Serious event at Skilled Nursing

Oh, Riverdale! I am so sorry to hear that this happened to your mom. No advice, just (((((hugs)))))).

Oh. My. God.

I'm sorry Riverdale, words fail me. How is she?

So sorry this happened. At least the facility telling the truth.

If she likes therapy there is a chance that she could get better.

Riverdale, I am so sorry.

If it is possible to add a couple cups of bone broth to her daily routine, this will help her body recover.

I pray that she is able to continue navigating her wheel chair in the near future and has no trauma from this sad situation.

Riverdale,

I am so sorry. How are YOU doing?

I think creating a very positive, supportive environment will help support her healing.   Are you close enough to visit regularly, if it's allowed (b/c of the pandemic)?   If so, I would make it a practice of visiting, either before PT  when she's not as tired, or after PT and nap time.   

What are her interests?   Can you bring photos of the family, or something that's positive and makes her feel good?  I always brought cards as well.  It's something a patient can look at and be reminded of how much he or she is loved and valued by the family.   I also encouraged friends and family to visit and/or send cards.    That meant a lot.

And, perhaps most importantly, are there musical activities, guest musicians, or other activities she can attend so she isn't as isolated?   My mother always perked up when I took her to a musical activity or brought my music, took her to the music room, and played for her.  My father looked forward to his musical entertainment as well.

If there are no concerts, do you have a CD player or something to bring so she can listen to music?    At Dad's last placement, the facility had a wall mounted tv with a music channel.  One of the pastors found the channel and we left it on all day and night.  The music was so soft it even soothed me.

I am so sorry to hear that this happened to your mom. Like Barb I have no advice, just letting you know I'm thinking of and keeping you in my prayers.

Wow, that hurts, my condolences. My niece is a CNA in a nursing home and she told me of a similar incident of another CNA who violated the protocol on proper transfers. Luckily, nothing bad happened, but it could have. Every healthcare institution in this country is understaffed and exhausted from COVID. Like every profession, there are good, caring, CNA's and a few bad apples. The pay isn't great, they have to work long shifts, and they are usually young and starting families. It's unexcusable what happened to your mom. The only thing we can do is get vaccinated and give these exhausted, dedicated, caregivers a rest. Peace.

Thank you all. I brought her a drink yesterday with a bone support ingredient. We also purchased bone broth and I will bring her both regularly.

I am close enough and although the facility is back on lockdown they are allowing me in due to her situation. She presently has to stay in bed but in time they hope to transition her to an appropriate wheelchair. She also has a good lounge chair we purchased. She also right now is on oxygen but an Xray yesterday was clear. The machine makes alot of noise but hopefully it won't be there many days.

Thank you all for your cares. I have been pretty sad this past week but working to get back to my routine and purchasing what we did for her and bringing it to her will help. I don't think she can participate in activities from a bed but the therapy she now qualifies for her will hopefully help.

Riverdale, how are you and your mom today?

Today was sad. One of the PT group came into the room. She said this was all very difficult and her pain is intense. When I pressed the wrong button to raise her to drink the drink I brought she expressed great discomfort. I solved that easily with the right button but knowing how the slightest movement causes pain is discouraging. She also is on oxygen. Also pain medication. Just one of those days one asks yourself why did this have to happen to someone so compromised already. Thank you for your concern.

So sorry RD. Hope things will get better for her soon.

Today when I visited they had her dressed and in her recliner. I was quite surprised. She seemed a tiny upbeat about it. There wasn't the right person around to discuss this. There was an ambulance outside so that might have caused staff to be in other areas. She is still on oxygen but she was working the remote on her TV. So progress.

I'm just seeing this post now. I'm so sorry to hear what happened Riverdale! Glad to see your update just now, that mom is a tiny bit upbeat.........that's good to hear. I remember when dad was in Brookdale & the nurse in charge dropped him.........nothing terrible happened to him; no broken bones or anything, and she admitted to it and felt terrible about it, but we were all pretty shaken up about it. To think your mom has 2 fractured femurs as a result is a horrifying thing to process.

Sending prayers for a quick recovery for your mom and here's a big HUG for you that you can get some rest and relaxation for yourself.

Such good news. Thank you for letting us know how she is doing.

Continued prayers for a speedy recovery.

So glad she is looking good!

Well more difficult news to be expected. My mother has now developed a very painful bed sore which they are treating but is making everything more difficult and painful. So just wondering if any of you have advice about this. It is hard to imagine how this will heal as compromised as she is. I think now she needs serious pain medication around the clock. I was there and it took awhile but 15 minutes or so after receiving it she was not in pain but this seems as though it will be constant.

I'm sorry to hear about the bedsore Riverdale. Do you think a hospice evaluation is in order since serious pain meds w/b required around the clock? What does the doc have to say? It's amazing how quickly things can go downhill once an event happens. Especially one of this magnitude.
Sending prayers

If things get worse I would certainly consider hospice evaluation. Tomorrow she is being taken for a transfusion as her hemoglobin is low. They are going to give her around the clock pain medication. They also plan to change the dressing on the wound twice a day.

My mother has not said she has had it with life. So far no matter what happens she soldiers on. Just have to take it a day at a time.

Riverdale: Be ever vigilant about "bed sores" or pressure ulcers (same thing). My mom died from sepsis and necrotizing fasciitis (flesh eating bacteria) from a pressure ulcer on her hip. Pressure ulcers usually occur around bony protuberances such as ankles, hips, etc... At the first sight of her wound, my sister and I had her at her PCP within 5 hours. 3 weeks later, we had a visiting nurse come in once a week to check the wound (ordered by her PCP). My mom refused to keep the pressure off her wound. I'll spare you the rest of the details. This type of wound is treatable if caught early enough. Depending on the location, it might involve a colostomy and debridement surgery depending on the progression of the wound. It can progress very seriously very fast. Your mom's Dr may recommend a hospital bed with some type of fluid mattress (air or sand) to take the pressure off the wound if your mom is non-compliant. I truly wish you the best outcome. Peace.

Thank you CT. I am very worried now that she has one. At least they seem to be taking it seriously. They have a wound nurse who visits once a week. They are also going back to an air mattress which I wish they had begun earlier. Since her fall I have had to deal with so many issues. Now I feel I was neglectful in not bringing up the mattress earlier. I remember worrying this could happen but then that thought escaped me. The changing of the dressing twice a day seems reliable. It was very difficult to see her experience such pain from the wound as well as the femur fractures.

Riverdale, please don't think it was your job to come up with the idea on an air mattress!

Keep on top of the pain medication; I think being pain-free is so conducive to healing! ((((Hugs))))).

Done anyone have knowledge about bedsores and general time frame of healing? My mother has been seen by a wound care nurse. Her wound has to be packed twice a day with gauxe inside the wound. She was told to lie on her side which I saw her doing yesterday after lunch. This means she is putting more pressure on the femur that was operated on but the alternative would be lying on the side that has a brace. Just a hot mess!

Riverdale, is she already on a variable pressure air mattress?

Countrymouse, Yes she is at least

I highly recommend you to use your nose. If you smell anything out of the ordinary, get your mom to a hospital fast. I'm sure the visiting nurse would have told you this as well, I'm just emphasizing the point. Best wishes.

Bedsores and healing time: From my experience it is a slow process. The wound needs to be checked daily for progress or more deterioration. Many times bedsore prevention and healing is an art and part science. I say this because rotating a patient for pressure relief is not always satisfactory. Sometimes you need to try different body positions to find the right one that works. For example my patient had a buttock bedsore on the right side, so you think of elevating or cushioning the right body side, but that made it worse. We found that elevating the left body side relieved the pressure and it healed. This is why the bedsore needs to be looked at everyday. A keen eye witness will know how it is/or is not healing. From your description your mother has a deep wound. You should ask what stage it is. Do they take pictures of it? Do you look at it? When does the doctor look at it? Do they use promogran and medihoney for the wound? How do they clean it with saline or Vashe?

A wound care nurse has seen it. I can ask some of those specific questions when she is back at the facility this Wednesday. I did speak to this nurse last week. I know it is being packed with gauze twice a day(gauze removed and new gauze placed in wound). I appreciate hearing those specific terms. I know they use lidocaine to help with pain. I don't know what level it is but I will find out this week. I have not seen it. Because of fractured femurs I don't think my husband and I should try to position her in order to see it. I wouldn't want to be accused of causing her more harm. Thank you for all that information.

Riverdale, I have no good advice, just much sympathy for your mom and you , going through this sad and painful process.

All of your mother’s information should be available for you upon request by you. If your mom had to be sent to the hospital the NH would have to copy and release that information to the hospital so the doctors know what is going-on and what medications your mom has been taking. They know what stage the bedsore is and the medicine to treat it. You can ask to be present when the nurse or nurse’s aide changes the wound. They should be using Mepilex dressing to cover the wound. It’s your mother! You are entitled to know. Ask questions.