Friday, March 13, 2009

Pharmaceutical Euthanasia

With the approaching number of baby boomers reaching old age, I got to witness in my father's treatment what is in store for us if the pharmaceutical/government bonds are not challenged or changed. A Social Director of the Columbia Care Center in little Scappoose, Oregon reported to me with enthusiasm, that she attended a meeting in which a representative from John Hopkins presented to care center, medical and social service personnel information claiming to be able to diagnose Alzheimer's early, and offering 3-4 medications "titrated up" to the highest possible level to keep folks out of care centers for a year or two. The down side of course was they would toxify and die much sooner, but 'quality' life (?) and staying at home was the sales pitch.

During the fight to protect my father, a nurse from an Adult Fostercare home related to me that she got in trouble with the Hospice care people for not wanting to drug people to their deaths as they were dying. Drug amounts are not reduced, even when the person can't take in fluids or enough fluids, creating profound drug effects and hastening the process already in place, of basic Pharmaceutical Euthanasia. This woman quickly withdrew from wanting to talk to me further, as she was afraid if she spoke up her State Fostercare license would not be renewed, and that of course was her living.

You are outspoken? So am I. Below is the account of my father in short. I hope you will have some feedback for me, and share this with others. This goes far beyond me or my father, as you will realize.
My father had vascular dementia. In reality, he had short term memory loss from a stroke and small strokes called TIA's. The term dementia became the lens he was seen with. There are 5-6 kinds of dementia, and everyone is unique in how they are affected. Here I wrote a paper in my Social Work Graduate School on the problems of Labeling, and had I not had to take a reprieve from watching over my father full-time because of cancer, he would have remained safe and sound in my home. He also lost his primary care doctor who took a leave of absence for pregnancy. The way he was seen and treated, and the depersonalization and justification for drugging demonstrate how labels and stereotyping are not in our best interest. What happened was criminal.
Obituary and Account of my father's death by Pamela Cohen.
December 29, 2008
Alvin Marc Cowden, born April 18, 1922, passed around 3 AM December 11, 2008 at age 86. He had another (10th?) case of aspiration pneumonia, caused by Seroquel, an anti-psychotic (per manufacturer warnings). He also experienced seizures and strokes with Seroqel, as he was put on and off of it without a chance to stabilize. Since he had a previous seizure and stroke when put on Seroquel years earlier, he should have never been put on it at all. He was given a dangerous newer antibiotic called Levaquin for this last case of pneumonia, without the permission of his authorized medical representative on the POLST which are the last orders for the Physician. Pamela, as his daughter had the responsibility of being her father's Power of Attorney. There were two POA's, as when convenient, or while breaking Oregon Statutes, agencies would disregard the first one. The second was more specific, and extended. Both were Durable, recorded POA's. No staff would even tell me what antibiotic he had been given until he was dying, the day or so before.

See important info on Levaquin:

Dr. Barney Saunders of the 35B Medical Ward had never designated my father as Hospice though he was on the "failing list", and called my cell phone to discuss whether I wanted my dad to have more liquids via IV when he wasn't getting enough. He didn't call my main home number, or both, per medical record instructions, and when I got the message almost two days later, he never returned my call to the nurses desk (Melissa) or his voice mail. When I called to speak to my dad on Tuesday, Dr. Saunders got on the phone and said he certainly wanted to respect my father's wishes and my wishes. I said that if I felt respected, Dr. Chen would have called me to ask permission to give my father the antibiotic. Silence. Then he said I guess you have spoken to staff about the decision whether to hydrate your father. I said, "What staff would that be?" Silence. From my return call to Dr. Saunders Thursday until Tuesday is inappropriate to discuss last minute decisions. I had come to expect unprofessional behavior from this hospital after a plethora of it. I have had to blunt my human emotions for some time.
With the Levaquin added to the other medications, my father became unable to drink enough liquid, which quickly worked to toxify his body further with the 25 medications he was on. Without enough liquid, the medications not only can shut the kidneys down, but they can perforate the stomach and cause sepsis as the stomach contents leak into the body cavity. My father became 'unresponsive' after writhing in pain and being put on morphine, after which the 25 medications could no longer be administered. The severe withdrawal finally created his death. My father was "processed". As the heart can no longer keep up under this abuse, the lungs fill up with fluid, and my father died of drowning in his fluid as his heart labored to keep up with the struggle to breathe. Two fluorescent lights glared above as he labored to breathe, eyes open, mouth open. The oxygen was turned on at the highest level.
When I got to the Oregon State Hospital Dec. 10th, Wednesday afternoon around 2:30 pm, and sat with my father, a young staff came in to put a blood pressure cuff on my elderly father's arm. She was pumping it up to over 220, and I asked her if that was necessary. My father was dying. Why did he need to be in more pain? She said no, you don't want me to take his blood pressure? No, I said. She left, but right after that, a crew of 2-3 people came in to do 'Cares' which meant turning him from one side to another, and checking him, and giving him an injection of morphine-(had to ask what it was.) They didn't ask me if it was all right, or tell me what they were giving him. I don't know that they are licensed to administer Hospice care.
One young man had no identification, and when I asked him where it was, he said he didn't always wear it. I looked at him and couldn't help saying, "You're special". The rules don't apply to him. His name was Chris, one of the nurses there who had told me my father was sleeping, and hung up on me once when I called to speak to my dad, and referred to me as Mrs. Castro on another occasion. Perhaps he didn't want me to know his last name fearing I was going to file a complaint with his nursing Board. His hostility was yet another roadblock I dealt with while trying in vain to get my father either to another care facility, or home. The St. Benedictine Care Center receptionist, Mary said there was not anything they could do, as the State would not let my father go. (A Guardianship hearing had been filed by the OSH on the pretense that I was a hindrance to my father being placed in the community). Emily Daisy, the Administrator of the Providence Care Center never would call me back, though she said she would, and I came by personally, to Mt. Angel, and kept calling. Mt. Angel would be a transition for my father to come home, so he could die there, with the only family he had. What disturbed me, was hearing that their Nurse Practitioner's medication orders had never been challenged or changed. I asked Emily Daisy in an earlier conversation if signing a parent into their institution meant giving up any and all oversight in their medical care. That sounded like blackmail, to take care of patients for their convenience, as some of my previous experience with rest homes had shown. There had to be a balance in what was best for the patient, the center, and acknowledgment that the wishes and particular medical history was usually best known by an elderly person's family or medical representative. Not all of us will turn our heads when an elderly parent is overmedicated, for example, for profit margins to be kept so teenage CNA's can light-staff a care center. Too many of America's elderly have been depersonalized and disenfranchised.
The OSH 35-B medical floor staff had been instructed by Nancy Johnson's "guidance" as the Nursing Supervisor, to put me on hold when I called to speak to my father during his last days and weeks of life, come back several minutes later and tell me he was sleeping, and not give me any information about my father. This only changed at the last when they seemed to feel sorry that my dad was actually dying. One of their staff, told me if this were her father, she would feel furious. She was crying. I always wonder what else she could have told me.
Through the mini-blinds, as they weren't pulled down completely on the left side, I witnessed these people putting the blood pressure cuff on my father, regardless of my instructions and request. One of the staff looked at me when she came out of the room-as I was asked to leave for my 'father's privacy'- and said they had to take the blood pressure when giving certain medications. They did this every time they did his 'Cares' while I was there until 11 pm, about every 30-60 min.
When I left during my father's dying process briefly to get something to eat, I got a cell phone message from Michael ___ an Assistant Atty. General from the Oregon Dept. of Justice who had called around 6pm to tell me he was filing a Temporary Guardianship petition at 9am the next morning at a court in Salem. I'm sure this lack of notification is also inappropriate and unethical. My father seemed to be calmer around 11 pm, and the witness I always had to bring with me to that hospital, was tired, his dog unfed, so I left to return the next morning. I got home at 2am. Pat, a nurse from the OSH called around 3am telling me my father was gone.
That morning I heard from my father's appointed Disability Rights Oregon attorney, Jan Friedman, that the basis for this final Temporary Guardianship insult was since my father's death was imminent, the hospital was filing to appoint a private Guardian to make the end of life decisions. (I suspect it was a final grasping to collect the Social Security I finally withheld, after OSH harmed my father and held him without due process and civil rights.) She asked if I had an attorney for the February Guardianship hearing, because if I did, she couldn't talk to me. I told her I was appearing Sui Juris, but my father was dead. He had done his 'job', and died at 3 AM, before these horrors could further insult his human and civil rights. This was when I told Ms. Friedman that when I got her letter stating that my father's Power of Attorneys were "my" Power of Attorneys, (and she wasn't interested in defending my father's representation as legitimate because the Oregon State Hospital had dismissed them as 'invalid') I lost all respect for her, and didn't want to speak to her any more. "I'm sorry, I said. I have to go."
Two pharmacists identified malpractice in sudden withdrawal of Seroquel which causes psychotic breaks, seizures and strokes for my father, and contraindications of at least 4 of the 25 medications he was on. Another biochemist/Nutritionist doctor (Appointment pictured above with OSH 'guards') said there would have to be a computer stronger than NASA's to determine the polypharmacy effects of all the medications with each other, much less within the body. I have the lab results which are horrific. The day I got my dad transported to get a nutritional status and blood work, the two Oregon State Hospital staff refused to allow my father and I medical privacy rights, saying they were responsible for him, and would attend the entire time. The Doctor came out into the waiting room to do a consultation and then the blood draw, while the two 'guards' took notes.
In the last 'Treatment 'Team' Meeting' I attended, Dr. Barney Saunders didn't want to have my notes from the Pharmacist consultations. When I told him the pharmacists suggested getting a geriatric pharmacist as a consultant Dr. Saunders said, "That would be too much time for one person."
My father would call out in pain, "Wow", because the medications were creating high blood pressure and joint pain, etc., and was just medicated further, as if he was mentally ill. I had to point out that when his veins are standing up, and he is holding his head, saying "Wow", his head hurt from the high blood pressure and migraine-like headaches from past vascular incidents.I had saved my father from death by this treatment before, and have two videos chronicling his complete recovery. Doing 'all you can' is just not relevant if you love your parent.
When I succeeded in getting my father off Seroquel, he looked at an interim doctor and refused his medications, saying, "You're poisoning me". (Which they were.) This doctor immediately decided that my father was psychotic, and therefore must be put back on Seroquel. To do so, there was a quick court hearing in which I was not notified, until an appointed attorney who had no time to look at his records or gather needed information called me while I was at a Texas gas station. (A daughter needed her mother, so I left Oregon to help her.) My father was put on and off Seroquel, without proper care to stabilize him and allow him withdrawal time. The OSH did not have the facilities to do that, much like not having enough staff (3 for 29 patients with high care needs) to toilet my dad, thus drugging him into European diapers so he could lay in his urine and feces until morning. He was drugged so he couldn't talk and request toileting.
When my father was dying, the young man without ID, Chris, said my father was just dying of his "disease process". How convenient. My father had short term memory damage from strokes, and in 12 years, never forgot who I was, or was unable to carry a conversation except for his drugging. All along I was attacked as some enemy when I tried to advocate for care, pain management or prevent malpractice and harm to my father. Roy Orr, the OSH Administrator refused to make an appt. to speak to me, or call me. After allowing me copies of my father's medical records after much blocking, the hospital took the position that my father's POA's were invalid. They never allowed my father representation by me or an attorney every 6 months when they would walk up to him and casually ask if he had any problem in being committed further. He was disabled on psychiatric drugs. Even though this is highly unethical and illegal, when I stopped paying my dad's $430 Social Security for him to be abused further, they are badgering me for that money withheld. I needed it for legal help and medical second opinions, as lawyers don't pay for expert witnesses and filing fees, etc. I am still seeking help. It will probably be a Jewish attorney.
My father and I suffered together for over 2 years in this process, and an additional year of previous abuses from the Columbia Care Center, and especially Oregon Health Sciences University. The 6 mg.'s of Ativan administered to my dad when admitted to OHSU disappeared from his medical record. Because I objected to this abuse, I was attacked and not allowed to visit my father. In the drugging down of this human being, like an animal, why would family be allowed to see the horror as they would want to protect their loved one. The state DHS Senior and Disabled Services had denounced my POA as invalid and refused to allow my father's care at my home for 'relative foster care', at 96 cents an hour pretax. OSH charged the taxpayer $20,000 per month. They don't want their cash kingdom disturbed.
When I first saw my dad in the Oregon State Hospital 34-D Geriatric ward, where he was housed with sex offenders, he wept and begged me to take him home with me. Instead of "Wow", his last phone conversation with me was him repeating, "Why?" I hope he knows the answer now.
This is a small part of the abuse of my elderly father. I don't know who cares in this world anymore, but I will make this accounting.

Labels: elder abuse, pharmaceutical euthanasia, OHSU, OSH, Oregon State Hospital, Disability Rights Oregon, St. Benedictine Care Center at Mt. Angel, Oregon, levaquin, Dr. Barney Saunders, alzheimers, adult fostercare, John Hopkins University

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