The family of an elderly woman who died in hospice care is suing a local nursing home, charging that the staff's failure to follow a care plan resulted in acute dehydration that crippled the woman.

According to court papers in the wrongful death suit, Eulalia Grimoldi's final days came quickly. She was admitted to Napa Nursing Center on May 23, 2006, transferred to Queen of the Valley Medical Center by June 15, 2006, and died July 1, 2006. She died under care of Hospice of Napa Valley while at another Napa facility, Choctaw House.

According to the lawsuit, Grimoldi's daughters are seeking unspecified damages for wrongful death, elder abuse, neglect, negligence and violation of rights.

Linda Lutz, director of legal affairs for Napa Nursing Center's Horizon West Healthcare corporate parent, said the company had not yet been served with the lawsuit and could not comment.

Grimoldi had a diagnosis of dementia when she entered hospice care, where disabled elders and terminally ill patients go to die with dignity.

According to the state Department of Public Health, Napa Nursing Center was cited $15,000 in May 2007 for failing to follow a care plan that called for staff to encourage Grimoldi to drink fluids.

"The violation of this regulation ... presented imminent danger that death or serious harm would result or a substantial probability that death or serious harm would result," the citation concluded.

Refusing food, water

Napa Nursing Center staff called for an ambulance on June 15, 2006, because Grimoldi showed "a decreased level of consciousness." Queen of the Valley medical staff noted that Grimoldi had been admitted for acute dehydration.

A later medical discharge notice to Choctaw House noted a primary diagnosis of "debility and decline/failure to thrive" and noted some problems during Grimoldi's hospital stay.

"During the patient's hospital stay she began refusing food, hydration and medication," the report read. "It became clear that the patient seemed not to have much will to live. After prolonged discussions with the patient's daughter, Virginia Loeffler, durable power of attorney for health care, it was decided that the patient should be discharged to Choctaw House with hospice care."

Elizabeth Mautner, Napa County Long-Term Care Ombudsman, said even if Grimoldi refused help with drinking fluids, the state citation showed the home did have a further delicate responsibility. The ombudsman's office is staffed by nursing home resident advocates who both tour facilities and talk with residents to make sure their rights are protected.

"They could also be cited for forcing her to drink against her will, but they at least have to encourage her to drink, they can't just leave her alone and expect her to pick up the glass and drink," she said.

Mautner also said Napa Nursing Center is generally regarded highly by the ombudsman's office, with a track record of good reports from state inspectors.