My mother-in-law passed away this last Tuesday. She had fallen and fractured her femur when she got out of bed in assisted living in the middle of the night without pushing her call button. She had surgery to repair the break and was doing okay until her stay in the SNF. She went in without a pressure sore on her heel (unless one had developed in the hospital) and came out 30 days later with a level-4 sore on her heel. She finally had an M.D. who had diagnosed her dementia so she was able to go into hospice which was helpful because she could go back to assisted living to her comfortable apartment and still have wound care. Everyone who saw her heel there seemed shocked at how quickly it had developed. She then contracted a UTI and her body just shut down. The hospice nurse said that the UTI, the wound and the healing from the leg break were just too much for her body to handle. So, with all that going on, we're wondering whether we should complain about the SNF seemingly allowing her heel to get in such a state. We're not contemplating a lawsuit, BTW, just wanting to get more from the SNF as far as not letting an ornery patient try to prevent them from standing her up and getting her out of bed and then also caring for her wound.
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Yes, you need to put in a complaint starting with your State Ombudsman. Your MILs heel should have been cared for by a Woundcare Nurse. (My DD is one) There should be an admissions record where the patient is looked at from top to bottom. Pressure points should be noted and watched. Its up to Rehab to care for these wounds.
Are you asking for feedback because you aren’t sure whether you should or shouldn’t report it?
If you feel like it is important for you to discuss this further, you should do so.
It would be interesting to hear how they respond to your thoughts on your mom’s care in their facility.
You aren’t interested in suing anyone. If your motive is only to let them know how you feel, then by all means speak to them. If you have questions that you need answers to, don’t hesitate to ask them.
Pressure sores are serious and awful to deal with. Your mom had other serious issues as well. It’s sad to read a story such as this.
Wishing you peace as you grieve your loss.
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Trying to stand an elderly patient upright who's in pain from a broken femur is not logical or prudent. What is logical and prudent, however, is to place waffle boots on a bedridden patient in order to prevent sores from developing on their heels. This is the first thing the hospice RN did for mom when she became bedridden.
https://www.amazon.com/NYOrtho-Heel-Protector-Cushion-Pair/dp/B005DLL83Y/ref=sr_1_2_sspa?crid=3A8QDLE1IWJEZ&keywords=waffle%2Bboots%2Bheel%2Bprotector&qid=1701387290&sprefix=Waffle%2Bboots%2Caps%2C195&sr=8-2-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9hdGY&th=1
This should be protocol in all managed care facilities where a patient or resident lies in bed with their heels against the mattress 24/7.
If you file a complaint, I'd encourage you to demand such a protocol be implemented immediately.
My sincere condolences on the loss of your dear mom.
My very elderly Aunt with advanced dementia climbed out of her bed "fortress" in her own home and broke her hip up by the ball. We declined surgery. In rehab she continued to try to get out of bed. Please understand there is no reasonable way to prevent a determined, demented person from getting out of bed except to put their mattress directly on the ground, and that is still no guarantee. My Aunt passed in her sleep at the rehab... we're not sure why. She could have passed a clot that is often a problem with a large bone break.
The Hospice nurse is right that with her body healing from the fracture and recovering from the surgery.
I am curious did the pressure sore develop on the same side as the fracture?
If the leg is not elevated to take pressure off the heel and she was not moving the leg due to pain either actual or perceived or the fear of pain then the pressure sore can happen quickly.
Then getting a UTI on top of all that it is likely that her body just could not recover.
You can file a complaint BUT the fact that she did not press a call button. (not to add fuel to the fire but are you 100% sure that she did not press the call button? Are the calls recorded somehow so they know who pressed a button and when?) The only way that someone would have known that she needed to go to the bathroom is if they happened to walk into the room at that moment or they knew her "schedule" and that every night at 2:00am she had to go to the bathroom or if her door was open and someone happened to hear her trying to get out of bed.
One of the facts of life is...falls happen. It is a matter of how severe a fall it is. She could have fallen with someone at her side.
I am sorry for your loss, I am glad that she had Hospice to help care for her.
All decubiti are reportable for any facility. And bedsores have serious repercussions for a facility if they happen too often.
I myself would not be reporting this. Clearly there was sepsis involved from more than a few areas in the body. But it certainly is up to this OP. And records can be reviewed to see if the facility itself did self-reporting as it should.
There would be no lawsuit whatsoever in a case like this. It is simply to see that it is recorded.