My mom was admitted to SNF for therapy to recover from upper leg bone break surgery. In just 7 days she developed a STAGE 4 wound. She could not participate in therapy because of the wound so they gave me 2 options:
1. Take her home
2. Admit her as a long-term resident.
Because of the severity and level of care this wound needs I'm not able to care for her at home. She also would have hospice care to help but she is now bedridden and in adult diapers so 24-hour care is the only option I believe. Any suggestions how to provide care at home other than by myself? (Family is not available)
You would need:
daily visits (possibly more than one) from wound care specialist nurses
a maximum package of care - this is usually 4 visits per day, morning, lunch, afternoon, evening; two aides if your mother can't mobilise or change position independently.
a profiling bed
a variable pressure air mattress
a slide sheet
possibly a hoist (you'll need to get advice from an Occupational Therapist in any case)
lots of continence care supplies
lots of skin integrity supplies
a SSKIN (risk assessment and care plan combined) checklist
quite a lot of other things - this is just a rough sketch
Has there been a formal Assessment of Needs?
Has your mother been able to express her preference?
Without knowing more about her medical history and general condition prior to her arrival at hospital and then to SNFs, hospice care at the SNF might be the way to ensure she is comfortable and receives some individualized attention. Hospice care focus will be on comfort, not on healing that wound. Hospice can keep the wound covered and drainage contained. Hospice can also medicate her in advance of wound care, to decrease her discomfort.
Hard to heal a stage 4 wound, and debridement is very painful and may make wound worse.
Think about asking the SNF about getting an order for hospice evaluation and then you can specify what hospice you want to use. Often a SNF has a 'favorite' hospice...start with them.
Or just call a local hospice and ask to talk to an outreach worker about the situation. Don't get talked into a hospice evaluation, though. You have the right to choose, and if this particular agency seems too pushy, thank them for the information and say goodbye.
Good luck. You can see how a fall often triggers the downward spiral for frail elders.
You can put Mom on Hospice and demand that a wound care nurse be brought in to care for the wound. Mom is to be under no discomfort when on Hospice. IMO, someone is at fault her for properly not caring for it.
If you place her in SN the cost will come out of Moms pocket. Medicare will not pay if she is not given therapy. If Mom has no money then Medicaid would be applied for. You could bring her home with the requirement that a woundcare nurse see her. If she gets "in home" care medicare pays for it and you get an aide. But its not 24/7 care.
It was 7 days after she was in 1st SNF, that by accident, I seen when I walked in as an aide was changing her. I heard her Hollar as I walked backed to her room and rushed to see. Pulled back the curtain and freaked out. I have been scared for my mom's care because she wasn't a pleasant compliant as some would expect. It was hard for me to hold years back and not lash back at times of her sharp tongue. I just want her home. But I'm afraid she'll just wind up back in the ER if I try to care for her my self. I have no other family that's in good health them selves to help. Hospice is great but they aren't consistent with same nurses. That would just eat at my mom. I couldn't do that to her. Well gotta go. TORNADO WARNING ALARMS ARE GOING OFF HERE IN OKLAHOMA! TTYL