Isolation is over but I find other problems at the nursing home

I finally got in a good visit with Mom.  I traveled 7 hours to her home town and got to see her daily for three days. On my first visit, after I hugged her like crazy, I took a good long look around.  I looked at the bedding, her clothes, her shoes, her drawers in the night stand - everything, anything...  What I found was disturbing and encouraging.  All of her clothes and shoes where there, her bedding was clean. ... however.... in the bottom drawer of her nightstand I found a bed pan.   This is the normal storage for bedpans in Mom's nursing home; they use them, rinse and wash them and store each in a thick plastic bag.  This one was not in a bag and was smeared with something brown.... it's a bed pan, that can only mean one thing.... EEEEEeeeUUUU uuuuu!!!!

So, I asked floor nurse - not the aid - to come to look at "something disturbing".
Me: pointing to the open drawer: "Is that a bed pan?"
Nurse: glancing down, hands on hips: "Yes, it is. We always keep them in the bottom drawer."
Me: pointing to the  bed pan and the smear, "What do you suppose that brown substance might be?"
Nurse: suddenly paying close attention,  "Oh! that's not acceptable!"
Me:  bending over and pointing, "And, those, are those the same bandages you use on Mom's stasis ulcers?"
Nurse: "I'll have someone clean it up right away."

...and she did.  The nurse threw the bedpan in the trash and soon housekeeping came to clean the drawer with a bleach solution.  I am left wondering how long a dirty bed pan had been in the drawer and if the nurse putting on Mom's bandages would have used them or thrown them away.  Someone put a dirty bed pan in the drawer- it could have been the night before or days before.  Someone might have been using a dirty bed pan for days. Someone changes mom's bandages daily and should have seen it and done something. It's always "someone else" whenever I find this type of stuff at the nursing home.  

Every visit I find something terribly disturbing.  It does not leave me confident that Mom's getting good care.  This nursing home is ranked fairly well compared to others across the state, I can only imagine how crappy - no pun intended - that must be. 

"Exile" continues this time due to shingles.

Friday, Oct 14.  I rushed 7 hours from my home to Mom's so I could attend a doctor visit with her. The prior weekend, the nursing home sent her to the ER for a "rash" on her forehead. The ER sent her home with antibiotic ointment.  Two days later it was a larger rash, swelling and a bruise.  Today she looked like someone kicked her in the left eye.  Her eye was swollen nearly shut and oozing goop.   She has what looks like scabby scrapes on her forehead and into her hair line.

As soon as I saw her get off the bus, I bent and gently hugged her without coming into contact with her swollen face.  I lifted her hair to note a couple of "rashy" spots on her scalp.  After seeing the doctor, he called in a colleague and they decided that Mom has shingles.  Then he turns to me and says, "I hope you've had chicken pox because this is highly contagious..."  oh sh___!!!  I don't remember having it but did have measles 3 times, we're hoping that  one of those was chicken pox and that I have immunity.

Poor mom has only been out of isolation a week and now she'll go back in.   And, I can't go see her until I get the results of a blood test to determine if I'm immune or not.   She was looking forward to my visit and I planned to take her cousin there for a visit with pie and coffee - that's all on hold now.   As for me, I need to stay optimistic and pray the virus away because chicken pox in adults can get bad.  


I think the ER missed the shingles diagnosis because it doesn't normally show up on the face and scalp.  Mom's had it in the past on her back around her waist.  The doctor said they look for "geometry" or lines where the pox appear - it has definite boundaries.   In this case, the pox are quite concentrated on the upper left side of her head.  Picture this; the "bottom" boundary is an imaginary a line from under her nose horizontally toward her ear and around the back of her head.  The other "line" goes from her left nostril up straight over her forehead and over the top to the nape of her neck.   It was just all swollen and painful looking.  She's on a pain patch to help with her arthritis so the infection doesn't hurt as bad as it might otherwise.   So - now we're both in a sort of isolation - she must stay in her room and I have to stay away from others and her - for now anyway.  Damn.

Shingles on the face,  shingles around the eye, shingles on the head, scabby rash red swelling swollen eye face

MRSA puts mom "in exile" and it demonstrates holes in the rules

Confined to a wheelchair now, my mom has begun to get stasis ulcers on her lower legs. These are oozing gross wounds that open up on her chins.  Apparently these are ulcers are common for people who have limited motion in their lower extremities (legs and feet).  My niece, the 25-year career nurse - tells me its caused by poor circulation of blood and lymph fluids.  The skin tissue in the legs doesn't get nutrients from blood flow so it begins to breakdown.   Mom insists it only hurts when they apply salve but the tissue around these sores is often so swollen, red and angry looking that I can't imagine it doesn't hurt.  Since June, I've been concerned about a large on her left calf that would not heal.  Over the past 4 months it's improved then become worse and improved again several times.  In early September a nurse called to tell me it tested positive for MRSA and Mom would be put into "isolation" to prevent infecting anyone else.

I was very upset because she had the wound for so long and they hadn't tested it for any virus or bacteria. I asked if there was more they could do - different medication, vitamins, better diet...I got no answers.  They watched the wound closely for changes that indicate MRSA and finally in early September they "swabbed" the wound and ran tests. The nurse told me they look for discharges of pus and blood and a particular odor that indicates staph might be infecting a wound; once they see it, they test for staph infection. 

After the positive MRSA test, they had to put mom into isolation - no room mate, visitors must wear gowns and gloves, a bed side commode but that as long as the wound was covered, she could go to meals in the dining room.   I felt good that she'd have someone to visit with now and then. I also asked if she could have a larger TV until her isolation was over.  I got no answers even after leaving several messages. 

When I was able to visit 2 weeks later, I learned that Mom had NOT been to meals and that she'd been stuck in her room, alone most of the time.   "...being in exile, like Napoleon", she said. I was so angry.  If I'd know she was NOT going to meals, I'd have sent flowers every few days.  I'd have written letters - something, ANYTHING to help lift her spirits.  I tried to talk with the nurse on duty and she gave me a different story - that Mom HAD been to meals, that visitors didn't need gowns or gloves to protect them from infection.. Two hours later aides brought meals to mom in her room but before entering they put on paper gowns and gloves!..  I asked about the inconsistency but could not get a straight answer from the aides or nurses.  Now I have to call and complain because of these inconsistencies.  It makes me so frustrated!  How hard is it to train people to know what to do?  Infections like MRSA, colds, stomach bugs - are pervasive once they get a hold in nursing homes so all of their staff need to treat the patients the SAME way.  Families and visitors need to follow consistent - and best practice - methods to prevent spreading or getting illnesses.  I want to know that the staff does the RIGHT things to keep things from spreading - to my own mom, to themselves, visitors or other patients. 

I hate that Mom had to be "isolated". All of her clothing, towels, bedding and dining plates and utensils had to be bagged in special red biohazard bags before leaving her room.  The nurse tells me that they tried to "enrich" her activities with extra visits from their staff but it's not the same as family or friends.  Given the inconsistent messages from their own nurses and other crap that goes on, I doubt they do much "enrichment".   My family was quite freaked out and didn't want to visit; they feared mom was exhaling the virus and that they'd become infected.  I went anyway because I read enough about MRSA to understand that it was most likely caught quickly and thus a local infection - meaning it was only in the tissue on her leg and not spread throughout her system.  I also spoke with the nurse before my visit and learned that the sores on her legs were nearly completely healed.  I didn't intend to touch her wounds, bandages or the like so I knew that chances of being infected were very, very small.  Visiting my Mom after she'd been isolated for two weeks out weighed my concerns about getting any virus. 


This is the definition of MRSA from wikipedia:
Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium responsible for several difficult-to-treat infections in humans. It may also be called multidrug-resistant Staphylococcus aureus or oxacillin-resistant Staphylococcus aureus (ORSA).


More on stasis or venous ulcers at wikipedia: http://en.wikipedia.org/wiki/Venous_ulcer

How could my mom get MRSA?  Mom has MRSA, can i get it? Dad has MRSA can I get it.  What should nursing homes do about MRSA?

Momma Mia made me cry over my own Mom.

This blog is supposed to be about my mom but often it ends up being about my feelings - I suppose that's natural since I'm writing from my personal point of view and there is so much anxiety and guilt associated with sick and aging parents that it would not be right to exclude that from my various topics.   I've not added any posts since Mom's latest health scare because I've had little to share that's positive.  I've not wanted to whine, moan or complain.  This morning though, I was overwhelmed by such a deep sense of sadness that I must write about it.

For several years now I've wished so badly that I had the money to buy a big house, hire a staff of 4 to help with Mom and then just live, doing all the things that I enjoy and finding some way to make her a part of it - making jam, gardening, sewing - just those day to day things.  My mom is still curious - she wants to watch CNN and PBS, the history channel or animal planet but the set up in her room at the nursing home doesn't permit it.  I want to have her at home where she can have HER favorite chair, HER large screen TV, HER 4 walls around her - but she needs so much assistance, I just can't do it all.   I know she's not as happy as she could be; she longs for company from her family but my brothers never see her.  The saving grace is a neighbor who's tried to see her at least once a week and a cousin who's gone by now and then over the summer.   

My sobbing melt down came as I was reading news and watching Momma Mia on TV.  Meryl Streep was singing about loosing her daughter to adulthood.  The lyrics have her remembering sitting at the kitchen table with her little girl, spending simple times just eating or doing the day to day things.   It just hit me so hard to think of my mom enjoying those times with me, then watching me get my first car and taking off, leaving her in the house alone.  I remember leaving for college; she and my dad weren't getting along and I was in such a hurry to escape it.  I didn't think about her and that she might feel abandoned with no ability to drive herself (she had a stroke during my delivery which left her partially blind and with epilepsy), no job, no money of her own - she must have felt awful but that didn't occur to me.  I was happy to get the hell out of there, to be free to have fun.  I left and didn't look back to see her sad face.   To be fair to myself - I did visit often and called her every Sunday but it's not the same.

Now she's in the same boat - she's stuck there and I end up driving away. At least I always come back!  She has people around her but it's a string of different people and she can't do the things she enjoys. All she wants is to sit in her comfy chair with a remote to a TV she can easily see.   That's not too much to ask and I can't make it happen.   She's never asked for much of anyone yet she's done a lot for others just by creating a home where we could all feel welcome and supported.     I hate that I can't do that for her. Even taking her to her little house isn't possible - it needs so much repair and would require total remodeling to accommodate her wheelchair.  

As for me, I also miss my mom but the "mom" I miss doesn't show herself often due to pain, hearing loss and naps.  She has a good sense of humor; she's smart and witty.  She's done so many things and remembers how to do most of it - she's a wealth of information!!  She's also wise - which I miss, she always has good advice for me, though now I don't ask much because I don't want her to worry.  There's just so much I want to know about her, about my dad, my grandparents- I want so much for her to look forward to a good meal, to taste freshly picked berries, ice cream when she wants it not when it's on the menu; to sleeping in and eating when she wants not on someone else's schedule... to sit hear her roses and enjoy their color and scent in the warm sunshine..  this is how growing old should be not in some institution where she's a "client" not a person.  

Ah well, my crying won't help her and now I've got a head ache... all I can do is try to get there to love her and make her feel as loved as possible.   If anyone out there reads this - do me a favor - go love on your family.  Young or old, listen to their stories and ask them about the most important things in their life.   Talk WITH them and Listen; share things WITH them and you'll feel better about everything!