Okay, my father has the beginning of what seems to be bed sores. The staff in the nursing home will turn blue in the face and tell us they are not. Being not a physician I went on line to see a picture of bed sores, well it's a bed sore problem for my father.
What in fact should be our next steps? We have requested a wound nurse. I have 3-5 times. I have never heard back from them. They recommended a dermatologist but it is in a basement of a building with no elevator. My father is confined to a wheelchair. What should we do next? We are thinking about a hospital visit? Please tell us what to do next in regarding this manner. This is so wrong, in so many ways.
Anywhere on the body where the skin lying over a bone or bony protuberance is at risk. Lying in urine-soaked sheets will make breakdown more likely.
Good nursing care will prevent a variety of conditions that the indolent and could-care-less will sit by and allow to happen.
Do not be complicit in their neglect by staying silent. Holler! The louder the better! The more often the better!
mOving them side to side, getting the proper ointment, which is availabe, and yet get hold of the Area on Aging in your area.Is he able at all to walk with assistance? just some blood flow into the area can help.If you push on the area
and it turns white at all, that means that there is still blood flow ot the area, if not, get on this yesterday. These are unacceptable, and need constant watching. Good Luck, my thoughts are with you.
Complain to the ombudsman, your city councillors, your reps senators, Governor, and even Barack. Get someone moving in the right direction.
Stand unafraid and never surrender until his needs are met
PHOTOS, RECORD CONVERSATIONS, MEASURE THEM WITH A RULER OR WHATEVER. Tailbone area is usually where they get it. You can get them anywhere there is pressure. Dad probably needs one of those air matresses to help relieve pressure point.
TAKE PHOTOS OF THEM NOW. KEEP A LOG. MEASURE THEM. RECORD YOUR CONVERSATIONS WITH THE STAFF ABOUT THE BEDSORES. ASK WHY HE ISN'T BEING TURNED, CHANGED, AND CLEANED AS HE NEEDS TO BE.
1. Back
2. Bladder
3. Bowels
4. Bed [pressure sores]
These are always priorities and no member of staff should need telling to attend to them at all times because they are the primary causes of patient discomfort, infection, confusion, and concomitant infection often leading to death.
I was pretty confused when my mother went to a nursing home, and trusted that the facility doctor would do the trick. Turns out it took absolutely weeks to get a low sodium diet for her, even though her hand swelled like inflated plastic gloves.
I have also worked in a nursing home (a long time ago) and more recently in other areas of residential care. There is a strong pecking order about who can tell the doctor what. (pretty much nobody). I also wonder how often the doctor actually examines the patient, and not just their chart.
My dad's doctor is happy to look at pictures of his behind on a cell phone photo, which can also be emailed.
Reestablish with an outside doctor who specializes in elderly non ambulatory adults.
Texarkana has this spot on in being assertive but not aggressive.
If you go the nuclear route of contacting an attorney or being demanding and telling them what they "have" to do, the NH may well send you a "30 Day Notice". In the notice (which is sent to the state and their insurers), it will be brief and say something like Mr. Smith needs a higher or more specialized level of care than we can provide at this time and so Mr Smith will need to move to another facility within 30 days. If you get a 30 Day Notice, you will need to find another facility for him. They could extend the days (Medicare & Medicaid have safeguards on this) but really you will have to find another NH. So you will have to find a specialized facility that deals with wound care. This may not be easy to find.
You can take him to see an outside MD. I took by mom to see her private practice opthamologist & her old podiatrist even through she is in a NH for the first couple of years. The NH did require that they faxed over a short report that was included in mom's file @ the NH. (I could not bring the report over, had to come from the doctors office directly) This may be a good way to approach this to determine just what is happening with dad's situation from an objective third party. You can request a care plan meeting after dad sees the dermatologist too. They usually are every 90 days (at least they are for TX NH) but you can request in writing to the DON (director of nursing) for it a care plan meeting to be done the week after the dermatologist visit (so they get the dermatologists report & review it). The care plan meeting is really a good opportunity for everybody to voice their concerns. In addition to nursing, dietary & activities & social worker will be at the meeting or on CC line. For us, dietary has been especially great as they have tweaked mom's foods for her being bedfast this last year and getting items with prebiotics so that her elimination is better. What if dad is straining for bowel movements and that is causing the pressure? then dietary changes could make a difference. Really it needs to be a team approach to care. Good luck.
I used to have a mini-sound recorder [H2] in my pocket for visits, especially when a clinician or physician was present.
As it was, whenever I drew attention to a problem, it was immediately seen to.
When a member of the nursing staff came into my wife's room and threw a pillow around in anger for something that had happened elsewhere, I ordered her from the room and had her unassigned to my wife. The floor sister was quite co-operative.
On another occasion, a PT was yarking my wife's legs out of bed the day after her knee replacement, ignoring my wife cries of pain. I ordered her from the room saying, "If you do not get out, I will throw you out!" I am not usually so irritated, but when someone does something that causes a patient in pain to have even more pain, then whatever it is they are doing has to stop, stat.
As I have said before, the cared for is more important than the carer. Not everyone agrees with that, but that is my philosophy. The helpless have to be helped, and that is why we are caregivers.
Carers under stress can attend support groups where others in similar situations will share their experiences and, hopefully, good advice on how to cope with difficult loved ones.