Serious event at Skilled Nursing

I don’t have advice on this, but am so sorry it happened. My mother was a two person assist for every move and I’d have been mortified if she was ever dropped. Prayers for your mom’s healing

An additional comment just as "FYI": The NH brought in a Wound Care Nurse from an Agency they use, have a relationship with, or possibly referred to by the in-house doctor. If for any reason you are not satisfied with their service you have the right to request another Agency for wound care nursing services. Personally, I have found that referrals from a Hospital Social Worker very helpful, because they usually will get feedback about Home Health Care Agencies.

I know this is not good news in the least but I felt I should report back as some here know so much about bedsores. My mother's is beyond the worse stage. It is 3 centimeters deep. Muscle is visible but not bone. There is now an odor and oozing. They are going to start an antibiotic and a catheter. I know this could be heading to her end. My husband is wondering why she isn't being hospitalized. I worry if she is and they want to release her and the SN place doesn't want to take her back then what do I do. I did ask as many questions I could from advice here. They are using Dakins solution and putting a foam cover after changing the dressing. The culture from the wound should be known within 48 hours. Her white blood cell count is elevated but not very high. Thank you to all of you who have given me advice.

So sorry to read this update. I wish you all healing and peace

Oh dang Riverdale!

I am so sorry to hear this. I pray that she isn't suffering and that whatever is meant to be will be gentle on her.

So sorry, to read this. Thinking of you and mom.

Your husband is wondering why your mom is not hospitalized. If I were you I would ask the house doctor to order it. All hospitals have wound care physicians on staff. If he refuses take her to the ER yourself. Maybe a skin graft is possible or needed.

As far as SN not wanting to take her back is nonsense. Who is telling you these stories? You have the right to take care of your mother. The SN cannot preclude you from seeking more professional help for your mom in the hospital.

The wound is infected. She is on a 7 day course of an antibiotic for it. She turns 91 tomorrow and we can go but will wear gowns,gloves as well as a mask. They said she did not need to be in the hospital,that they could treat it at the facility. I was just thinking the worse regarding hospitalization. They did not say that to me,I just feared it. I also feared that if she is in the hospital that only one of us would be allowed in at a time to see her. I don't know if they will still want to take her on Monday to the surgeon's office for Xrays is she is infectious. This is 4 weeks post op and the nurse said they do Xrays 6 weeks post op but no one can give me a straight answer as to why they are doing Xrays now if they have to do them again in 2 weeks. We also did not learn the results of the nature of the wound until after the surgeon's office was closed for the day. Sorry to have caused confusion.

Thx for the update. The x-rays are for the fracture. The x-rays are low grade so I would not worry about them. All hospitalizations are a concern; especially because of Covid. Is your mom getting oral or IV antibiotics? The former usually will cause diarrhea (which could complicate her situation more because of dehydration) and the latter might not, but should be more effective, but is normally done inpatient. You have to determine if you are satisfied with mom’s treatment at the SN. Can her previous outside Primary Care Physician review your mom’s prognosis; like a second opinion for you? Watch her vitals for the white blood count and fever.

Just catching up with your updates Riverdale. What's happening today, Monday? Sending hugs and prayers your way.

Yesterday's Xrays were canceled due to her bedsore infection. I think just as well since it is 4 weeks post op and nurse at surgeon's office said standard Xrays were 6 weeks post op but no one could give me a solid reason why they were doing them at 4 weeks. It's an ordeal to get her anywhere in her condition. The wound nurse will be at the facility tomorrow. She is the best person to speak to right now.

She was 91 on Sunday. We brought birthday cake and left what we didn't eat for the staff. She seemed to enjoy most of it. I also brought her this pretty pink drink from Starbucks. She loved that. She is drinking Boost twice a day. She seemed a little better on Sunday. I am going today again with drink at lunchtime. Thanks for your wishes. I hope I might have a little better news tomorrow regarding the wound.

Riverdale, I'm glad she is a bit improved.

We found that mobile x-rays were the best thing ever once transport became a huge issue.

Call the ortho office and ask if they can order the 6vweek films they want from the mobile service the SNF uses.

They have taken a bone sample to get a biopsy. They want to get a vacuum pump to help the wound heal faster. The doctor has to order that. I feel as though everything is in slow motion. We had to ask them to change her meals so that the choices are easier for her to eat. Otherwise she tries and food gets all over her. She can't sit too upright due to her legs and bedsore. She also has cognitive issues and sometimes can't form words. This feels endless.

Speak to a personal injury law firm that offers specialty in nursing home neglect and abuse. Most of them will not take a penny from you unless they take the case and recover damages.
The lawyers will get all the exact facts. They know how to investigate.
All nursing homes will lie when an incident happens or they will blame an incident on the lower-pay CNA staff. The aide's actions being 'strictly against protocol' is probably more likely the charge nurse instructs that the residents have to be dressed and up by a certain hour because it looks bad for them to still be in bed. Very likely the CNA has been transferring your mother like this for a long time. It's also very likely she's been doing so with her supervisor's permission if the Hoyer isn't available.
If you talk to a law firm, the lawyers will speak to the CNA who was let go and you'll probably hear a very different story than what you're being told by the facility.

My mother fell in between 2 Aides in the house & needed emergency surgery 5 years ago. She has dementia & is immobile & incontinent. 5 years ago she was losing her ability to walk or stand too long …& she was becoming combative. She survived the surgery..stayed 10 months in rehab/ pvt pay SNF. I took her home 4.5 years ago. I’m so burnt out even though I have pvt pay home caregiver for 35 hours a week. I purchased lift machine that the nursing home was using..the stand assist lift. With this, she is transferred from bed to wheelchair or to commode. The CNA from SNF trained me how to use it while she was a resident there. My mother has not fallen once in 4.5 years from a transfer. However, this past February, since she has dementia, she unbuckled her seatbelt on wheelchair & thought she could walk, fell & required stitches. She was in short term rehab 2 weeks & I took her back home. Long story short, your mother should have 2 aides operating hoyer transfer for her incase stand assist lift not available. No shortcuts with one CNA…who probably was not regular one. They have to know each patient’s care plan, Have Ombudsman notified & file complaint. Unfortunately, these falls can happen anywhere. Hugs 🤗

Caregiver,wow that's alot to happen and for you. I never understood the ombudsman concept and how to find that. Right now the facility is trying hard to help her so I am wary of ruffling feathers while she is so vulnerable. I have considered future actions if she succumbs to any of what has been brought on. She has also lost alot of cognitive function but I am not sure if that is partly due to constant pain medications. It has been made known to me she was only to be lifted with hoyer and 2 person assist. As I said the aid was fired that day. I am trying to work presently with the help they are providing as we hope (even blindly) she might improve. We also go much more often and stay and try to deal with needed issues. At present all this is being billed to Medicare so we are not paying out of pocket.

Exactly how do I find out about the ombudsman?

Riverdale, the should be information about how to contact the Ombudsman in the lobby of the facility, right next to the Patient's Bill of Rights.

My heart aches for you and your mom.

Do I recall you are in NC?

https://www.ncdhhs.gov/divisions/aging-and-adult-services/long-term-care-ombudsman-advocacy-residents-long-term-care-facilities

We are in SC. Thank you for those thoughts. I don't see paperwork in the lobby. I just feel I have to presently lay low as I need their help for her almost desperately. Her wound is presently unstageable as there is too much necrotic tissue. She also needs to be fed which we do but not sure they are doing even though they say they will but she often gets food all over her.

Here is the link for South Carolina:
https://aging.sc.gov/programs-initiatives/long-term-care-ombudsman-program

Getting your mom proper nutrition is critical if the wound is going to heal.

I am curious why you feel you need to "lay low"? They have admitted culpality for this injury and your mother would doubtless prevail in a lawsuit brought against them for her injuries and they know it.

Sorry, I meant culpability.

Ombudsman information usually posted by Nursing station. Every resident’s family member entitled to contact Ombudsman regarding any injury sustained in nursing facility. I’d start there & might hold off suing them until after she no longer needs facility care…you want to concentrate on helping your mother & being her advocate. A lawsuit now will probably stress you out more…& then they may say they can’t meet your mother’s needs….& go find another facility. …& blame it on something else.

By laying low I also mean not showing all my cards. It is what Caregiver mentions. The lawyer we contacted said we had a 3 year window. I just need them to try to provide the best care. They are always assessing the wound. Thanks BarbB for that information.

We obviously are in strange times with Covid. They now always let me in even when they have a new lockdown. Last year when she was there in AL I did not see her from March to November. I could talk to her on the phone and drop off supplies outside the building. Now she cannot really talk on the phone but we go often and try to help with little issues that they will never have the time to deal with. They do have to change the wound dressing twice a day,change her incontinent briefs, empty the catheter bathe her some etc. I just am presently trying to keep peace if she is at all ever to heal. We are not paying presently. It is all through Medicare right now. It is very sad and stressful so I am just focusing on her health but I do understand all of you who say to possibly take it further. One aid in the room lifting her and dropping her has created a nightmare.

Riverdale, I didn't realize you had already consulted a lawyer and sorry that I misinterpreted "laying low".

I think following up with the Ombudsman program is a great idea.

(((((Hugs))))) to you and especially to your poor mom.

My mother was taken to the hospital today with rectal bleeding.

I am so sorry to hear that. Prayers sent!

I'm so sorry, Riverdale!

I found out from the nurse at the hospital she has a second bedsore,in around stage 2. I asked several staff members if she had more than one and was told no. That was even told to me by a senior staff member. This wound had also been packed.

I contacted the lawyer. I think now I have to speak to social services to find other placement for her if she survives all this. Her blood pressure was very low but has risen slightly. They are doing alot of testing. I don't know how long Medicare keeps a patient so compromised but also with serious bedsores.

Poor lady, what a mill she's going through. Hugs to you, Riverdale. I don't suppose anyone's telling you anything helpful just yet?