not be affected by the moving or not. Actually since it was 10 months ago, if your father hasn’t had new symptoms it is probable for the dissection to have healed spontaneously over the months. Of course that should be confirmed by control imaging, but after so many months that may well be the case. You wonder whether you should ask a second opinion about surgery, but I do not believe surgery to be wise, the risks of the procedure surpass those of the dissection itself.
Regarding further steps to take I do not think an interim solution is advisable. Patients with dementia can have difficulty orienting themselves in new living environments, they lose the few referral points they have left, it might cause confusion and agitation. For that reason it would be advisable to switch arrangements more than once, better to wait a little more than having to move again in a couple of months.
I believe that you should go ahead and ask for a meeting with the placement coordinator as it is the one most enabled to establish connections and speed up the acceptance in an appropriate home which fulfills your needs. Afterwards if the coordinator will need information from the hospital will contact the hospital his/herself. I am sure the hospital will cooperate as it will be in its best interest to speed up the process as much as it can.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Would it be a problem to bypass a meeting with ccac and go placement coordinator.
Would dad if he did go to a interim would the benefit as a family menber hopes for remove him from isolation?
If he became very agitated could they remove him?
Would the hospital have to take him back?
It's a concern of mine they might not have too.Would it be seen as a problem to bypass a meeting with ccac and go placement coordinator? Protocol?
Would dad if he did go to a interim would the benefit from more interaction and activities he is hopelessly bored. Is there any guarantee this would even remove him from isolation?
If he became very agitated could they remove him?
Would the hospital have to take him back?
It's a concern of mine they might not have too.
I did request a family meeting it has gone from that to a ccac meeting.
I have concerns about my father being moved to a LTC home from hospital after a year as I have understood transition is difficult.
If we meet with CCAC I am concerned about are they the people to answer these questions or should we ask a doctor present ... should this be a separate meeting ?
Which meeting should come first?
Hello,
I have tried to coordinate one meeting with the hospital/CCAC and the family of the client. Unfortunately due to conflicting schedules it has been challenging.
CCAC ( XXXX) is available to meet with you on Thursday Dec. 17 @ 1000.
The hospital staff are unable to attend this meeting. I have sent an email to xxxxxxxxxxxxxxxxxxxx (XXXX) asking her to either arrange a conference call or a separate meeting with the hospital staff/MD to answer any questions you may have about the client.
Pls confirm this appointment day and time is agreeable to you both.
Thanks
XXXX
xxxxxxxxr - XXXX
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
45 xxxxxxxxxxxxxxxxxxx, xxxxxxxxxxx700
x, xxx XXXX xxxxxxxxxxxxxxXXXX
Would dad if he did go to a interim would the benefit as a family menber hopes for remove him from isolation?
If he became very agitated could they remove him?
Would the hospital have to take him back?
It's a concern of mine they might not have too.Would it be seen as a problem to bypass a meeting with ccac and go placement coordinator? Protocol?
Would dad if he did go to a interim would the benefit from more interaction and activities he is hopelessly bored. Is there any guarantee this would even remove him from isolation?
If he became very agitated could they remove him?
Would the hospital have to take him back?
It's a concern of mine they might not have too.
I did request a family meeting it has gone from that to a ccac meeting.
I have concerns about my father being moved to a LTC home from hospital after a year as I have understood transition is difficult.
If we meet with CCAC I am concerned about are they the people to answer these questions or should we ask a doctor present ... should this be a separate meeting ?
Which meeting should come first?
Hello,
I have tried to coordinate one meeting with the hospital/CCAC and the family of the client. Unfortunately due to conflicting schedules it has been challenging.
CCAC ( XXXX) is available to meet with you on Thursday Dec. 17 @ 1000.
The hospital staff are unable to attend this meeting. I have sent an email to xxxxxxxxxxxxxxxxxxxx (XXXX) asking her to either arrange a conference call or a separate meeting with the hospital staff/MD to answer any questions you may have about the client.
Pls confirm this appointment day and time is agreeable to you both.
Thanks
XXXX
xxxxxxxxr - XXXX
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
45 xxxxxxxxxxxxxxxxxxx, xxxxxxxxxxx700
x, xxx XXXX xxxxxxxxxxxxxxXXXX
Brief Answer:
Read below.
Detailed Answer:
Hello again!
You will contact the placement coordinator eventually, by law the placement process is between the person/SDM and the placement coordinator, no role is given to hospital workers. The placement coordinator though, will need confirmation by the hospital care team that the person needs long term care and a filled application from the person SDM. After that you will discuss the placement with the placement coordinator, you are allowed to choose several homes which are suitable to you (I believe it can be up to 5). Whether this means that you will be guaranteed a place convenient to you, not necessarily, but you will have to negotiate and work with them as your father can't stay endlessly at the hospital. To be honest I am surprised they have allowed him to stay since January, most hospital's policy is even to send to the first available bed in a home, send back at home or to charge for additional days of stay at the hospital. So a compromise will have to be reached as soon as possible.
Yes your father might benefit from a place with more activities and interaction, it is certainly better than an isolated room. These places generally have their physician and problems can be managed on site usually, the hospital does not have to accept the patient back, not for dementia manifestations as it is a chronic issue which does not benefit from a (costly) hospital admission. If you choose an interim option though, apart from the frequent switching I mentioned above, there is no guarantee you will be able to find another care center. If it was not possible during these months where the issue was more pressing for the authorities as the patient was "stuck" in a hospital, I do not see how things will proceed more easily if he's accommodated somewhere else. So if that will be proposed to you, you should be careful and accept only if there is a certainty of a better place in a near future.
Read below.
Detailed Answer:
Hello again!
You will contact the placement coordinator eventually, by law the placement process is between the person/SDM and the placement coordinator, no role is given to hospital workers. The placement coordinator though, will need confirmation by the hospital care team that the person needs long term care and a filled application from the person SDM. After that you will discuss the placement with the placement coordinator, you are allowed to choose several homes which are suitable to you (I believe it can be up to 5). Whether this means that you will be guaranteed a place convenient to you, not necessarily, but you will have to negotiate and work with them as your father can't stay endlessly at the hospital. To be honest I am surprised they have allowed him to stay since January, most hospital's policy is even to send to the first available bed in a home, send back at home or to charge for additional days of stay at the hospital. So a compromise will have to be reached as soon as possible.
Yes your father might benefit from a place with more activities and interaction, it is certainly better than an isolated room. These places generally have their physician and problems can be managed on site usually, the hospital does not have to accept the patient back, not for dementia manifestations as it is a chronic issue which does not benefit from a (costly) hospital admission. If you choose an interim option though, apart from the frequent switching I mentioned above, there is no guarantee you will be able to find another care center. If it was not possible during these months where the issue was more pressing for the authorities as the patient was "stuck" in a hospital, I do not see how things will proceed more easily if he's accommodated somewhere else. So if that will be proposed to you, you should be careful and accept only if there is a certainty of a better place in a near future.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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