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My uncle died a few weeks ago and we finally got the death certificate back. It lists vascular dementia and Cerebral Atherosclerosis as the cause of death. He did not have vascular dementia, he had Alzheimer's but hospice did not know that. He was only in their care for two weeks and they did not have all of his health records.


There is nothing in his records about Cerebral Atherosclerosis. He was never tested for it (no CT scans, no MRI or anything else).


He went on hospice care solely because his sodium was low and the doctors could not get it corrected. It caused him to become very weak and "out of his mind." The hospital doctor and his primary care physician both recommended hospice, but they did not give a reason as to why. There was a diagnosis in the hospital of metabolic encephalopathy.


We're pretty sure hospice made up the diagnosis of Cerebral Atherosclerosis and vascular dementia. Can they do that? My uncle's son (my cousin) doesn't necessarily care, but he's wondering whether we should tell the rest of the family the truth - that we don't really know the cause of death.

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Had he had all of the discrete diagnostic assessments to identify the diagnosis of Alzheimer’s. Is there any objective reason why the specific diagnosis is relevant to his surviving family?

Do you have the money and time to challenge what was stated on the DC, research the attendants and their qualifications, ascertain the source of their decision, etc.?

If so, and all can come to agreement, worth proceeding. If not, rest easy with what is recorded.
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Your use of the word Falsify implies a deliberate attempt to obscure the record and I really doubt anybody has anything to gain by that. I'm sure it's quite possible that many death certificates are wrong though, especially when there is really no continuing history to go by. What was the condition that got him approved for Hospice services?
As for what to tell the family - Alzheimer's is a terminal disease it just takes an interminable amount of time to reach it's final conclusion, I would say there isn't anything specific, his body just wore out.
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Did he have an autopsy?
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Sorry for your loss. I would think that Hospice doesn't determine the cause of death. The patient's doctor would list the cause and would fill out the death certificate. Even though Hospice didn't have his records, there was some communication with them from the doctor so they probably knew the basics of why he was moved into their care. Many times, even though the patient had a certain condition, it is another underlying condition that results in death. My mother had vascular dementia but she died from heart failure which she had recently developed. I would ask your uncle's doctor.
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Does it really matter?
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In two weeks, with a complex end-of-life where they were focused on care rather than cause, they may have got it all wrong. At least it doesn't give 'heart failure' as the cause of death - isn't it always?

We had the same issue with DH's father. He and my MIL had just moved into a care facility, and his death was very likely caused by the facility's new doctor who didn't continue a particular drug he was taking. My DH decided that there was nothing to be gained by making a fuss about it. I thought he should, but it was his call and his siblings were difficult anyway. The old man was ready to go, and he had achieved his ambition to arrange care after his death for MIL.

Work out what's best for everyone. Best wishes, Margaret
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I am very sorry for your loss.   Unless you suspect foul play, I would let it go.
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I think the Dr. associated with Hospice put in the cause of death. Maybe he got patients mixed up. Call the Agency. My Mom had Dementia and went thru all the stages. But her DC said heart failure. My Mom had nothing wrong with her heart. I asked the funeral director about it he said thats pretty much what they use as cause of death with Dementia so I let it go.
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No one is interested in pursuing a case against hospice. We just wanted to know why they would put down false information. We thought maybe that was just a common thing they do, especially if there is no disease involved for needing hospice care.

If the only medical issue going on is an electrolyte imbalance, I would think they would need to come up with a reason for admission for Medicare. You can't just sign anyone up for hospice care. Maybe we should just call them and ask for the paperwork.

Alzheimer's was not the cause of death and he barely had any symptoms. He may not have even had that, but that's a long story.
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Hi Kate
The reason I asked if they did an autopsy is I wondered if they may have discovered Alz when they performed an autopsy. We are always reading that the only true way one can know if a person had Alz is an autopsy.
The DC in my family I am familiar with were all correct.
I do a bit of genealogy. It’s always a special “find” when I come across a DC for a relative because of all the information that can be on it.
It isn’t always correct as to parents names etc. But it is an important document and I would at least make a phone call to the hospice and discuss if I felt the information was incorrect.
Let us know if you find out.
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