Elderly Man Not Properly Cared for in Nursing Home

This senior care case involves an 84-year-old male with a medical history significant for CVA, cachexia, hypertension, type II diabetes, and mild anemia. The patient recently suffered a CVA with left hemiparesis and was discharged to a nursing home for further care. The patient’s condition deteriorated immensely upon his transfer to this facility and it was at this point he was made DNR/DNI.

Over the course of his stay, the patient developed several pressure ulcers, several leg contractures, and required a peg tube as he became more malnourished. Complications over the course of one year included urinary tract infections, pneumonia, kidney failure, chronic pain syndrome, and arterial and small vessel disease. Additionally, the patient was severely dehydrated and malnourished over the last several weeks of his life, and his health began to decline so much that he was no longer able to use his dentures, even when fitted with special adhesives. He developed gangrene of his right heel and had to undergo several rounds of surgical debridement that ultimately required several amputations, including his right hand. After an unsuccessful hand transplant in the aftermath of his amputations, the patient’s health fatally declined. The cause of death was listed as Legionella pneumonia, hypertension, hyperlipidemia, and atrial fibrillation. No autopsy was performed. An expert with a specialty in decubitus ulcer care was retained for this case.