Dear Doctor Gonzales,
During the past 11-12 months, I/we have felt frustration and deep concern for my husband, due to the treatment we received from you and Kaitlin Fifarek, APRN.
1. We came back to see you in January of 2023. (You said to come in if we had any concerns or noticed changes.) I had a list of changes, a. He thought we were in New York. We have not visited New York for years and have not lived there since 1967. b He was unable to manage his I phone. c He could not balance the bank statement, which he had done for many years for his clients and family. d He had difficulty maneuvering the computer from one program to another.
You said, "It is just old age"! In other words, what the wife lives with and sees every day, is not valid or worth considering. It is ridiculous for you to assume the spouse' s report means nothing. In our case I am a Licensed Clinical Social Worker. I have often collaborated with patients and families dealing with dementia. The court has paid me to administer Mental Status Exams to dementia patients to assess the need for Guardianships. Your disregard for my report caused Mr. Schimmel to suffer needlessly for two more years with symptoms of worsening dementia.
2. Before you dismissed us, we requested a referral for Neuro/Psychological testing.
3. Thomas J. Longo, Psy.D, M.S. stated that Mr. Schimmel's testing showed many deficits in cognitive functioning. Testing also suggested his driving skills could be impaired.
4. In June, we had an appointment with Kaitlin Fifarek to go over the Neuro/Psychologicak exam. Prior to our arrival, she had not reviewed the report. Once she had located the report from Dr. Longo, she took only a moment or two to peruse it. She then said, "It is just old age!" We were surprised, since this was not what Dr. Longo had said. (At that point, we did not have a copy of Dr. Longo's report).
5. When we expressed concern, she asked us what we wanted to do. She offered no options, even though Dr. Longo had numerous recommendations. (We requested a Brain Scan, which she ordered.)
6. We returned to see Kaitlin Fifarek in August to discuss the results of the brain scan. She said there was nothing evident in that report. We later learned that the scan report suggested NPHC (Normal Pressure Hydrocephalus). It is our understanding that she could have discussed looking into the possibility of further testing ( a lumbar puncture) and discussion of NPHC.
7. I had a copy of the psychological exam with me. I had highlighted the recommendations and the Clinical Impression Dr Longo had found concerning. Kaitlin responded with "What do you want to do now"? She offered medication. We are concerned with the side effects of available medications, so declined that offer. We have wondered what she might have suggested, or what referrals she might have made, based om Dr. Longo's report? We did not receive good medical care when she did not suggest pursuing the diagnosis of NPHC. She and you just settled for "old age."
8. When Mr. Schimmel went to see his new primary care physician in December2023, Dr. Fineman told us he saw signs of NPHC. He educated us on the condition and asked if we wanted to be referred to a Neurologist. We followed through with that referral.
In April, Mr. Schimmel had a lumbar puncture. Unfortunately, the results of the before and after psychological examination and the evaluation of the P.T. were inconclusive. As his symptoms became worse, we pursued the option of a shunt.
9. The shunt surgery was about two months ago. His cognitive abilities and walking improve daily.
We are concerned that your office wrote Mr. Schimmel off with "It is just old age"! We were not aware of that being a medical diagnosis. I had told you that his dementia was "different." I had told you of some of the changes in his memory and bhavior. It seems weird to me that a physician takes a few minutes in the office as the picture of the patient and ignores what the family describes.
I cannot even end this note with a "thank you". I will send a copy to the central office of Intercoastal and to the medical society. I hope you begin to care more about your patients, and listen to family members.
Sincerely,
Brenda H Schimmel, LCSW read more
