Protocol for bed bugs in assisted living facility?

Call the 311 agency and report them, and take her out of that place.

I have just recently broke out with what looked like bugs bites, itchy as could be. I felt tormented, my husband came home and the first thing he said was , you have hives what did you do?

Just realized yesterday that the new medication for the dog has coconut oil and I am super allergic.

Could be they changed something like laundry soap, medicine or the water company could have made a change in chemicals or even manufacturers.

Just some information that might help you.

Please let us know the outcome.

I pray it is easily treatable and nothing traumatic like an infestation.

my husband does bedbug work and unfortunately in most places the health department does not think of bedbugs as a health issue but only a pest. He has done several inservices with nursing homes and home health care to educate the staff on how to spot a bedbug infestation and what to do to if there is an issue. The legalities are very vague as to who must pay to take care of the issue because it’s hard to prove who brought them in. Some ALF’s are good and proactive, others are reactive and then there are many that are in denial or too worried about the almighty dollar more than their patients health and well-being. As others have said, check all the crevices of the mattress, under the mattress and in the bed frame. Little black blood spots are the first indication. Bedbugs will always be where there is a host, in a bed or chair, unless the infestation is bad, then they can be everywhere. I always know when he has done a really bad bedbug job because he strips in the garage and his clothes go directly in the dryer!! Good luck on finding the issue and getting it resolved.

Thanks everyone! The dermatologist is treating her for scabies even though she couldn’t find any microscopic evidence that it is. The folks at the AL have been very cooperative. The professionals who were called in could find no evidence of bedbugs so that was a relief, but left us with no real answer. Hopefully the creams and oral medicine will help. If not, then we will be back where we started. Fingers crossed! And thanks again for the ideas and support!

As someone else pointed out, it is much more likely to be scabies. And yes, they are very common. They also cause much more itching than bed bugs and will need treatment (i.e. permethrin) head to toe and repeat in a week to 10 days, I believe. Report to AHCA. They must and will investigate.

Capture one of these bed bugs and put it in a plastic baggie. Snap a photo of your mother's skin area. There is your evidence.

A quick way to stop scratching is to tie each hand up in a large square like an old fashioned cloth nappy. My mother did this for thumb sucking, and called them 'bunnies'. It might help for a couple of nights when the scratching is unconscious, to let things heal.

What a horror story. I have no answers, But SOMEHOW they must be FORCED to fumigate. LEGALLY? I dont know the answer....But u are probably still paying for her to live there, SO u have to have some LEGAL recourse. Her body and the dr's diagnosis should be proof enough for an attorney.....get going and may the grace of God be with u.....

In regards to itching:
The best anti itch product that I have found is called TriCalm. It has no steroids or antihistamines. It's the ONLY product that I've tried that works for me. Stops the itch, or your money back.
It's a little pricey compared to other products, but a little bit of gel goes a long way.
The product works best if once you apply it, you stop scratching the spot for a few minutes. Gives the gel time to dry and do it's magic.
It even works on fire ant, ticks, and no seeums bites!

Examine under the mattress and if you see the little beasties..Report it immediately to your health department please. Bed bugs and scabies are pretty common in nursing homes. if the welts are between her fingers and toes it's probably scabies. report that to the health department. And you better take STRICT PRECUTIONS to keep them from spreading into your home otherwise it will cost over a thousand dollars to call an exterminator.

Lift the edges of the mattress and chairs and couches and see if there are yucky moving things anyplace. In drawers too.

Has your mother been tested for scabies. This is common in nursing homes and ALFs. It took almost three months for them to diagnose my husband. It's a two month treatment but finally they cured it. He had symptoms just like you described. I also had to be treated. Good luck.

FLEAS is my first thought having had close and personal experience with them several times.
Does your mother have a cat or dog or does one visit.
Did Mom recently move into this apartment? Was it empty for a while? Did the previous owner have animals?
Flea eggs can survive up to a year and as soon as something warm blooded arrives they spring into action. They are actually species specific but when hungry bite anything. If you go into a badly infested room wearing light colored pants you will immediately see your legs covered in black spots.You can brush them off but inevitably a few will hitch a ride home.
It is said that if you place a dish in the room with a lighted candle in water you will find dead ones in the morning.
They do itch like crazy and there is no way Mom can keep from scratching so find a good anti itch cream and cover her with it.
The best thing to do would be to call an exterminator and you should insist that the facility does this immediately and remediates the problem at their expense.
Do not bring any of Mom's clothes to your home till the exterminator has done his job.
There are plenty of sprays and bombs you can use if it comes down to a DIY job. You may need several applications but they are pretty effective these days.
My only is on fleas however loudly CM is screaming as she runs down the road in her underwear.

Are you in a hot climate? My SIL developed a huge allergic reaction to “no-see-ums” out of the blue. They’re all dead now up north, but may be still active in the south. She had to get on steroids to stop the terrible itching and swelling. Just a thought.

If you get nowhere with the facility call the Dept of Health.

Thanks, everyone! The ALF had a professional inspection done and there were no bedbugs to be found! So I’ve spent the rest of the day trying to get her an appointment with a dermatologist. Finally, I was able to get her an appointment for tomorrow morning. Her skin is covered with with bite-like lesions which are itching like crazy! Apparently, the Urgent Care Doctor was mistaken, but we will keep trying to find an answer. I didn’t mention that Mother is 94......has anyone else had skin breakdowns in elderly Alzheimer’s patients which are related to Alzheimer’s? There is no reasoning with her to try to stop scratching! We have to get some help for this!

When you say "staff", to whom did you report the report from Urgent Care?

This information should go to the DON and Social Worker, in writing. And you need to ask what their plan for remediation is. There is usually a State-specific mandated protocol that is required in places like hotels, ALs and apartments that must be followed.

At least in NYC, an on-site inspection must be done by a qualified professional within X number of hours/days. If evidence to bed bugs is found, extermination procedures must be obtained by the landlord and all adjacent units examined. There is specific protocol for bedding, clothing, etc.

Have you examined your mother's clothing, bedding, etc. for evidence?

What does staff think the bites come from?

Please let us know the outcome of this; I had bedbugs, discovered on Christmas Eve two years ago. It's not an experience I'd wish on anyone.

My personal protocol for hearing rumours of bed bugs is to squeal hysterically and run away. I realise that is not terribly helpful to you.

Have you got Urgent Care's opinion in writing? If not, can you get it? You then copy this to the ALF's lead manager, to the CEO if the facility is part of a group, and to whichever state regulators operate in your locale - you can find them online if you dig around a bit, try "reporting ALF problems in [name of county or state]."

What would make me see red is not so much the potential infestation but the facility's dismissive attitude. Keep your mother safe with you until this is resolved. Hire help, and keep every invoice. If you can, withhold her ALF fees. You are going for:

a) a proper investigation of your mother's room
b) if an infestation is found, the total replacement of her mattress and all soft furnishings and any clothing that may be harbouring varmints
c) deep cleaning
d) wider investigation of other residents' rooms
e) reimbursement of all expenses you have incurred

If the manager of the ALF has the sense he or she was born with, the second you start making this complaint formal s/he will spring into action and begin the protocol they must certainly have in place. In that case, assuming you don't want to move your mother, be gracious and co-operative. But if that doesn't happen FAST, keep referring up until you get results. Good luck, let us know how you're doing.