My mother went from the hospital to a skill nursing facility. My mother stayed 9 days in the hospital. This was because her wound had some dead tissue and it needed to be cleaned out. She has a bone infection and previously been given 2 IV meds for 5 weeks and oral meds a little over a month. Her doctor said she has a new infection. Previously given Daptomycin - This time started with Daptomycin but when a skilled nursing facility was called they said it cost $700 a day and the insurance only pays $200. Therefore they can not lose $500. The the med was changed to Vancomycin 1 gram/200ml. She is now also given ampililin sulbactan every 6 hours. About 4 days before she left the hospital a few blisters appeared near the wound vac. One blister underneath and a few about one inch away from the vac. Now in the Skilled nursing facility within 2 days her right hand is bent and she screams in pain when touched. On the same arm just below the wrist the skin is torn about the size of a full inch and about a half of inch below that is a smaller tear in the skin. I have asked her roommate and nurses did she fall. They all said no. Mother is still retaining fluid in legs and stomach. This first happen in hospital when they put constant drip of saline solution. She swelled until the membrane sac in eyes hanging out of her eyes. I requested an xray and they say it is not broken. I now notice a couple more blisters appear on her skin. My mother has never blistered and her skin was clear before. I was told her muscle has contracted. Now 3 days with her hand bent down. I told them I think it needs to be in a brace and I know it will hurt to put it in one. They said nothing will be done until Monday. I am not sure why this has happened? I made the nursing assistant place pillows to hold her hand. I am thinking they will need to adjust it each day myself to try and straighten it. As the nurses just leave the wounds tears exposed and hand bent? Any advice on what to do? I have never met the doctor as only nurses can text him. He just texts them back.
I am so sorry about what is happening to your Mom. I can assure you that this type of situation does not happen in all of the nursing homes. You need to investigate other nursing homes while your Mom is in the hospital as she needs much more care than what you can give her at home.
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I don't remember, have you taken care of your Mom in your home before? In not, then you need to:
rent a hospital bed, a Hoyer or Easy Lift machine, a bedside commode;
buy a baby monitor so that you can monitor your Mom at all times;
arrange for Home Health nurses and CNAs and Wound Care Nurse or hire nurses from an agency;
be prepared to stay home 24 hours/7 days a week and to quit your job (if you are working).
This is just a small "To Do List".
You need to seriously think that having your Mom go to ANOTHER nursing home (even though the last nursing home was lousy) because I don't know that you can take care of your Mom adequately or properly unless you have an army of nursing/healthcare professionals which could cost you as much as a nursing home.
At the minimum, they need to reassess the situation and maybe give her a different antibiotic and something for pain. There's no reason why she should sit in pain while the SNF staff take their time getting answers.
I'm so sorry you and your mom are going through this.
Is a Wound Care Nurse visiting your Mom at the Skilled Nursing Home? Even if a "Wet-to-Dry" dressing is being applied, a WCN still needs to be following the progress of the wound. Where is the wound located--at her wrist? EDIT: What did your Mom rub her wrist on that she got such a wound?
Osteomyelitis infection is very "NASTY" and very hard to treat (although it is easy to get from a very deep skin scratch or puncture wound). The antibiotic needs to "FIT" the infection organism/bacteria. If the wrong antibiotic is given, then the infection is not going to get better.
The bend in your Mom's wrist might be related to the osteomyelitis either because of the infection or because of pain.
A) The vancomycin is not controlling the growth of the infection/bacteria and it is getting worse and spreading to the skin;
B) your Mom is having a reaction to the vancomycin which is causing the blisters
C) the Wound Vac is MALFUNCTIONING and air is entering under the skin via the wound vac. You need to DEMAND that the WOUND CARE NURSE who is following your Mom's wound care at the skilled nursing home to visit your Mom TODAY!
If the facility states that they do not have a Wound Care Nurse, then you tell them that they MUST get a WOUND CARE NURSE to supervise your Mom's wound while she is at the facility. Do not take "NO' for an answer.
I know that Doctors "Hate" nursing homes and that is why your Mom's doctor will only receive and send Text Messages to the nursing home. I knew a doctor who would only receive FAXES and would not take any phone calls from a nursing home. More that once, I was faxing the doctor that we were sending a resident to the ER Dept. via ambulance as the resident was being wheeled out the door because the doctor would not take my phone call so that I could let him know that the resident was on their way to ER Dept.
I don't understand the statement made by the skilled nursing facility "that they would lose $500/day if your Mom received Daptomycin". Does your Mom have Medicare Supplemental Insurance? IF so, then the pharmacy that is supplying the antibiotic should be able to send a claim to your Mom's Medicare Supplemental Insurance company or to the Medicare Pharmacy Insurance and get paid a percentage for the remaining $500.00. The other possibility is that YOU might HAVE TO PAY for a percentage of the Daptomycin antibiotic so that your Mom can receive it. But I would think that it should be the Pharmacy that is losing the $500, not the nursing home.
It sounds like your Mom needs to be given the Daptomycin again as the vancomycin might not have any affect on the infection/bacteria/organism. Take your Mom to the ER Dept. TODAY before her skin gets any worse.
You need to ask the doctor for the name of the specific bacteria organism that is causing your Mom's wound infection.
Good Luck. Let us know what happens with your Mom.