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?

There's a special place for those who steal from nursing home residents!

Hell has a special place for those creeps who steal from nursing home residents!!!  And, trust me - it will be FULL!!

I already wrote about Mom's brand new go-with-everything pants in brown and navy - but I have two new examples to gripe about.  Mom's roomate is a sickly little gal who is getting sicker all the time.  She is a dwarf and has suffered from physical problems and constant pain all her life. She has no family and has very few personal possessions so when something goes missing she is especially distressed and hurt.  She has no way to go looking for it and no money to replace it.   One of her favorite things was a quilt made JUST for her by a friend of her long-dead mother.  It was white with embroidered red roses and red bands between the white fields of flowers.   She went out of town for a biopsy and it was gone from her bed when she returned.  The aides gave her their standard answer, "It must be in the wash.."  Any dope would know you don't "wash" a handmade RED quilt!!!   Three days later it was still missing and she was quite upset.  She cried and cried.  I felt so very bad since there was nothing I could do.    She has NOTHING! - nothing to her name -  just this one thing that made her feel loved and remembered and it's gone.   She also told me that she is missing a few dollars but that is all secondary to her quilt. 

Another resident  - who is on medicaide and receives $40 per month for "personal" needs - told me through tears how her DVDs disappeared while she was away for an appointment.   She had saved and gone without things for months and months to buy a few movies to watch on a borrowed DVD player and now it's all gone.  Someone had to have known when she was out and gone in to her room to take them.   They knew just where to look, only the DVDs were missing, nothing else was disturbed.   If I had the money, I'd buy replacements for her AND a locking cabinet for her closet so her things would STAY PUT. 

I am flabbergasted that anyone could be so very LOW DOWN and  evil that they'd steal from such vulnerable people.   Often nursing home residents have nothing; their homes are sold off, furniture given or donated away and friends and pets long gone.  Some don't have enough room to hang a photo or put  a chair near their bed.  To take things from them is the WORST sin possible. 

Post vacation - Big "whew" as Mom seems great

After three weeks of vacation out of state I was anxious to see Mom and was relieved to find her very well and content.   I spent more than two hours with her catching up on things she reads in the paper, her friends and sharing stories from our travels.   

One concern continues with Mom:  How long do I have to stay here?  She means the nursing home of course... My answer is always the same:   Well, you can't be at home and you need more help than an assisted living facility can offer.  This is the safest place for you right now... then I ask about something she's read in the paper or if she's talked with a certain friend lately.  This tactic seems to work well for now and I hope it will be enough next time and the next and the next. 

Mom seems more content in this nursing home. She's willing to ask for help and willing to stick up for herself if she feels things aren't right.   I think the time in assisted living actually made her MORE willing to request help and let the aides know when she's unhappy about her treatment.   Sharing a room seems good for her too -  even though she always insists she needs a room of her own.   She has table mates that are alert and able to carry a conversation.  She made a friend in a lady that was there to recouperate from a stroke.  I am concerned though if her friend is able to move to assisted living or home with her family.  Who will take her place at the dining table?

Ah well... we'll just have to work on that matter when it happens.  For now, there is spring yard work, roof repairs and cleaning to do at Mom's house, plus planning her 90th birthday celebration.   She doesn't want to do a thing but it's a milestone we can't let pass.  
Getting Mom used to nursing home how do i get mom to stop asking to go home

Therapist FINALLY gets it but it's too late to help Mom

After finally getting Mom's therapist on the phone, some changes are made but I'm wondering if it's too late to do good for Mom.   I learned a lot from talking with Mom's therapist.  Mom's supposed to go to therapy for an hour a day.  The doctor ordered 30 days of it then a review to see if it's doing any good.  The therapist is frustrated with Mom because she thinks Mom's not trying to get stronger. The therapist spent 10 minutes complaining to me about how uncooperative Mom was.  "She'd rather have a Pepsi with a friend than go to therapy." She seemed pretty upset over the whole situation.  The therapist didn't realize Mom is 89 nor that she's grown increasingly weaker over the last year.   She didn't know Mom was successfully using a lift pole in assisted living.  She didn't know Mom was complaining about her wheelchair, that she couldn't work the phone or TV, or that she was willing to try using the bathroom by herself.   I was ASTOUNDED and mad as hell because this information wasn't transfered at the time Mom was transferred to this joint! (One that her physician INSISTS is the best in town.) This time it was MY turn to get mad and frustrated.   I had conversations about her history, abilities and such with the Executive Directior and with Social Services staff, and, a few days later, the nurse on mom's floor.  All of them said they'd "spread the word". None of them suggested that I speak with the therapist.  They all knew she was there for 30 days of therapy!!  It's quite logical to me that the therapist would need to know a LOT about Mom to judge her improvement.   Unfortunately, I didn't realize they would not communicate.  I never expected that I would have to DO THEIR DAMNED JOB!! 

Unfortunately, this seems all too common.   No one seems to have the time to do more than the immediate task in the moment.  Being a process person, and one who's made a living moving data around into usable information - I am VERY frustrated by this and wonder how much harm has been done to my Mom because of their inability to see that they need more understanding.  They need processes to look at a patients WHOLE condition and history when they arrive.  They need to orient the patient/resident to their surroundings VERY well and spend some extra time for a few days to get the resident/patient out of their shell and involved.  They need to ask lots of questions of the patient/resident and family. They need to LISTEN to what each says.    The therapist didn't realize how old my Mom was for crying out loud!!!  How can she provide good therapy if she didn't think to look at her age.   It doesn't give me much confidence in the ability of this place. I'll finally get to visit next week so they'd better get ready - the inquisition is about to begin!