Richard Mertek

Richard Mertek is an 88-year-old retired physician who has been hospitalized for the second time in three months with Lewy Body Dementia. In spite of the dementia, he is still able to carry on a conversation and answer questions about current events and perform simple math calculations. He is ambulatory with a walker and is able to dress and feed himself, but he has become incontinent. In addition to suffering from loss of cognitive capacity and motor control, this form of dementia is affecting Richard’s emotional stability. Unfortunately, Lewy Body dementia also causes paradoxical reactions to antipsychotic medications, so that sedative medications that could ordinarily treat his psychological symptoms would instead cause agitation and hallucinations. Richard’s unmanageable behavior has been problematic, to the point where he tried to choke a nurse under the delusion that his medication was poisoned.

            At this point, Richard is medically ready for hospital discharge, and psychiatric medications have been optimized. However, Richard’s doctors are family are struggling to plan his discharge. Because of his history of belligerent conduct, Richard has been rejected by more than 20 assisted living facilities and nursing homes. His elderly wife suffers from emphysema and may be developing dementia herself, and has refused the necessary healthcare aids that she and her husband would need to remain in their own home. None of Richard’s children are prepared to take their father into their own homes. Doctors are reluctant to release Richard to his home.