Jump to content

Menu

Nursing home injury


Storygirl
 Share

Recommended Posts

My mom with late stage Alzheimer's has lived in the same nursing home for eight years, and we have been satisfied with the care she gets there. I am not the primary person overseeing her care (Dad is), and I live a couple of hours away. But I do have contact information for administrative staff and, in fact, talked with the executive director on the phone just last week (for the first time ever) regarding an unrelated concern that I had.

My mom experienced a very bad injury at the nursing home on Saturday night. I was out of the loop and didn't hear about it until Sunday afternoon, but I have been upset and concerned ever since and have been mulling over whether I should press the staff for more information or more action of some sort. I'm planning to talk to my dad about this before contacting anyone, but I thought it might help to solicit some other opinions.

Anyone squeamish may want to skip the next paragraph.

Mom received a horrible gash in her leg while the aides were transferring her with a lift from her wheelchair to her bed. It was a horrifying gaping wound, not just a cut, and she was at the ER for hours getting X-rays and stitches. I guess they had to do many internal stitches to close the wound, as flesh was torn and missing, and then it took 12 stitches to close it. I have seen a picture, and it is absolutely horrifying. More like a shark bite than a cut.

My dad and sister went to the nursing home yesterday and talked to the nurse, who said they would be inspecting the machinery and wheelchair to make sure there is nothing mechanically wrong that caused the problem. They seem to think that her foot got caught somehow, and the aides did not notice. Mom tends to be stiff and difficult to move and does not cooperate, because she does not understand, so they are used to having resistance when moving her and did not realize this resistance was due to her being tangled.

If this were your loved one, what questions would you be asking? What accountability should there be? Would you be reporting it to the state or another outside authority or just talking to the nursing home staff? Would you expect the nursing home to pay the ER bill? Would you expect to receive copies of any written incident reports?

Because it happened overnight on a weekend, I am considering forwarding the picture to the executive director, so that she can see for herself the extent of the injury. Anyone who has looked at it since will only see it after being stitched up. The gaping wound was absolutely shocking and horrifying, and I think they should see it.

Again, I would talk to my dad before contacting anyone at the nursing home, but I don't expect he would mind.  He is a nonconfrontational type himself.

Any thoughts?

 

  • Sad 2
Link to comment
Share on other sites

I have no good advice other than that I would be very angry. That is just not acceptable. How would you feel if your small child who cannot speak up for herself got injured at childcare like that? I would definitely want answers and potentially not want those workers working with her. I am betting she screamed or cried and they blew her off.  ((hugs))

Edited by Janeway
  • Like 1
Link to comment
Share on other sites

I think unless you go for an in person visit, you probably aren’t going to get a lot of information. 

If you can visit, I would approach it from a ‘show me what you were doing so I can understand’ approach and ask how your mom was during the transfer.  When MIL’s dementia became advanced, she would become frightened when handled and would not only stiffen, she would get combative.  It doesn’t mean MIL was at fault, but it helped us to understand that the staff sometimes had to choose to do something quickly so mil could calm down. And mistakes can be made.   Making it clear that your primary focus is on how to move forward with safe care for her is important. If you learn facts that lead you to believe they were negligent, then you can sort through what to do next.  

It’s really hard to see an injury like that and not want to go in with a kick butt attitude.  But you might get better info if you approach it from a ‘how can we prevent this’ mentality.  I hope you can be the voice for your dad- he likely feels the same as you but he’s afraid to upset the staff. 

  • Like 3
Link to comment
Share on other sites

I talked to Dad this morning. He is planning to go to the nursing home today to talk to someone in administration, but he doesn't have an appointment; he is just going to show up and find someone. If it were me, I'd make an appointment. I can't go to my hometown today, because I have some family commitments here. I let my sister know that Dad planned to find someone to talk to, so that she could consider going with him, but she is working.

Dad is 84 but is very independent still. He still works, for example. He is capable of bringing up concerns on his own, but I think it's always good to have another person present. I wish I could be there.

I know that the administration would talk to me, if I called or emailed, even though I am not on the POA, because they talked to me last week and said they would always welcome communication from me or anyone in my family. But since Dad is planning to go in today, I'll stand back and let him deal with it and wait to hear what he learns. I'm glad he is going to talk to someone. He told me he would show them the picture he took at the hospital, so that they can see how serious the injury was. He thinks Medicaid should cover the ER bill and isn't worried about that.

Mom seems to be doing okay so far. Dad says when he visited her yesterday, she seemed normal and not in pain (she is nonverbal).

I think this was just an isolated incident and not an indication of poor care. She has seemed to be in good hands for all of these years. She did have one other time when she fell and broke her wrist, years ago, when she was still mobile but becoming less stable, and they adjusted their way of moving her around back then. Dad said they told him yesterday that they are already planning to be lifting her in a different way from now on out, with the heavier lift machine instead of what they have been using, so I think they are likely to respond with ways to prevent further accidents.

Thinking about it is distressing, though. I know that she is hard to move, but I can't imagine how that injury could happen. A piece of her leg was ripped out. There had to be considerable force on her leg for that to happen.

Link to comment
Share on other sites

35 minutes ago, Seasider too said:

 

OP, your dad may need your help in voicing this. For one, it’s likely traumatic for him. For another, it lets the nursing home staff know that there are additional, educated younger/middle-aged adults involved in her life and representing her interests. 

What sort of facility is it, Medicaid or high dollar private pay?

How energetic and articulate is your father? Will he want/accept your help? He may need to add your name to mom's HIPPA documents. 

Mom is on Medicaid, but she was private pay through their pay down period, so they do take private pay patients. It's part of a continuing care community with independent and assisted living, and they have multiple locations throughout our state, so it's a big organization, not a privately owned facility.

You have a good point about them knowing that the whole family is concerned. I may think about sending an email, not to preempt whatever Dad will say, but just to remind him that I am involved. The complaint I made last week was not really about Mom personally but just something I observed about staffing while I was there, but they took it very seriously and would definitely remember that I am a concerned family member. They would not be surprised to hear from me about this, but I don't want to jump over Dad.

Link to comment
Share on other sites

Ha! Last week I wrote my email complaint on Tuesday, and everyone was "in a meeting" all day on Wednesday and needed to wait until Thursday to call me. I didn't think anything of that at the time, but now I wonder if being "in a meeting" is a common way to delay meetings while gathering information. On the other hand, I'm sure they have meetings often, so I'll try to believe them. 😏

Link to comment
Share on other sites

I have seen both of my parents through nursing home stays and both parents had levels of dementia. I have been in your shoes.

That injury is horrific and should NOT have happened at a nursing home. There MUST be an investigation by whatever department licenses nursing homes in your state.  The staff who were involved should be disciplined and retained at a minimum. I would want them fired. That's negligence.  All of the residents are at risk. Adult Protective Services should be called and you may want to get a lawyer.  The medical care she received should  be paid for by the nursing home's liability insurance and she would probably qualify for a settlement for pain and suffering. An injury like this puts the nursing home's license at risk. This is a BIG DEAL, as it should be. A patient like your mom being difficult to move is a normal part of their day. They did not follow protocol to keep her safe. She is vulnerable and they let her down. 

Your dad is probably going to have a hard time insisting on those steps as he will want to try to work it out with the staff he trusts and be afraid of the changes it causes to her care. I found it helpful to let that family member play the "good cop" while I played the "bad cop". The good cop can make peace, which is easier for them since they are on the scene daily. The bad cop makes sure the right steps are taken and nothing is covered up. 👿  I vote that you show up so they do not have time to get their ducks in a row. You need a copy of the incident report ASAP. If there is not an incident report, call the police. 

Best wishes to your mom and the rest of you while you sort this out. It's going to be a sh*t show but you will NEVER regret advocating for your mother and fighting for her safety.  This is the real work of family and commitment. Hugs to you. 

 

 

  • Like 3
Link to comment
Share on other sites

24 minutes ago, Storygirl said:

Ha! Last week I wrote my email complaint on Tuesday, and everyone was "in a meeting" all day on Wednesday and needed to wait until Thursday to call me. I didn't think anything of that at the time, but now I wonder if being "in a meeting" is a common way to delay meetings while gathering information. On the other hand, I'm sure they have meetings often, so I'll try to believe them. 😏

This is nonsense. They could have called. They are trying to avoid conflict. You sent an email last week about staff problems and then this happens? That is a VERY BAD sign that all is not well there. Please call adult protective services. 

  • Like 1
Link to comment
Share on other sites

I called the local long-term care ombudsmen's office to consult with them. It's towards the end of the work day, and I had to leave a message, so I'm not sure if I will hear back today. I thought it would be helpful to talk to them about our rights, the nursing home's responsibilities, and any resources they can recommend, because they are a third-party advocate.

I haven't heard back from my dad about whether he was able to track anyone down today in the executive offices. He is not a great communicator, so he wouldn't necessarily tell me until I ask. I'm hoping he didn't, because I'd like to be able to be there and could go tomorrow. NorthwestMom, you are right about the bad cop thing -- he is not good at that at all. Generally, I'm not either, but I find I can step up and advocate when needed.

I'm annoyed that my sister and brother don't feel the need to step up and get involved more, since they live there and I don't. But that's typical, and I can't expect them to change. My brother avoids all of it completely. My sister is good about visiting Mom regularly but is not the type to make waves or take charge.

  • Like 2
Link to comment
Share on other sites

Make sure you are documenting everything in writing as much as possible. Follow up any in-person or telephone conversations with an e mail that documents the salient points covered in the discussion. Even if this doesn't become a legal issue, the factual documentation will be helpful for any authorities who wish to pursue changes in protocol.

  • Like 4
Link to comment
Share on other sites

Thanks, everyone!

So, I talked to Dad just now, and he did talk with the social worker that he knows at the nursing home. And she pulled the director of nursing into the conversation. They looked at the pictures that he took and had a nice chat.

Yes, he was all good cop, no bad cop, I guess.

They talked about Mom's wheelchair and making sure it had no sharp parts sticking out of it. Dad kept saying that it wasn't something sharp that did it; he thinks her leg perhaps got tangled behind the foot rest. They all agreed to check out the wheelchair.

And that seems to be it!! ARGH!!

I asked Dad if they were going to fire the aide, and he seemed surprised and said he wouldn't know. I said that it was not the wheelchair that caused this; it was the staff. I said that the only thing I can imagine happened is that Mom's leg got hung up, and the aide did not realize it, because she was not paying proper attention, and that they had to feel the resistance but thought that Mom was resisting, and so they had to have forced her down to the bed. They had to have been too rough. This kind of injury had to come from force, not just a slip or fall.

He agreed with all of that. I said that it's not right for a nursing home aide to treat patients that way, and that she should be disciplined or fired. I said there are ways for us to report this, and that we need to make sure that the nursing home reports it to whomever they are required to. He said he doesn't know anything about how to do that. I told him about the ombudsman and that I would ask questions when she calls me back.

He's not opposed to making complaints or asking more questions, but doesn't know what to do. He seems fine with me gathering information and letting him know what I find out. He agreed with everything i had to say, but had not seemed to have any of those thoughts himself. He did say he would like to see their incident report after I suggested that we should ask for it.

He doesn't seem to mind if I play bad cop, and I think I will need to, or things will stay at "too bad this happened; let's make sure the wheelchair is okay." Which would be a great outcome from the nursing home's point of view.

The ombudsman's job is to help speak for the legal rights of nursing home residents, so I'm hopeful they will be able to give us some good advice about what to do.

  • Like 1
Link to comment
Share on other sites

It is kind of beyond me how this can happen at a nursing home and no one in a position of authority there says holy crap, how did this happen and what can we do to make sure it doesn't happen again? I mean, this isn't just some incidental bump or bruise.  It's awful.  If this isn't the exact thing you're trying to prevent from happening to elderly people, why run a nursing home in the first place?  just ugh.  I am glad you are going to do the difficult work of being bad cop.

  • Like 1
Link to comment
Share on other sites

I’m so sorry for your mom, and that you’re dealing with this. Your mom and dad are so blessed to have you on their side! I agree that you’re going to have to go bad cop, or this will be resolved in the eyes of the nursing home, which obviously should not be at all. 

  • Like 1
Link to comment
Share on other sites

Just a little update.

The ombudsman was really, really, really helpful to talk to. I got good information from her and made a plan with my sister and Dad after I told them what I had learned. And then I heard later this afternoon that Dad needs to slow down, because he is really stressed. He is also in the middle of a move from his house to a condo, with some related renovations happening this week. Plus some work related things going on. So we are going to pause and pursue the nursing home issues after his move, which may happen next week.  Which is fine. We believe Mom is safe right now, and the questions we need to ask and documents we want to request will still be there in a week or so. We need to look after Dad's health and well-being, too, and he needs to not gear up for a fight at this exact moment.

I myself would rather charge forward, but I'm respecting what he is able to do.

So for anyone who happens upon this thread, I highly recommend calling your local area long term care omsbudsman, who is a neutral third party whose mission is to advocate for the care of nursing home residents. She helped me understand some points of law, did some research for me on some questions I had, and said that if we so choose, we can sign a form asking them to investigate the situation on our behalf, because they have access to records that we wouldn't. And they would help us prepare for any meetings we might have and would attend them with us, if we so desired. There is no charge for this service.

Our plan is to utilize their help when we are ready to move forward.

  • Like 10
Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...