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My mother has been in memory care for 6 months. She has advanced dementia. In the past month she has developed a pressure sore which the team at her facility have not been able to control. It has become necrotic. They want to call in hospice or have her moved to a skilled nursing facility because they say they cannot take care of the wound. Because of their assessment her insurance is refusing any more treatment, saying the wound is "unsealable". We took her to a wound care center last week and they claim it is definitely treatable. It seems we are at the mercy of the insurance company. If they continue to refuse further treatment we will have to call in hospice or move her to a SNF. We feel that moving her at this point will create more depression and confusion. Any advice? Will hospice do any wound treatment or will they only provide comfort?

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Hospice can indeed treat wounds, as they can do any treatments that are meant to alleviate pain; that surely is one. But I am concerned here. I am thinking they want her moved to Hospice and will begin with the morphine, no treatment, and essentially usher her out. I am a huge advocate of hospice, but not is there is something treatable. You need now to go through insurance with the recommendation of the wound care people. She can be moved to skilled nursing; she NEEDS skilled nursing now, and still not call in hospice unless the sore proves to be so necrotic that it goes systemic to blood and does indeed take her out. Bedsores this bad DO kill. They are lethal. But you have the assessment of a wound care consult that says this is treatable. You do not speak of her general condition and I will count on her doctor to discuss that with you. But if you go with Hospice I think you need to get it clear if this is just "give pain meds until she goes of the wound" or if there will be TREATMENT of the ulcer". You need to be comfortable and have ALL THE FACTS so be certain they give them to you. I wish you so much luck and hope you will update us. You have to widely divergent opinions by two medical entities. Wound Care is now become a specialty. I would at least try what they say. And yes, the move to skilled nursing likely needed now whether with or without hospice.
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I would have the woundcare facility do a predetermination with the insurance company. Maybe coming from them and saying it can be healed they will authorize the care. Insurance findings can be questioned. I doubt if the MC has a nurse well versed in woundcare. Someone in skilled nursing should be. That is how my daughter started out. Now she is unit manager for a Woundcare facility associated with a hospital.

Isn't Mom on Medicare with a supplement? Or is it Medicare advantage?
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Has anyone raised the issue of contacting a wound care specialist to treat her where she is now?   We had a problem in our first go around with a rehab center.   Their so-called doctor didn't treat Mom's heal wound properly; we went to a wound care center at a local hospital, before I knew the hospital had a reputation for malpractice.

The wound care nurse recommended using  toothbrush (yes, that's right, a toothbrush), to brush the wound.    We found a dermatologist, he saw Mom at the center, recommended specific treatment (which I don't recall now) and cured the wound.

I don't recall how deep it was, but it was an eye opening experience into the lack of competency at rehab centers as well as that local hospital (which now has a list of malpractice suits against it.)

I hope you find a good solution and that your mother heals quickly and properly.    Good nutrition would I believe also play a part, so you might want to check her meals and make sure she's getting good food.

Offhand, I don't recall which vitamins are good for healing.   I did search, but I'd rather you rely on the doctor as I don't know what other conditions Mom may have.

Also, you might ask for an alternating pressure pad mattress if the wound isn't on her feet; my father had one for home recovery.    Alternating sections of a pad are raised and lowered so that body parts aren't continually resting (or rubbing) against a particular area.

I've also seen nurses put wadded up blankets or something else under a foot to keep the skin from abrading and chafing against a mattress. 

If the nurses at the care center don't have them available, I believe they can be bought as I've seen posts here in which others inquires about sources for them.

Best wishes for a successful outcome!
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