Alzheimer's Treatment Under Scrutiny
Posted: 3:06 pm EDT October 10, 2006Updated: 10:43 am EST November 10, 2006
Somerset County -- A Somerset County woman claims the Area Agency for Aging ignored, and even over-ruled, an expert's opinion, putting her sick mother in danger.Now, Tammy Emerick says she is speaking out in order to change a system she says isn't giving aging citizens the care they need.Her mother, Janet Emerick, currently calls a Cumberland, Md., Alzheimer's facility home. She has adjusted well, her medications are finally regulated and she is familiar, and even comfortable, with her surroundings.But, eight years after she was diagnosed with the disease, Janet is beginning to show signs of advanced Alzheimer's.Sometimes, the visits between mother and daughter are peaceful, but other times the disease turns the 69-year-old into a sometimes violent and confused person."Scratching, biting, ripping...I had to have a tetanus shot because she broke skin and bit me and kicked us," Tammy Emerick said.When Tammy's father, Janet's primary caregiver, became ill, they had no other choice but to take her out of the family's home."If mom grabs his arm and yanks on it like she did to mine with her fingernails, it will pull out his port and he could die. He could bleed to death," Tammy said.In April, Janet's doctor of 10 years wrote a prescription recommending she be put into a locked nursing home. But, in order to be Medicaid eligible, she had to undergo a level of care assessment by a caseworker from the county's Area Agency For Aging.Art DiLoretto, an administrator for the Somerset County Area Agency On Aging, said, "The state determines by very strict definition what people qualify for at certain levels of care. We're obligated as an agency to look at what is the least restrictive service environment."Tammy said she told DiLoretto the "horror stories" that she and her father went though."We showed her the script from mom's doctor saying she was nursing home appropriate. She said, 'No, I overrule that. That means nothing to me,'" Tammy said.The judge ruled that Janet should be put into an unlocked personal care home.Somerset County Commissioner Brad Cober, said, "The case workers and the nurses at our agency have been trained. They have seen this and again, nobody wants to question what a doctor is saying, but sometimes that's a difference in judgment."Tammy Emerick said the reason a doctor can be overruled is because her family lives in a rural area."Families often become very familiar with their doctor and talk them into doing something that's not in the best interest of the patient," she said.Dr. Tejas Patel, a geriatric psychiatrist at Memorial Medical Center in Johnstown, was not involved in this case and has not interviewed Janet. However, he said it is possible two medical experts could come to a different conclusion on the level of care needed by an Alzheimer's patient."There are many ways to classify (Alzheimer's patients.) One of the common ways to diagnose mild, moderate and severe (is) based on their many mental exam scores," Patel said.As the AAA recommended, Janet was put in a personal care home."She exhausted the personal care staff," Tammy Emerick said. "She tried to find her way out of the personal care home. The alarms were going off all the time."After just 25 hours, Janet was removed and admitted to Somerset Hospital's psychiatric ward, where she stayed for two weeks. With their mother in limbo, Tammy and her sister decided to bypass the assessment appeal process and move her to a Cumberland nursing home.DiLoretto said, "The consumer, other than being persistent and patient, I believe has a responsibility to use the system as it's structured."Tammy Emerick said the family tried to keep Janet in Pennsylvania, but "it was just one thing after another. It was one closed door after another."Somerset County Commissioners approached the Area Agency for Aging for details about their placement process. But, when they asked for a copy of the agency's procedures, commissioners received a surprising answer.Changes are in the works. But, are they enough to protect those suffering from Alzheimer's?Our Channel 6 News Investigation continues here.
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