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Death cert - cause of death
Posted: Tuesday, March 5, 2013 7:49 PM
Joined: 12/20/2011
Posts: 60

After reading posts on the caregivers site, I was anxious for mom's death certificate to reference Alzheimer's as a cause, but since everything happened so wuickly and because the Hospice doctor met mom 10 minutes before she died, I forgot to express my wishes  

The. I heard from the funeral home that if they mentioned the hip, there may be a long delay.   

Mom died after two hip surgeries which led to pnemonia and blood clots.   She died rom a pulmonary embolism while the doctor was in the room watching. 

So, the death certificate doesn't have three causes as I expected.   Nope.   On one line it says "advanced dementia".   

I'm glad that's there to bring focus to the fact that alz is terminal, but I don't like that the pulmonary embolism wasn't there.    

And I am so sad just to see the lonely one line item.  It reminds me of how isolating dementia was for mom.   


It's like the doctor at hospice didn't even want to spend time on her last paperwork.  Like she had. I value anymore.  

Posted: Tuesday, March 5, 2013 8:22 PM
Joined: 4/19/2012
Posts: 414

First off, I am sorry for the loss of your mother.


I was shocked to see 4 things listed for my mom, the first was inanition, I had to look that up & it means lack of food and water. The second was Alz/dementia, the 3rd was congestive heart failure, the 4th hypertension.


She was 95, at one point I was told she took 27 pills a day by dad, which was shocking and so wrong imho.


Who decides what goes on the death certificate is a puzzle to me. I guess the mortuary asked my sis the caregiver? Or maybe they asked the hospice nurse or doctor, I just don't know who decides what goes on it. But the Certifying Physician was a D. O., not even a real doctor, odd to me.


I imagine you could ask around and see if it couldn't be changed if it means that much to you, and it just may. We all are affected by many things after they die, and if it gives you comfort to have the certificate adjusted, I would pursue it.


What ever gives you comfort IS important.

Posted: Tuesday, March 5, 2013 11:02 PM
Joined: 12/18/2011
Posts: 3097

How weird they didn't mention the embolism.


There is just no rhyme or reason to these death certificates.  My mother's primary cause of death was COPD, which she did have, but that was NOT the primary cause of death.  And I've written before, no mention of dementia anywhere.


It's just crazy.  I think the cause of death information comes from different places depending on where the person dies.  Mom's came from the NH doctor (who was her doctor for 3 years there) so I expected a little more.

dj okay
Posted: Wednesday, March 6, 2013 7:11 AM
Joined: 11/29/2011
Posts: 1840

I think the whole death certificate thing is upsetting.  It seems so final and there doesn't seem to be anything we can do to change the certificate.  I'm sorry for the pain this causes.


I would like to address the comment made by farawaydaughter in regards to D.O. doctors.  "not a real doctor" was the comment.


The doctor I went to during my whole life up to and including after my son was born was a D.O.  I didn't know enough to understand the difference.  But he was a wonderful doctor and I only stopped seeing him when he retired.


My mother's doctor the last year and a half of her life was a D.O.  This was not an issue when I selected her.  Again, she was a wonderful doctor.


There are more and more medical practices that include both MD's and DO's these days, so I think any differences are becoming smaller and smaller.


Both disciplines must pass the same board exams and all licensing requirements.  I found the following explanation of the differences that helps explain.


I hope the comment didn't reflect a bad experience with a DO, but even so, bad experiences can happen with MD's as well.

Posted: Wednesday, March 6, 2013 9:40 AM
Joined: 4/19/2012
Posts: 414

dj, I did look up/research DO after I wrote that. Yes they are very well trained, I was just surprised. A new learning curve for me.

Posted: Wednesday, March 6, 2013 2:18 PM
Joined: 2/14/2012
Posts: 1752

Amandams, don't let the death cert hurt you.

For a long time, doctors would enter the "immediate" cause of death -- e.g., the embolism.

However, the "immediate" cause of death often does not indicate the true, underlying cause of death -- in your mother's case, Alzheimer's.  And since the real cause of death in dementia patients has not been mentioned on death certificates very often, the impact of this dreadful disease has been very seriously under-reported.

As a result, it is not getting the attention it needs from those who decide on the research that is funded, or the health care benefits that are received, or the support programs and services that are needed.

It is actually a very good thing that your mom's death certificate tells the truth.  She probably would never have had the surgeries, pneumonia, or embolism had she not been end-stage Alzheimer's.

It sounds to me like the hospice doctor knew what was important ... and cared about you and your mom, and about future generations to come, too.
Johanna C.
Posted: Thursday, March 7, 2013 7:52 AM
Joined: 12/9/2011
Posts: 12697

It is always the physician that attests to the cause of death.


My mother and step-dad had the same primary MD.  Mom died of pneumonia, but he placed cause of death as, "FrontoTemporal Dementia."


My step-dad had Alzheimer's Disease, but he placed the cause of death as, "Pneumonia."


Go figure.


Johanna C.

Posted: Thursday, March 7, 2013 11:46 AM
Joined: 2/14/2012
Posts: 1752

Johanna, was he the one who actually signed both death certs?  Because the doctor who signs it can be, e.g., the patient's regular attending physician, the hospice physician, or, if the loved one dies in the hospital, the doctor on call.  I imagine if the patient dies at home and a coroner is called, the coroner would be the one to sign.


They can all have very different perspectives about what to put on the certificate.

Posted: Thursday, March 7, 2013 12:14 PM
Joined: 11/30/2011
Posts: 2105

The doctor who signed my dad's death certificate was the Kaiser doctor in charge of the palliative care program, never even saw my dad ever, but he's the one who signed off on the death certificate, not the hospice doctor.  Alzheimer's was listed on my dad's death certificate.  The reason probably was my father's regular physician had passed him off to the palliative care team and his medical provider became the palliative nurse practitioner.
Posted: Friday, April 26, 2013 11:42 AM
Joined: 4/26/2013
Posts: 1

I am very sorry about your Mom.  

When my father's death certificate came back and it said heart failure I was so upset.  I wanted it to reflect his Parkinson's for a couple reasons.  One being that in the future when family members are looking into generations, they will know that Parkinson's was in the family.  I think genealogy is very important.  I contacted the hospice doctor (who only saw my dad once, maybe twice) and let him know I wanted that changed ASAP.  My Dad's death certificate now has an additional page to reflect Parkinson's. I hope this helps.  

Posted: Wednesday, May 1, 2013 7:34 PM
Joined: 11/3/2012
Posts: 91

Just received my mom's death certificate and it states cause of death as senile dementia. That is all it states. She did have high blood pressure, depression, thyroid problems and anxiety but ultimately the dementia is what caused her death. Does it help to have it listed as dementia as far as more research or not?


Posted: Wednesday, May 1, 2013 11:18 PM
Joined: 12/18/2011
Posts: 3097

Yes, it does.  

"Senile" is such an old fashioned word, I wish they wouldn't use it.  But "dementia" is the important one.  I'm glad you got a truthful death certificate.