Saturday, February 27, 2021

THE DECUBITIS ULCER A.K.A. PRESSURE ULCER OR PRESSURE SORE OR BEDSORE

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.

32 comments:

  1. So sad. That is what you hear about so many places that are understaffed. And they drug up the patients who give them trouble with demands and complaints. So sad. :(

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    1. The use of sedatives was controlled very strictly where I worked. We had a woman who was nuts. She was getting something that made her drowsy--and much easier to handle. The state inspectors said it had to stop. Soon after she grabbed my face with her fingernails.

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  2. This is not only sad but criminal. It happens here too. Insufficient staff are hired, the facility runs at a profit, and the residents suffer. And often die, before they should, in pain.

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    1. The nursing home advertised that they were hiring all the time. Turnover was high. It was difficult to get people, and not only where I worked. It's the kind of work that exhausts people and injuries are common.

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  3. Janie, This breaks my heart. I know it happens all over. No home has enough helpers, ever. I also know some are lazy. My sister used to work in a home and saw all kinds of problems. I pray once the covid can be controlled that family can visit their loved ones. I know that family can help with some situations. Blessings to you sweet lady. xoxo, Susie

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    1. Thank you. You're so kind. The lazy people made it so difficult. They weren't fired because if they did anything at all, it helped.

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  4. I swear I'd rather just die in my home than to end up in a place like that in my final days. Heartbreaking.

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    1. All of us said that we would rather die than go in a nursing home. No matter how much we did, it was a horrible place.

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  5. Bedsores are the scourge of nursing homes and hospitals, that's for sure. I'm glad Vivie seemed not to suffer too much from hers.

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    1. I can't remember ever hearing a patient complain about pain from bedsores, but the people who had them, in my experience, were pretty out of it. Vivie was aware of what was going on and could express herself but never said a word about pain.

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    1. I guess I could handle the job because I didn't dwell on the sadness.

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  7. I'm so sorry. I felt the need to skim to end today. Sadly so common in patient care.

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    1. No need to apologize. I think it's more upsetting if you've never done that kind of work.

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  8. Reading this made me want to move back to Sweden, where old people are treated with care and respect. Some day, I must post about my sister, who had Down syndrome and was in a care all her life. I know Sweden is a small country, but no matter how large and complex the US is, we still need to do better than this.

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    1. I'd love to read about your sister, Inger. Sweden is known for its excellent healthcare.

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  9. Aging is not for sissies, as they say. It's criminal that these places are so understaffed.

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    1. Understaffing is also a big part of workers leaving the job or being injured.

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  10. As mum keeps saying get old sucks...............
    She always returns from hospital stays with bed sores that the district nurse comes and attends to till the heal.

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    1. I'm so glad her bedsores heal. I never saw any heal.

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  11. I did a couple of stints in rehab, one of which was a wonderful facility where I will go for independent living. The other was the same as your home, for care. I was on the receiving side of not being helped from bed to a wheel chair to go to the bathroom. I turned them in, first to the owner and then to the court of public opinion when nothing changed. Don't ever thing your google review is a waste of time. Google sends me notices periodically on how often my review has been read. Well over ten thousand times. I hope it kept some one's parents out of that terrible place.

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    1. How awful that you had that experience. I don't wish bad care on anyone.

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  12. This is just terrible! 😢 The sad state of old-age homes has certainly come to light during the pandemic, with their numerous outbreaks and deaths. Whether or not anything will be done about it remains a question. Politicians talk a good game, but "talk is cheap" as they say.

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    1. Although state inspectors insisted that certain things be done, they only visited about once a year. I wonder if they've even done that during COVID.

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  13. This is so very sad. When did we think just putting people somewhere so we do not have to care for them is OK ?
    Hope you are well !

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    1. Few families care for their parents and grandparents at home. It is sad. I am well, thanks Parsnip!

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  14. Reading the comment from the woman from Sweden, I am thinking that the elderly have better care in Britain too. Why can't we have that level of care in America? It is so terribly sad.

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    1. The majority of the people in the U.S. don't respect the elderly.

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  15. I fear the situation is the same in care homes in the UK too. Understaffed, poorly-paid staff, rapid turnover. I don't believe a care home has to smell of urine but good care is expensive and there are just too many old people.
    It is sad that the elderly aren't cared for by their families any more but on the other hand, I don't want to be a burden to my children and would rather be in a home when the time comes.

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    1. Aging baby boomers will probably overload nursing homes, if they aren't already. I don't want to be a burden, but the only way to get me into a home would be to haul me there by force.

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  16. What a sad story. If a society is judged by how they treat the most vulnerable, ours wouldn't pass, I'm afraid.

    https://www.fromarockyhillside.com

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    1. Definitely wouldn't pass. We let children go hungry in this country where we have so much.

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