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TinaTinaTina Asked May 2020

90 yr old Mom doesn’t move, has a Stage 2 wound on butt. Medicare sent a “GEL” mattress but it’s made of egg carton foam inside cover/no gel?

Since Mom’s stroke, she won’t move herself. We (hubby & I) care for her 24/7 & tried to get a mattress that’ll move her at night but the wound doctor said a Stage 2 wound only gets a GEL mattress. Yet she never moves by herself. She has Medicare & Blue Cross but Medicare decided she only gets a GEL mattress. The mattress delivered is NOT GEL, it’s just foam shaped like egg cartons inside a zippered cover. We have complained but they insist they delivered the correct mattress. Her wound is all across both butt cheeks but it’s not oozing, just dark red. We’re putting ointments on it prescribed by a dermatologist that saw the wound through a video visit since COVID-19 restricts face-to-face appointments nowadays. Since Medicare rules what mattress she gets & they practice reactive vs preventive medicine, how can I get a mattress that’ll turn her? I still work full-time & after hubby started turning her 3 times a night, he ended up having a stroke they said was related to lack of sleep. He’s okay, thankfully, but we both have to sleep to function. We’ve been caring for Mom in our home for almost 6 years, 3 of those years we also had my Dad but he’s passed on now. And I’m still very confused how foam mattress shaped like egg cartons is considered a GEL mattress. Anyone have any suggestions that might help me? I really appreciate all comments & advice.

JoAnn29 May 2020
Just have to say that Medicare does not send stuff. They don't even order it. If you didn't then the doctor's office did from a company who supplies the cushion. Who are you complaining too. What the order says and how it was "picked" is two different things. I worked for a pharmaceutical company who supplied this kind of thing to pharmacies and hospitals. Many a time a customer would complain about not getting the correct thing more then once. I would put in a request forva "bin" check. It would be found out wrong item in the bin or wrong sticker on the bin.

Take a picture and tell "they" that this does not look like a gell cushion.

Shane1124 May 2020
Agree with worried. No mattress is a cure. She will still need to be turned every two hours to keep off that area no matter what mattress she is prescribed.
I think if I remember correctly Stage 2 LU don’t qualify for an alternating pressure gel mattress overlay. You stated there was no breakdown just redness at this time. You manage this the same- repositioning every 2 hrs - as you would a Stage 4-5 PU.

You have nothing to lose by investigating the order and how the DME provider interpreted it. Sometimes it is simply a coding error. DME companies are not supposed to provide the proper coding for reimbursement- the ordering doctor initiated the order, so you need to start with them. Ask the billing office (or look at an AOB notice if you’ve received one already) then research what code they used, write it down then google search it to figure out if that code is consistent with your mom’s condition. It may be worth a try.

I hope your husband is getting well. It does sound like your family is overwhelmed now and Covid19 makes things worse. It may be time to place mom in a SNF as her level of care and her needs will only increase. It’s not fair to your family to bear the burden of what sounds like a person who has care that can’t be provided in her present setting.

Don’t feel guilty about it either. You have needs as well as your husband who has suffered a stroke due to the physical aspects of providing care . It may be time to take the burden off both of you.

I know this wasn’t your question but I would take this as another reason to make it a goal to get mom’s finances in order and apply for Medicaid if she qualifies.

Good luck to you.

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Geaton777 May 2020
Tina, I so agree with worriedinCali... the issue is not the gel or foam pad. If caring for your mom is causing declining health in your immediate family, you need to step back and think deeply about the logic of this arrangement. It will only get more intense. Your husband is first priority over your mother. Even if you're an only child (like me) and your mom is single (like mine). Maybe she made you promise not to put her in a NH. Or you promised this to yourself. Or your mom just assumed you'd take care of her at home or is resistant to the thought. None of those things come before your husband and your marital relationship. On this forum under Caregiver Burnout are thousands of posts made by loving, well-intentioned adult children who lost marriages, money and health when they didn't stop to assess the chaos. I wish you much clarity as you read the responses to your post. Please don't be put off by any of it. Think of it as experienced voices concerned for your future talking to you in the present.

AlvaDeer May 2020
Be certain they are culturing and checking as often antibiotic ointments causes fungal and fungal creams cause infection to flourish. It is often a back and forth. Be certain, if she was on antibiotics at all that you try to monitstat type creams that stop the flourishing candida type fungal things. Air is the best. And of course eggcrate is NOT gel and if they are charging for gel they are taking advantage of insurance and getting by cheap. Sorry you are going through this, but you are quite bright and quite right, and know what is happening.

worriedinCali May 2020
Even if they had sent a real gel mattress, you do know that it’s not a cure right? She still needs to be turned very frequently. If the burden of caregiving has already given your husband a stroke, why hasn’t your mother been placed in a skilled nursing facility? And is she able to move? You say she won’t.....but is it that she won’t move or can’t move?

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