My step dad recently passed away while in a nursing facility for rehabilation. A nurse called that night and recounted the events of my step dad choking to my mother over the phone. When we arrived at the facility, the administrator was there and he also said he choked. Now the death certificate states that it was cardiovascular disease and the administrator says they conducted an investigation and determined he didn't actually choke. He had been eating only puréed meats and vegetables up until the day of the incident when therapy determined he was ready for soft solids. I feel like this is a cover up but because he's cremated I'm not sure what our options are.

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my good wife died last week..the death certificate included the ailments from 12 years ago that triggered a massive stroke at that time...Thus the immediate cause of death was not the primary reason shown, but instead the initial events that cause it were: Atrial Fibrillation, and so on...

Grace + Peace,

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I'm truly sorry for your loss.

I don't understand your concern about a "cover up." What would they be covering up? Why would it matter to them whether the cause of death is choking or cardiovascular disease? Could it have been a heart attack brought on by the stress of choking? Or a heart attack that caused the choking?

In any case, choking is a high risk for people who have swallowing problems, and cardiovascular events are a very common way to die. I imagine that your dad could have died from either one, or from a combination. Again, I don't understand what you think they might be covering up, and why they would do so.
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Your questions mentions your options. What if you had had an autopsy performed? Say it concluded that blockage of the air passage was the immediate cause of death -- then what? If the autopsy concluded he died of a cardiovascular event, what is your option? If it determined that a cardiovascular event and choking occurred almost simultaneously, what are your options? And what if the autopsy determined a different cause altogether?

What do you think your options would be if you knew absolutely for certain what caused your father's death?
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Ultimately all deaths are cardiac arrest which only means the heart has stopped beating.
I have seen this listed on the death certificate and it was explained to me as I just stated.

Even cancer or a brain tumor, eventually the heart stops and they use that as the reason for expiration.

As jeannegibbs states, what is it you are hoping to accomplish? Nothing will bring him back. If you are thinking of suing the NH, your chances are slim at best.

If he was in a NH, this means no one was able to take care of him at home. He could have choked at home just as easily. My DH has Dysphagia and it is a swallowing disorder. The possibility of choking is just something we live with.

I am sorry for your loss - but I have heard it is very difficult to prove negligence.
Helpful Answer (9)

I assume he was on a dysphagia diet b/c of swallowing difficulties, and that he was subject to aspiration? Choking on foods is one of the dangers of aspiration. I've been advised that aspiration (and aspiration pneumonia) can still occur even on dysphasia diets.

I've seen some frightening episodes of choking, even when on a dysphagia diet. Coughing is intense, the face turns red, and sometimes it's hard to catch one's breath.

Heather, I suspect this is what happened, and that the death was in fact a result of the choking, perhaps aspiration, and perhaps even blockage. I'm not really sure about the cardio issue as cause of death. Can you contact the individual who completed the death certificate for an explanation?

Did you ever see an active videoscopic swallow study? If one was done for your stepfather, you might have been in the room watching the video monitor. I've seen several, but the most recent one was the most illuminating. I could see liquids and food being swallowed and being aspirated. I could also see food getting stuck and not being swallowed or aspirated.

After seeing this latest study, it was easier to understand how fatal choking can occur.

I assume your stepfather had some cardiovascular disease? Had he been treated for it in the past?

If you really think there's a cover-up, your best option is to retain a medical malpractice attorney, ask him/her to order the medical records and have them reviewed by a cardiac expert. That would give you a better idea what an independent physician might determine as a cause of death after reviewing the records.

I am sorry for your loss and hope this helps explain what could have happened.
Helpful Answer (8)

Prior to cremation, it's required and by law to have autopsy results from the medical examiners or coroners. So, they cannot lie about how your father died of. The death certificate is the is actual evidence. However, if your father choked, it probably coincidental due to his heart failure. He may have had a sharp pain on his chest and then gasped while he was eating his food. Remember, CNAs are not doctors. They told you what they saw. Just go by what the death certificate says. Relax your mind and let your father rest in peace.
Helpful Answer (6)

I am so sorry for your loss. It is definitely emotional, no matter the cause or timing. Big hugs.

As to cause, I agree with jeannegibbs and Madtoe. My own mother died in my brother's arms. She was choking, and he tried heimlich, but she had a heart attack. Who knows if the choking came first, or as a result of the heart attack? It upset him greatly.

I wish you peace and comfort, which will take time.
Helpful Answer (6)

Many infirmed and older people have difficulty swallowing and often cough and choke. Just sit in a dining room at a nursing home and you'll see, and those people are sitting upright, not reclined in bed. Did you see any signs of bruising around the neck of your loved one? Are those bruises documented (ie. in nurses notes or photos). Short of that, the time to question was before the cremation. The easiest explanation is that the assessment that he could graduate to soft solids was permature, causing the choking scenario. I am sorry for your loss. Have doubts and questions concerning a loved ones care is upsetting. I've been there.....most people have been there, and it isn't easy.
Helpful Answer (5)

I am sorry for your loss of your stepdad.It's obvious that you loved him and miss him.
Sometimes people just die unexpectedly. He had complicated medical problems and they caused his death. It was his time.
We are all going to die this way - our bodies will no longer be able to keep us alive, and we will die. In the end it really does not matter which of his illnesses caused his body to no longer work.
Why would the staff at the nursing home want him to die? They don't stay in business that way.
Then there are the folks that are supporting this thinking.
Talking about getting the staff. "go after those bastards teach them a lesson" after all they are uncaring, arrogant, egomaniacs.
This is not what will bring you peace and healing.
No one who works in long term care is there for the glory of the work, or the money. The work is back breaking and wages are far below what they could make in another setting.
Can you believe that it was his heart that gave out, and because he was eating he started to choke?
Try it out when you are feeling angry and helpless. Then surrender it to who or what ever you believe in.
Asking for peace is so much more healing than seeking vengeance.
Helpful Answer (5)

I agree with jeannegibbs. My mother died last May and I know that the nurse employed by the nursing home killed her. We had just put her on hospice and this one particular nurse just kept giving her Morphine every time I turned around. Even though she NEVER asked for nor did I ever request it for her. And before I could say anything to anyone they called me and told me she was gone! BUT, I did not have the money to pursue it and I was distraught and there was just no fight left in me. BUT, to this day I still am kicking myself and I need to stop this......and so do you because it will eat you alive and that is not healthy.
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