Just another story for the records. I never imagined…..

My mother took a fall and broke her hip in mid November. She had multiple fractures, 2 incisions. Prior to her fall, she was declining, has been blind from acute macular degeneration and overall, as mentioned, declining steadily since my father passed away 2 years ago.

5 days after her surgery, she was transported to a skilled nursing/rehab facility where, 4 days later I received a call from administration, telling me that they had just transported her back to the hospital because of a low grade fever she was running and being in a non-responsive state. As it was discovered in e.r. by the infectious disease doc, her bandages had not been changed, her incisions were not treated, nothing whatsoever had been addressed at the SNF and hence, her incisions were filled with puss. This nursing facility had totally neglected her post operative care, no disputing. The hospitals here date the bandages which were last changed there but had not been changed or addressed (as I mentioned) since her discharge. She ended up back in the hospital for 2 weeks, 1 week in ICU. From thereon she went into heart and lung failure, with a host of other complications.

She was then released and admitted back into another nursing/rehab. She’s been there for a little over a month now and I was just informed that they’re discharging her. Why? Because she has plateaued in her physical therapy and is not making improvement, plain and simple. Medicare will not allow a patient to remain in a SNF for the 99 days Medicare-allowed if they show no progress. My mother is now completely debilitated, can’t lift her head off the pillow, can’t support any of her weight when they lift her, just very sick but there’s nothing life threatening right now or “allowable”, according to the staff that would warrant transferring her back into the hospital. She’s going to come home next week with nursing that is going to break the bank, here.

The doctor took me aside and suggested that “there’s a way around all of this.” He told me to take her home and once there, I should call 911 and have her admitted back into the hospital where they’ll put her on feeding tubes because she’s not eating and “on the verge of needing these tubes.” The facility…right this very moment, should be overseeing this, wouldn’t one think? How frustrating and disgusting that there are ways to get around getting back to where she should be. I won’t subject her to all of this, just can’t do this to her, unless of course it becomes otherwise apparent. She should be in the care of health professionals and Medicare should be covering this, I don’t see it any other way.

One other thing is that I noticed her dementia has gotten 10X worse. I brought this up to the nurses where they asked, “What do you want us to do about this.” I told them, “No….it’s what are you going to do about this?”, to please alert the doctor and let him know. They reported to the doctor that they noticed no changes and when I reminded the staff and the doctor that I noted significant changes, the doctor responded that she’s failing and it’s not be unexpected. True, she’s damaged goods, in other words, so just forget about her, right!

Keeping vigil for Sandy & her mom... I spoke with her this afternoon and her passing is expected very soon...

Love & Light, Sandy! {{{{{{{{HUGS}}}}}}}}

quote:

I would rather have a robot provide me with care

When there is a robot, that's probably what we will get. But it will be even more expensive and, just my luck it will short out while bathing me and electrocute me. I think the Japanese are working on one as we speak.

I really would wait to say I prefer that though, until I saw one made, ready, and able. Maybe the "DunkenScrub" model or the "DiaperUp" 2010. I can't wait for the info-mercial.

"BUT WAIT, THERE'S MORE!!!!! with each purchase or year lease, you get a free case of GOJI JUICE for just $199.99 S&H

This message has been edited. Last edited by: Bobcat,

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Those that go to assisted living to avoid being admitted to nursing home are experiencing a false sense of security. ( I am sorry if I offend) This is the most dangerous of all the medical delivery systems and many pay big bucks to be taken financially advantage of.I have been in the absolute high end and the low end of the nursing home and assisted living spectrum. It is a dismal and ugly industry that needs reform and overhaul. we will not experience this in our lifetime. I feel that we are doomed to have poor care and individuals with poor attitudes that will care for us.

Diane,

This is not constructive, which surprises me coming from a Nurse and "Life Care Advocate". No offense. This is the only system we've got right now and I would think you could offer suggestions on how to work within this crippled system, rather than just make comments like "I would rather have a robot provide me with care." You are lucky that your son is a nurse. But it does none of our members any good to hear this without the benefit of some "positive" input.

Sandy, I agree. here's my take on it from my blog dated 4-24-09. My apologies in advance to those in the NH field. It is more a rant out of frustration than a reflection on your professionalism and care, but still some validity to it.

Edward, my 94 year old father, and the hoary patriarch of the Wisniewski/Stanley clan, fell and broke his hip two months ago. He doesn’t remember any of it, not the 4 day hospitalization to repair the damage, nor the subsequent stay in an award winning rehabilitation facility; which, in reality, is just a pretentious marketing term for a nursing/old people’s home with a meager physical therapy department with a few friendly, but overworked therapists (I’ve donated more and better ‘gently used’ exercise equipment to Goodwill Industries in the past year). Not surprisingly, these senior citizen warehouses are one of the few growth industries left in Florida. Most post-hospitalization convalescent stays in these types of facilities are paid for by Medicare or private insurance. So the patients are usually warehoused in and out as quickly as possible; unless the administration can ‘sell’ the family on the idea that their relative would be better off in their long-term custodial care for the low, low price of only $7,000 a month. Kind of like a geriatric bait and switch scam run by the health care industry. So unless you are a good sport and agree to eventually die in their award winning facility, a few days to a few weeks is the most you can normally expect to stay before they send you packing and they bring in the next batch of maimed prospects from the busy hospital surgical wards.

File a suit against the place who didn't change her dressings as they should have done & didn't......

SandyF,
I am never surprised by a post like yours.My experiences with hospitals and NH taught me to expect the worse and be grafful when it was the best.
All of my husbands set backs were due to doctor and hospital errors.
NH, MY OPINION WOULD FILL A BOOK

Oh Sandy I am so sorry you have to deal with all of this at the same time.
The cardiologist suggested hospice? What's wrong with her heart? Is it that close to possible failure? The 6 month limit can be extended, you know. And Medicare will pay for hospice sooner than they will an SNF/rehab place where there is no "noticeable improvement".
Did your mother ever make her feelings known regarding feeding tubes and all that? If not, and you are at such a stage, and she cannot tell you, what do you think she would want? That is all any of us can do; try to determine what our loved ones would want, and what is best for them.
I hope you can bring her home and give her the care she needs. I know that you will give her all the love she deserves.

Sandy, I am deeply concerned by all you and your mother are facing. Thank you for giving us all a call to alarm. Maybe I can't do anything more than be here to listen, but I will do that.

This message has been edited. Last edited by: Bobcat,

Bobcat, yes, I'm aware that this is the policy written by Medicare for SNF after discharge from the hospital. I transferred my mother to this SNF from another one after her 2nd hospital stay because I was faced with having to transport her to 5 different outside medical facilities for followup and the woman was way too sick then (and still is) to be transported back and forth. The doctor in the hospital is the chief medical adivisor at this SNF where she is now and urged me to transfer her there where he would oversee her care. He agreed then (and lately) that she was too sick for transporting back and forth for medical followups and that he would oversee her care, he'd come to see her twice a week and would consult with the doctors from the hospital who are the same docs. that the first SNF made all these outside appointments for. He has never once consulted any other doctors nor has he followed up with the twice a week visits. He also told me a couple of weeks ago when I was contemplating having her discharged and brought home, that I'd be foolish to because of her condition and that she would receive better care there than at home. Nothing has changed in her condition except his decision to keep her there.

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Originally posted by Bobcat:
Does the doc think she will acheive some improvement if she is fed, or will it just keep her going? That was a very hard question to ask and I don't need an answer, but you do in order to choose for her.

The doctor has brought this up to me with his additional thoughts that he's surprised that she has lived this long, adding that she'll do better at home and hopefully, eat. Her cardiologist told me to consider hospice but that's not an option at this time. So Bobcat, Yes...she'll make some strides by eating, of course and Yes....it'll just keep her going. And he's also acknowledged that she belongs in the hospital so he's discharging her back home....the doctor who I seek for guidance on her behalf.

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Originally posted by Bobcat:The first SNF/rehab should be held accountable for their neglect, but your mother's needs right now are of course, your only concern. This is all so terrible to hear.

I filed a complaint. The attorney generals office, APS and a RN hired from APS have all filed their official reports after their investigations, citing gross medical negligence. I recently hired an attorney to proceed with this. The first beneficiary to this claim is Medicare for her second stay in the hospital to treat her wounds. This was made manditory along with the reform bill passed in 2006. The status of their claim which is automatic, was at one time defined that entitlement to Medicare was within the 3 months of the patients admission to the SNF....no longer so. The SNF caused her decline and I'm now left to now care for a direly ill woman who's going to need 24 hours, round-the-clock care which will be paid for out of her account instead of being covered by the insurance companies or Medicare. This is my objection at this late stage.

Thanks for your input, Bobcat.

Sandy, I am so sorry to hear of this ordeal for you and your mother. What you have said about the Medicare coverage is just about what I have understood it to be, right or wrong. I did think they covered some home health visits though.

Does the doc think she will acheive some improvement if she is fed, or will it just keep her going? That was a very hard question to ask and I don't need an answer, but you do in order to choose for her.

The first SNF/rehab should be held accountable for their neglect, but your mother's needs right now are of course, your only concern. This is all so terrible to hear.