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Thanks, all. It is interesting to hear your perspectives. The hospice org is providing wound care 3x week now after I made it clear that I can't do that. My mother's sore is very small and she has the mattress to prevent them, plus her aides turn her and care for the wound, even though we can't tell the hospice people that.

These rules are bizarre. Why would it be better for me to tend to the wound, when I have no experience, am squeamish about blood in general, feel uncomfortable looking at my mother naked, and know she would be very upset if I were to attempt to try something like that?

Technically, I am supposed to be the one who fills my mom's pill boxes with her pills, but obviously the aides do that because I am there randomly. If the boxes are empty, are they not supposed to give her her medications until I visit again??

It's a weird "don't ask, don't tell" kind of thing.
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Xinabess,

Thank you for being refreshingly honest. It's bizarre to me as well, what's expected of people just because they're family members. Does that automatically make us health professionals? Strange. And just as strange is that people don't question things. They've been suffering for years in the name of 'love'. I said to someone that I didn't have to keep proving my love for family by having to keep doing for them. I will do what I can, but working on no more guilt tripping. Anyway, you will free yourself and others too, by questioning the status quo and helping to break down the walls of silent suffering.
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I may have said this before but Medicare seems to think people can do their own wound care if that is all the care they need. My daughter is a Wound care nurse and is trained to know when a Wound Doesn't look right. Which I don't think a layman would know. I had a Dr doctor tell me the wrong thing to do for Moms wound. TG for my daughter. She took care of it. PCP said the wound heeled really well. Good u stood up for yourself!
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CNA's can not give medications.
If however you have hired them privately you can instruct them what to do and this includes giving medications.
I discussed this with a CNA that I hired privately. Once I explained that hes was my employee and I could instruct her what to do then she could comply. If she were working for an agency or in a facility then as a CNA she could not by law give medications.
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xinabess: IMHO, I think it's appalling to expect a non-medical professional to change a difficult wound dressing or for that matter a simple one. My husband said NO WAY!
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Hi, I'm a hospice RN/case manager and most reputable hospices will require a nurse to see each of their patients a minimum of twice a week. I frequently have seen persons requiring wound care 3 or more times a week. While its frequent for family to provide dressing changes after being taught, it's certainly not expected if they don't feel comfortable...at least in the organization I work. I would personally recommend requesting the nurse provides this service. Hospice is a competitive industry (seems a bit weird to me, but their revenue is census based unfortunately), and you have the power here. I would tell them you are considering switching to a hospice that would provide this (which you have every right to do).
They most likely will honor your request. But if not, interview other hospice companies that serve your area and ask them straight up if that is something they would do. I can almost guarantee you would find they will.
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My MIL was sent home after cancer surgery on her head with a drainage tube, and my husband--a truck driver--was told how to care for it. He was totally unprepared, didn't know how to address problems, how much bleeding was too much, how to properly apply and remove dressings.
I understand that Medicare has its limits, but she could and would have paid for proper care if it had been ordered.
Are doctors and hospitals limited by Medicare rules in the care they provide or order?
Even if a patient is willing to pay for it herself?
Is this government-mandated or what? MIL wasn't offered the choice. She should have been recovering in a SNF, but she was under the impression that she'd be back at work in less than a week when she left the hospital.
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If Mom is tended to by 24/7 aides, that should fall under their responsibilities.  However, if a nurse told you this - it could be because the aide is not trained?  I haven't run into this situation but I did have to learn how to clean and tend to my DH's wounds and it really isn't as gross as it sounds.  My DH had a "scabby" Lymphedema on his foot, that was as big as your hand - and I just kept it clean and tried to keep it from growing.  We learned a year later that it was Lymphedema and we were lucky it didn't climb up his leg.  FYI, silver products helped it to heal, finally.

HOWEVER, what the nurse told you is true - Home Health is supposed to teach us how to tend/care for our loved ones.  I guess Hospice is under the same rules?  I live in a rural community and we've been most fortunate that our Home Health has been glad to assist me whenever possible.
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Hospice is paid a flat rate for each patient. Like 4 or 5 grand a month. All the costs come out of that, equipment rental, employee salaries, care items, like briefs, bed pads, wound dressings ect. So...its up to the hospice to provide care out of that. Most people are pretty ignorant about the medical field and just do whateber we recommend (not you, just a lot of people). If the family isn't an advocate or if families just take what hospice gives them and don't know how it works, you're loved one is not getting what they should. I guess my point is it's a lump sum, not per visit or whatever. Unfortunately some companies try to get away with bring cheap
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I quite agree with the responses that question why it is that an aide can't deal with the bed sores, but can teach a family member to do so -- just plain illogical!! And I do agree with firmly but civilly insisting that nurses and aides attending your loved one should be dealing with all things medical.
That said, I share TreeArtist's response as well -- my best friend had breast reduction that ended up with drains that needed to be cleaned daily. I never thought I could handle putting my hand inside someone else's body -- the 'holes' were quite deep -- but after the first time (and my friend reassuring me that I wasn't hurting her), I found that I could do it. There was a homecare nurse checking on her every few days -- and making sure that I was doing the right thing in between: that made me feel competent to continue. While I don't think family/friends should be forced to do this medical care, some of us will be able to do so if we choose to try. And for us, perhaps there is a bit of wisdom gained in knowing that we have lost some of the squimishness (at least that is what is was for me) about dealing with the needs of bodies.
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The reason all this is happening is that government is the largest player in health care and health insurance now. Whenever you have government involved, you have increasing costs and decreasing quality and access. In health care this results in skyrocketing costs, sub-standard care, and rationing to cut costs.
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