Psychiatric and neurological disorders are difficult for the patient. They are particularly difficult because, unlike a physical disease like high blood pressure or a broken leg, the patient often finds that the disease itself prevents self-care. Whereas a doctor can tell a patient to stay off a broken leg and reasonably expect that patient to do so. We must be careful to make too broad of a claim about these issues, but I have seen many times where a patient with a psychiatric or neurological disorder needs help managing their care, and without which they are at the mercy of their disease. So, healthcare providers must take special care that the help for these patients is adequate.
In one case recently, the VA Office of Inspector General found that healthcare providers at the Richmond VA Medical Center had not ensured their patient had adequate help at home when they released him from inpatient psychiatric care. This patient had a service-connected Post-Traumatic Stress Disorder (PTSD) combined with a traumatic brain injury (TBI). This is not an unusual combination for combat veterans. Add to that, this veteran—in his 70s—had begun to show signs of dementia and was eventually diagnosed with that disease.
This case was particularly egregious because VA healthcare providers knew that their patient had a very high risk of violent behavior and that their patient’s spouse would not be able to care for them at home alone. Healthcare providers knew the risk of sending him home. In fact, they had initially recommended him for a higher level of care than what even they were able to provide. However, multiple nursing homes rejected this patient because of his behavioral issues. So, instead of keeping him in inpatient care at the VA, they released him home to his spouse with the hopes that home support services would be enough.
This began when he was brought to a non-VA community hospital’s emergency department due to “changes in mental status and behaviors.” He was then transferred to the Richmond VA Medical Center. Healthcare providers at Richmond, VA, watched his confusion and aggression grow—saw him throw a wheelchair and wander hallways confused. They made various medicine changes, to no avail. They even, at one point, placed him in “therapeutic confinement.”
His healthcare providers had been told by his spouse and children that he could not be cared for at home. However, after approximately a month of inpatient care and after refusing requests to have him placed in long-term or memory care, and after the refusal of nursing homes, VA healthcare providers discharged him home, claiming that the veteran was “psychiatrically stable to go home.” VA even threatened to “begin the abandonment process” if the spouse did not pick him up on the planned discharge date.
Then, it gets worse. His VA psychiatrist and VA pharmacist failed to coordinate his necessary medicines with the spouse to at least attempt to address his issues. Also, for days after his discharge, phone calls were made to VA and the Veteran Crisis line about his behavior and the risk to his spouse. Within ten days, he assaulted a home healthcare worker, which resulted in his incarceration. This was avoidable. VA should have done better.
If you believe that healthcare you have received from VA is negligent, give our firm a call. We specialize in medical malpractice at federal healthcare facilities, like VA. We even have veterans on our staff who take these kinds of things personally.
https://www.wric.com/news/taking-action/disabled-veteran-unsafe-discharge-va-oig-report