Inquest into death of dementia patient Adelina D’Angelo opens

An elderly woman who became severely dehydrated while in care died of multiple organ failure, an inquest has heard.

An elderly woman living in an aged-care facility with dementia died after suffering extreme dehydration that led to multiple organ failure, an inquest has heard.

An inquest into the death of 88-year-old Adelina D’Angelo started on Tuesday, with forensic pathologist Professor Neil Langlois telling the court the cause of death was “dementia complicated by dehydration”.

“I think the fundamental issue here (is) dementia and dehydration,” Prof Langlois said. “There wouldn’t have been dehydration if there hadn’t been dementia.

“The deceased leading up to her death could not take a drink herself, she had to have drinks supplied so therefore her dementia had obviously got to a stage where she was at risk of dehydration if she wasn’t given enough fluid.

“Why she died at that time and not the previous week, or next year or the previous year was because at that time she became dehydrated. As far as I’m concerned, the dementia is the underlying cause and the dehydration is the provoking cause.

“It’s dehydration leading to multiple organ failure.”

Ms D’Angelo had been a resident in a nursing home providing high-level care since 2017 but was admitted to the Royal Adelaide Hospital on October 4, 2020, at the request of family.

Ms D’Angelo was admitted to the Royal Adelaide Hospital on October 4 2020. Picture: NCA NewsWire/Brenton Edwards

She had reportedly not been her “usual self”, and hadn’t been eating, drinking or taking her medication.

At the RAH, she was diagnosed with dehydration and presumed pre-renal acute or chronic kidney injury due to her poor oral intake. She continued to deteriorate, becoming hypotensive and less responsive.

She began palliative care and was pronounced dead on October 9, 2020.

Prof Langlois said Ms D’Angelo had been at “sub-par” renal function for “a while” leading up to her death.

“Both with the naked eye and under the microscope, a change to the kidneys that suggests they were chronically damaged,” he said.

“It’s not the renal failure that’s causing dehydration. The renal failure is causing a change in behaviour which is then leading to dehydration.

“Having presented to hospital, in a condition of dehydration, one would expect that drinking fluids would reverse that situation. The problem I suspect is the fact that by the time she’s come to hospital, there’s been further renal impairment due to the dehydration and we are in a situation now that we cannot reverse.”

The inquest will continue on Wednesday.