The decubitis ulcer is a scourge I wouldn't wish on anyone.
With the exception of a few minutes each day, Vivie lay in her bed or sat in her wheelchair. But her skin was fine until the day she pointed to her bottom and told me it was gooshie. Click HERE for that part of the story.
Bedsores can occur because of an inability to change positions, along with poor nutrition, irritation to the skin because of urine and feces, and the simple reality of being elderly. An old person's skin is fragile.
Over the next few months, the two red spots on Vivie's bottom became sores. They gradually deepened, wept, and turned yellow and ugly. I showed them to a night nurse, who said, No diapers when she's in bed. Air needs to get to those.
Every two hours, I turned her from one side to the other to keep her off of her bottom. I don't know what happened on the nights I worked in another area or wasn't there. During the day, she should have been helped up from her wheelchair to change her position. I doubt if that happened.
A friend who worked during the day, someone who was a good GNA and worked hard, told me that by the time they got everyone out of bed, it was time for the GNAs to take their lunch breaks, and then they served lunch to the patients and fed those who couldn't eat on their own. After lunch, the GNAs answered call bells and did what they could.
We never had enough staff to do everything that should have been done. People who could have been helped from their wheelchairs to the toilet sat in urine for hours. One patient who only needed to be reminded to use the toilet wasn't reminded. She was soaked almost all the time. Patients who were in bed during the day didn't get bedpans. A patient once told me she'd asked for a bedpan during the morning and a GNA said, I don't have time to do that. Just pee in your diaper.
Then she lay in the urine the rest of the day.
Someone who worked at night had a terrible idea. She put a patient on a bedpan and didn't remove it so the bed wouldn't get wet. The patient was on the bedpan for about eight hours.
That patient ended up with a black, necrotic ring of flesh on her bottom.
If patients still had teeth, their teeth hardly ever got brushed. If they didn't have teeth, their dentures often weren't cleaned and their gums weren't swabbed.
During the busiest hours––getting people up, mealtimes, and putting people to bed––we should have had twice as many GNAs as we had.
Some GNAs were lazy and could have done more, but more staff would have helped no matter what, unless two people who were lazy worked together. In that case, they seemed to encourage each other to slack off.
When I left the nursing home, Vivie had spent about a year with bedsores. I saw many that were worse than hers, but what happened to Vivie was of special concern to me because I was the one who cleaned her up after she had diarrhea. I saw the progression of the sores.
Vivie never complained about her bedores. She seemed unaware of them, and for that I'm grateful. Bedsores are usually painful, especially when the patient can't avoid the pressure on them.
Several months after I moved away, I returned for a brief visit. Vivie had died. When Bernadette the activities lady planned her summer vacation, she let Vivie know she'd be gone for a couple of weeks. Vivie said, I won't be here when you get back.
And she wasn't.