Sunday, January 22, 2012

Fall from a lift and mom's high tolerance to pain leave me worried

Mom's had another incident at the nursing home that will leave me worrying for a couple of weeks.   The aides use something called a "sit to stand lift" to move her from chair to toilet.  Apparently, she lost her grip and she slid out of the lift; the aid saw it coming and caught her and "sat her on the floor".  They said there's no bruising, no broken arms or legs and no pain so she seems fine. My fear now is that something more is wrong but the signs will be so subtle that it will go ignored or unnoticed until she's in excruciating pain; that's what happened last year about this time.
I worry that Mom will have pain but won't feel it.  Since her broken sacrum was diagnosed in February 2011, Mom's been on pain medication that works on her nerves (those little things that transmit pain to the brain) and she wears a pain patch.  To make it more complex, I believe that she has an increased tolerance to pain after a stroke during my birth.  I've seen her burn her hand canning and not realize it until her fingers are full of big blisters.  At that time she was un-phased and just kept working; she said "It doesn't hurt, it can't be that bad."

She "seemed fine" after the "assist to the floor" last January yet she ended up dead in the MRI machine.  I told the nurse who called to tell all the aides to look for "crankiness", impatience or asking the aides if it's time yet for another pain pill.  These are all signs that she's having more pain that SHE or the aide's realize.  I noticed it in her over the holidays - before the "assist to the floor", a month before her pain became excruciating.  Mom's normally in good spirits and doesn't complain; but at Christmas she was disgusted and griped constantly about everything - gifts, visitors, her shoes, her clothes, the aides, my hair, the beautician.  I realize now this was her pain talking.  We might have saved her from the MRI fiasco, the delerium of the narcotics and the bedridden period she required to "heal".  ( I don't believe her sacrum will ever "heal" but that's another post..)

I'm frustrated because I've expressed concern about this "sit-to-stand" lift for a few months.  It's a lift that uses straps under her arms to raise her up from a chair onto this small platform where she "stands" - holding on - while the lift is rolled right up to the toilet.  There she's lowered on to the commode to do her business.  The process is reversed to get her back to her chair.  

The straps that go under her arms are too loose and lift her from the shoulders than the behind.  I've told them she could suffer a dislocated shoulder; it falls on deaf ears.  She is also very weak in the hands and unable to grip the handles properly so I worry that she'll let go - which she did yesterday - and just fold up and fall out of the lift.  The aides and nurses don't seem to worry - when it comes to this stuff they are REACTIVE not PROACTIVE.  To do anything differently would require 2 aides not 1 - translation: the lift works for a one time price; another aide = another body at work costs too much.  I suppose they rationalize it by saying that they want the patient to do as much for themselves as possible. 

I know they are operating to make a profit but it often seems to be at the expense of my Mom's well being. 

Here are a couple of photos that illustrate the lift.  The one on the second is the type used with mom - the hand holds are black knobs.

sit-to-stand lifts risks, subtle signs of pain in elderly, use of lifts in nursing homes.