How severe stress was the start of a medical nightmare
April 2010
LIMERICK hackney driver William Ryan suffers stress due to personal problems and financial strains caused by the economic downturn. His behaviour begins to change. He has difficulties concentrating, his sisters witness hallucinations.
A local family GP suspects he is having a nervous breakdown.
Mr Ryan attends University Hospital Limerick and is hospitalised. Dr Peter Boers assesses that Mr Ryan’s symptoms are consistent with either frontotemporal dementia or Alzheimer’s. He is assessed as needing 24-hour care and is prescribed four drugs: the anti-psychotic Seroquel and dementia-specific drug Donepezil along with sleeping tablets Stilnoct and anti-depressant Lexapro.
May 2010
Mr Ryan is discharged from University Hospital Limerick to Adare Nursing Home, and later that month to Cahermoyle Nursing Home in Ardagh, Co. Limerick. His condition is too severe for these homes.
June 2010
He is transferred to Killeline Nursing Home in Newcastlewest, which specialises in dementia, and placed in a locked, secure unit.
June 2010 to mid-2011
He remains in the locked unit. A code is required for visitors to enter and leave. He has his own room but cannot leave freely.
Mid-2011 to June 2012
His family become increasingly concerned that he does not have dementia, based on their personal observations. They verbally seek re-assessment.
A brief assessment is carried out. He is given his own unlocked room on an upper floor.
24 June 2012
His family pay for an appointment at Limerick Hospital at Dr Peter Boers’ private clinic.
26 July 2012
Dr Boers writes to the nursing home GP, saying Mr Ryan had been diagnosed with dementia two years previously but he would now send him for further assessment. He speculates on other causes of his illness and says he will examine the 2010 notes.
January 2013
Another consultant psychologist, Dr Valerie Switzer, assesses Mr Ryan over a number of appointments: finds he does not have dementia.
March 2013
Dr Boers writes a handwritten note for the family stating Mr Ryan does not have dementia, that he does not require 24-hour care, and can be legally responsible for his own actions.
May 2013
Dr Boers formally confirms assessment and Mr Ryan is free to leave. However, he stays due to financial and other personal issues. This letter is later placed in Mr Ryan’s medical records at the family’s request, replacing earlier documents indicating he had dementia.
August 2013
Mr Ryan leaves Killeline. The nursing home gives him a going-away party. Since August 2013 he has lived alone in a rented home near his sisters.
October 2013
The family request an investigation into their concerns about a lack of follow-up care from Limerick Hospital.
October 2013
The family meet Dr Boers and a hospital manager. An investigation begins.
November 2013
The family write to HIQA about the lack of re-assessment. HIQA says they are giving this matter attention. They writes to the Ombudsman but he can’t act on clinical issues.
December 2013
Family seek response from the nursing home on why staff didn’t appear to act on Mr Ryan’s improvements.
March 2014
The family meet Denis McEligott and Pat Kennedy, owners of Killeline Nursing Home. They indicate that medical records cannot be released to the family. A freedom of information process begins.
July 2014
The hospital gives a report to the family that says Mr Ryan was diagnosed with frontotemporal dementia in 2010, but Dr Boers now states ‘no other specific cause of his symptoms was found’.