My Dad has been in his nursing home for 3 years. He is in a wheelchair and cannot move much. He has been participating in activities when I visit him and seems relatively happy. He has had a lot of the same staff for years. I got a call yesterday morning that he fell from the built in (on tracks) hoyer lift on the way to the shower. They sent him to the hospital. He fractured his pelvis and hit his head, but won’t need surgery. This morning the nurse at the hospital asked if I was aware of a pressure sore he had. I was not. I saw a picture of it, it looked pretty bad to me. She said it looked like it had been there a while and not from his fall. It’s about the size of a palm with no fingers and it’s a wound, not just a red spot. He can’t really adjust himself in his wheelchair or on a bed, so I just want to ask if anyone has experience with this? This sore plus the fall has got me so worried about his care where I was not before. I would appreciate your input/experience.Thank you!
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maria
My mom's NH let me know when they first noticed a small red mark on her backside during diaper changes and they kept her mostly in bed until it healed. I also invested in the ROHO seat cushion that was recommended by an OT since she did spend all her waking hours in her wheelchair. No more sores, not even stage 1.
The pressure sore may or may not be: where is it, how deep is it, is this actually a pressure sore or is it an abrasion or a moisture lesion or...
How is he? Hope he's comfortable now. Is he able to tell you anything about what happened?
I would call on an ombudsman. A pressure sore is reportable for almost any nursing home. Too many of them and state licensure is threatened. They CAN happen quickly and especially so with someone wheelchair bound.
I am so sorry you are dealing with this. It is reportable. You Dad is going, I think, to require good SNF placement now for at least a while.
It likely is neglect especially combined with the fall. It is wrong you were not informed about the sore. They are very hard to heal in the elderly.
He should have a special mattress and he should have his positions adjusted. He may very well need constant pain medication.
I would consider consulting a lawyer who specializes in elder care abuse. They will know if you have a case and will not charge any fees upfront. If you proceed with a case you should find a different and better SN facility for your father.
When I toured places for mom to enter rehab. The head nurse told me that those mattresses worked well in preventing sores from occurring.
Where is his pressure sore located? Is it visible due to being in an obvious place? If it is, then I would suspect negligence on the staff’s behalf.
The reason I ask is because my mom had a pressure sore that was really low on her bottom in a spot that wasn’t visible by seeing her backside. Who knows how long she had it before she told me about it. She sat in her recliner all day.
I bathed her on a regular basis and didn’t know that she had a sore because it was in a spot where it wasn’t visible. She washed her private areas herself so there wasn’t any way I would have discovered it.
When her doctor was about to retire, she said to me, “Honey, when you look for a new doctor, find a woman.” I said, “Okay, mom.” and didn’t think too much about it.
Then she says, “I have a sore that hurts and I would rather show it to a woman than a man.”
When I asked her how long she had it, she replied, “Oh, a long time, years.” I was very upset that she hadn’t told me.
She was extremely modest. It surprised me that she asked for a woman doctor because she had four children, all delivered by a man!
The sore was so bad that a nurse who specialized in wound care had to treat it. The nurse also instructed mom to use a special pillow for sitting in her recliner.
I am not familiar with hoyer lifts and how they work. Your dad took quite a tumble. I would absolutely want to get the entire story of what happened.
Best wishes to you and your father. I hope that he recovers as quickly as possible.
I think it would be a good idea to look into alternative options for his care. Between the sore and the fall I would be extremely concerned about his well being.
One has to wonder how often these things occur in general and certainly if it has happened before in his facility.
I know to err is human but there are protocols, procedures, regulations & charters designed specifically for the age care sector. Towards best care is the goal. To remove harm, minimise risk, ensure safety being the basic foundations of this.
Bedsores can & do happen despite all attempts to prevent - despite regular skin checks & the best air mattress & specialty cushions. BUT. They get reported, monitored & treated.
Things have gone wrong here.
Skin checks should be done.
Pressure areas monitored.
Any wound reported, to family, RN, Doctor. Wounds to be dressed & kept clean.
Hoyer lifts must be checked & deemed safe to use. Any faulty equipment reported & taken out of circulation. Staff must be trained to use, or working as a team under direct direction of a trained staff member.
I would want a meeting with the Facilty Manager. A chance to ask what happened & why. Instead of a blame session, I would attempt to stay neutral to find out the facts. An honest Management team will have some sort of negative event disclosure model of care. Tell you honestly what happened. Then what they are doing to prevent this happening again. To your Dad & others. Eg More staff training, equipment checks, more thorough skin checks.
If Management attempt to coverup or hide from full disclosure, get heavier. Legal weight heavy if you need.