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My mom passed away a few weeks ago. She was receiving Hospice care at a nursing home facility. A few days prior to her passing she suffered a seizure and she never recovered. She was to receive seizure medication twice daily. I was with her when she passed. On the death certificate the doctor list cause of death as heart attack. Also, time of death is incorrect. I feel the nurse staff did not alert the doctor of the seizure. I knew my mom was terminal, but something is not right. Maybe a cover up?

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I don't think it's a coverup..just Hospice not getting there to call Time of Death..thus when Hospice gets there..that's the time they put on the death certificate.

Been there as my dad's is almost an hour and a half after he passed away. It was at 12:36 am on Friday morning the 28th of July. His death certificate says it was at 1:50..when the Hospice nurse called it, and since he was in Hospice care..nursing staff that was right there at the time couldn't call it.

Ridiculous!!
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Don't disregard your feelings. Get the medical records and see if they correspond to your experience. I have a relative whose death certificate was falsified to cover up the fact that a nurse gave her a massive overdose of morphine, which was the actual cause of death. The family member was told this at the nursing home (that an inexperienced nurse had given the relative 20x the dose she was supposed to get) but the doctor never mentioned the morphine on the death certificate. When mistakes are made that cause someone's premature death, there must be consequences. These are people's lives.
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Watch NBC Nightly News tonight on the underreporting of Alzheimer's deaths on death certificates. The immediate cause is what is normally listed. Pushing for more information on death certificates in order to increase research funding for Alzheimer's.
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oldschool, so sorry for your loss.

eguillot, I was thinking the same thing, how death certificates are not specific regarding the death, how the term cardiac arrest is so quickly used. There are so many other things that could have been the root cause, which are dismissed, thus people think no one dies from such and such, when in fact it was the pathway to the fatal event .
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How old was your mother and why would they want to cover-up the death?
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I'm sorry for your loss. My brother was an attorney, and he told me a long time ago that most death certificates are wrong in that they simply state cardiac arrest or something similar without the conditions that caused the heart stop beating (multiple organ failure secondary to cancer, etc.) Everyone dies of cardiac arrest. Our hearts stop beating and we die.

In your case, the cause of death was a heart attack, secondary to whatever put your Mom in hospice. It wasn't the seizure - the seizure was a part of her dying process. Again, so sorry for your loss.
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I am sorry for your loss.

Did Mom have medical directives in place or a DNR? Were you or someone else POA? Most people have medical directives, they do not want many medical treatments that would only prolong life, without some sort of quality. I understand that you are emotionally tried at this time. How old was Mom? What was her quality of life before the event that led to the NH and hospice? She would not have been on hospice if it was not her time as determined by medical professionals.
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Everyone has made good points, some of which I hadn't even thought of, especially the issue of prolonging the issue of death and its attendant stress as well as the fact that time of death is "called" by medical people.

Jeanne and Veronica both commented on an issue that I recall after reading their comments. In joint estate planning documents for husband and wife, there were always clauses dealing with the potential of simultaneous or near simultaneous deaths, for the purpose of the inheritance issues.

I was reading my father's trust the other day as some changes need to be made and remembered the significance of order of death in terms of the heirs.

An example would be heirs in a blended family. If the husband died first, his heirs might be his wife or his children, but not her children. Or vice versa. If they died simultaneously, there might another provision, perhaps dividing the estate among the entire blended family.
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I'm sorry for your loss.

If it would make you rest easier to ask some questions then do so. However, a death certificate is a legal document and it will take a lot of time and maybe legal assistance to have it changed. After all that you've been through with your mom do you really want to drag this out?

My dad died a year ago. The weeks and days leading up to his death were stressful and heartbreaking. He was on hospice and I wasn't there when he died. If his death certificate said he died of uterine cancer I would have left it alone. I was too wrung out to draw things out any further. He was gone and there was other business to attend to.

But follow your heart. If you find that you can't let it go then you have to do what you have to do but since she's been gone and her body is gone I'm not sure how you'll ever be able to determine if the death certificate is inaccurate. Nursing charts are legal documents as well. I think you'd have an uphill battle on this one.
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Oh Pam that really creeps me out. As you say time of death is the time a medical profession makes that declaration. In our county a hospice nurse does it and there is no need for an autopsy unless the family requests it. Some of the Drs did not know what to put on the certificate and we would tell them multiple organ failure secondary to whatever their hospice diagnosis was. Again as Pam mentioned seizures are very common at the end of life and often mistaken for strokes which they can in fact preceed. If the patient recovers consciousness and can take medication anti seize medications are usually atarted. otherwise pain and anti anxiety meds again as Pam said. but I see absolutely no reason for a cover up. the only time actual time of death is important when one date or another has a significance. For example the last day of one month or the first of the next when social security has to be returned. if a hospice patient died after midnight then medicare pays for the whole next day
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Time of death is not when you observed death, it is the time the patient is declared dead by a medical professional. For example, nobody dies in an ambulance during transport , they are pronounced dead at the ER. In the Buffalo Psychiatric center, it was actually against the law to die in the main building. Dying patients were removed to death houses in the back of the property. A bit strange if you ask me, but that was the law.
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Cover up, no. A dying person may tremble or seize as the body is shutting down, suffer arrhythmia and display muscle contractions and strange vocalizations. This is not unusual, and very difficult to observe. This is why Hospice uses Morphine and Haldol, to ease the pain. If the patient is kept comfortable, the family nearby is less likely to become hysterical.
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When my mom died last year, we knew that the last time anyone here in the house knew was still alive was like 12:30pm - when they fed her lunch via the stomach tube. Sis found mom cold around 2pm. She went out to the porch telling my 2 brothers and other sister that she thinks mom is dead. No one was listening. Older sis kept going back and forth - back to mom, trying to warm her up because she was cold - and back to our siblings on the porch kept telling them that she thinks mom is dead. By 3pm, they finally "heard" her, checked mom, agreed mom has died - and called 911 at 330pm. The ambulance, the fire dept, the police all came. According to sis, they blinked when they saw the time she thought mom was dead - to the time when they called 911.

Mom has Alzheimer and has been bedridden for over 13years. In her death certificate, her time of death is 610pm. The cause of death: arteriosclerosis cerebrovascular and cardiovascular disease. Then on the next part on Other conditions, it has Alzheimer. // I remember when I saw this the first time, that it was wrong- time and reason of death. In the end, I just decided time of death is when the ER finally pronounced her death at 610pm, and because her heart stopped, "arteriosclerosis cerebrovascular and cardiovascular disease."
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I am sorry for your loss. What makes you think she did not die of a heart attack? You were with her when she passed, so what happened to make you think that a heart attack may not have accompanied whatever you witnessed? Seizures frequently affect the heart rate and rhythm, which could easily lead to a heart attack. Did no one do anything while you were there?

I only ask because I watched my grandmother have a brain seizure, and while she lived a little while after, her heart gave out within an hour and a half. The seizure caused the heart attack.
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I was kind of surprised at how informal the recording of a "natural" death was. My husband died at our home. He was receiving Hospice care. We were alone when he died. Hospice had coached me to jot down the time of death, then to spend as much time as I needed before calling them who would in term call the mortuary. I did jot the time down, but I can well imagine that sometimes people forget and get confused. The death certificate shows the time I reported and shows "Lewy Body Dementia" as the cause of death. Several months later I got autopsy results and a more specific cause of death and also the conclusion that it was surprising he hadn't already died of hardening of the arteries.

It doesn't seem really important to know the exact time of death (except in murder cases). Even the exact cause of death when it has been expected does not seem important. I don't know what purpose would be served by having my husband's death certificate changed to give the exact medical cause of death.

While these things seem intensely important to you now, the death certificate is just a piece of paper.

If it really makes a difference -- if inheritance would change depending on who died first of two people who died a few hours apart -- then, yes, it might be worth pursuing. But in the ordinary run of human affairs, this is not as important as I had previously thought.

Please accept my condolences on the death of your dear mother.
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I'm so sorry for your loss; it must have been so upsetting for you, but there's also comfort in sharing your mother's last moments together. I'm glad for you that you had that opportunity for a final goodbye.

The time of death could have just been a mistake; if it really concerns you, contact the doctor and explain that you were there when she died and the time is incorrect. He/she may have just picked it up from the hospice records.

As to a "cover-up", I'm not sure what the purpose would be, or what issues would be covered up. But it seems you feel the seizure might have been the cause, and perhaps left untreated? You know your mother's conditions better than we, so you might want to consider that the seizure did cause the heart attack.

I'm not a medical person, so I'm only suggesting that there might be a correlation.

I do wonder though what would be the purpose of a cover-up; you write that your mother was already in a terminal condition. Your concern is understandable, especially since your mother's death was so recent.

But you might want to ask yourself what the purpose would be in pursuing a course of action beyond clarification of the time of death. What would you hope to gain beyond a corrected death certificate? Do you feel there was some misdeed, error or other issue that needs to be addressed?

You can always order a copy of the hospice records, assuming you have the legal authority to do so. Perhaps that might set your mind at ease, especially as to the administration of the anti-seizure meds.
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I'm sorry for your loss. Was there an autopsy? Probably not, since her death wasn't unattended and she was terminally ill. You say she never recovered from the seizure, what do you mean by that? The seizure could have contributed to her death, and a heart attack could be the immediate cause of death. If the death certificate doesn't list any contributing causes, then none were found.
Why do you think there was a cover-up? Do you mean that the nursing staff were negligent in not reporting the seizure to her doctor? And how are you sure they didn't report it?
I know it seems unfair that your mom is gone. Even though you knew she was terminally ill, you were probably hoping for more time with her. Looking for someone to blame won't help you, but if it makes you feel better, you can talk to the doctor who signed the death certificate.
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WE are not on this Earth forever...I hope she didn't suffer, that is what I worry most about my mother's last breath, and of course my family and mine. I think there is a protection factor when your body can't handle too much.. I hope you find peace. Your mother is at peace now. HOspice is there to keep her comfortable. They are wonderful people, and they help my mother. Find peace..Do you want to spend more energy to find a coverup? Talk wit the doctor who signed the cert. ask him if he thinks it's worth it.
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