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Els1eL Asked January 2020

Why is my dad’s nursing home not informing the Dr about his dreadfully swollen feet, legs and ankles?

My father cannot get shoes or socks on anymore. His feet and legs have been red and very swollen for a couple of weeks now. He has developed sores on the soles of his feet and is in pain. He refuses to let staff change dressings sometimes and his feet look absolutely awful. I cannot understand why the Dr hasn’t been called to him. Should I see his Dr as POA? I don’t want the home to think I’m going behind their back or criticising them for lack of action but I am very worried. He has vascular dementia, has had a heart attack in the past and is on Warfarin so I’m wondering if the swelling is a result of his heart working inefficiently.

JoAnn29 Jan 2020
As Barb said, you can call 911. Dad is not in a prison.

NeedHelpWithMom Jan 2020
I wouldn’t let this go. Swelling happens for a reason. My mom suffers with edema. When she was in a nursing home for a rehab stint I noticed that they were not putting her compression stockings on her. Sure enough, the swelling got out of hand. Mom’s doctor continually told her about getting blood clots if swelling continued, also swelling of the lower extremities can be linked to heart disease. Like I said, swelling is related to a medical situation.

I brought up the swelling to the aid that helped dress her. She looked at her chart and told me that there were no orders from her doctor to wear stockings. I politely told her that mom has dealt with edema and her doctors do insist on her wearing compression stockings. She responded by telling me that she had to hear it from her doctor. In other words, I as her daughter with medical POA was going to be ignored so I learned an important lesson that day. EVERYTHING must be included in the doctor’s orders.

So, after any discrepancy comes up I feel it must be discussed with the DON, doctor and social worker. Otherwise, it may be brushed aside and never addressed even if a family member has inquired about it.

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MJ1929 Jan 2020
You absolutely should call the NH doctor yourself and request that your dad be seen. That's not going behind the staff's back, that's looking out for your father.

To give the staff the benefit of the doubt, they're dealing with a lot of sickly people and at times they drop the ball. If you have POA, you should be able to call the doctor's office, have conferences directly with him, and do what you'd do if he was an off-site PCP.

Keep the doctor's office info in your contacts list and never hesitate to deal directly with him and his office.
NeedHelpWithMom Jan 2020
Barb,

NP that mom had was really good!
shad250 Jan 2020
Only doctor he would see is the NH doctor. His PCP if he has one would not get involved unless he was at the hospital or if doc was also the NH doctor as well.
BarbBrooklyn Jan 2020
Shad, when my mom was in a NH, the NH doc saw her on a scheduled basis (I think every 3 months, same as her regular doc before admittance). But if we requested that she be seen, she was seen. When she was acutely I'll, the doc saw her as often as necessary.
Els1eL Jan 2020
Thank you all. I’ll get that done. It can’t go on.
BarbBrooklyn Jan 2020
Hope you get him the help he needs!
BarbBrooklyn Jan 2020
Have you requested that the doctor see him?

You may need to be proactive here; unless dad has been declared incompetent, they are asking HIM if he wants to see the doctor and I'm sure he says no.

Call a care meeting and meet with the DON and SW. Find out what they need from you to get him seen. Also, remember that you can always call 911 and have him taken to the ER.

That's what I would be doing in this situation.

needtowashhair Jan 2020
Sounds like it could be CHF. The NH should have at least a RN on duty. Has she seen him?

If it were me, I would make sure he gets seen by a doctor one way or another.

Els1eL Jan 2020
Yes, cwillie I have. I have expressed my concern and asked if the Dr has seen him and they just say, “No.”

cwillie Jan 2020
Have you talked to the RN on duty? And/or the DON?

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