Untreated diarrhea ImpactionDepression MalnutritionUrine Burns

Istoppedescaping

Hello,

I am not a doctor but have a question about IAD. Is this considered neglect. My LO had a rash on her buttocks. Any advice on what to do in this situation would be great. Thanks

mommyandme (m&m)

A barrier cream may help. For my mom, I use Desitin when needed.  It seems to work better than the cream I was given by the hospice staff.

Jamaicabound

My hospice nurse ordered Triple Paste medicated ointment. It is not as thick as the barrier cream and seems to be more healing.

harshedbuzz

A rash is not necessarily proof of neglect. A rash can pop up out of nowhere related to die, non-cooperation with changing/hygiene or even a change in the brand of detergent, wipes or incontinence products used. 

Barrier cream, treatment for yeast if that's an issue and even "air time" can help.

Istoppedescaping

HHi Harshed buzz,

TThanks for responding. However it is a terrible looking rash that was creeping up to her back. Someone at the nursing home should of addressed it. Thanks again.

The4thOne

I understand how you feel.  Understanding the staffing shortages and all of the issues that impact their ability to be 150% on top of everything, it is still necessary to let them know when you notice these issues, how was it missed, what is the plan of care to treat it, and how will it be prevented.  Letting them know that you are not satisfied will not be missed, nor ignored.  I have set a schedule of accountability that every change in medication, examination, and ordered test is to be shared with me, as I have established a 15min  monthly review with the social worker to share the nursing manager, doctor, etc.'s notes. If I don't have a record of it, then it was not either done or should have been done.  However, it is more important that I make sure the facility knows that I'm her advocate, that we are partnered in her care.  I have not stopped her primary care insurance yet, as I like the safety net of being able to see her pre-nursing home doctors, that they are still in the loop.  Example, she is diabetic, and the NH charged Medicaid for a podiatrist visit.  However, she complained of her toe hurting.  Knowing she is prone to ingrown toe-nails when I went to see her, her feet were unclean with 2 ingrown toe-nails.  Because of her diabetes, her feet have always been a priority and well maintained.  This was unacceptable, especially in charging Medicaid for a service that was not done.  We took her to her regular podiatrist, who was very concerned at the state of her feet and said he would let them know that he will continue her foot care.  By taking her out to another doctor who then reached back to them with a different report, drove the point for a clear understanding that 'lack' will not be tolerated.  This may be extreme, but that accountability schedule leaves no surprises, no unexpected situations.  It actually works well for both sides.

Istoppedescaping

YYou are right. Thanks for sharing.

Jo C.

It does indeed sound like a rash or even perhaps a yeast/fungal infection that has not had good results from any attention paid to it. Perhaps it is time for the NH physician to make a visit to diagnose what the type of  the rash it is and what to treat it with. If it is a yeast/fungal infection, treatment will be different than if it is a "diaper" sort of rash.  Such fungal infections will expand onto other areas if not treated and they are uncomfortable..

I am also concerned by the title of your Thread where you mention:  "Untreated diarrhea, urine burns, impaction, malnutrition and depression."   This is rather concerning; perhaps it is time to ask for a multidisciplinary staff meeting to put together a plan of care due to changes in condition.  With all that going on, no wonder your LO is depressed.

Multidisciplinary meetings are supposed to be done at intervals even when there is not a problem and should be done when there are changes in condition such as your mother is experiencing.  These meetings will usually have yourself; the licensed nurse from the patient's unit, the dietician, PT, Social Worker, an aide who works with the patient, and others as the facility puts on such a planning team.

At this meeting, you can address any and all concerns you may have and with your input, the staff will work with one another to put a plan of care into place to address the patient's needs.

I would, if this were me, insist on such a meeting and go into it in a polite and open manner regarding concerns.

Let us know how it is going; best wishes are being sent your way.

J.

Istoppedescaping

Hi J,

I would have a meeting and do exactly what you said to address the situation in a mild manner. However I do not have the final say with my mother. And I do not agree with the other person who is a family member. That family member reports everything and well we just do not agree with the care for my mother. I just wanted to know if this is considered neglect. Thanks for response. 

DrinaJGB

Ammonia from urine causes irritation to the skin and leads to rashes and skin breakdown. When my DH was in a SNF after having emergency hip repair I noticed each morning after going in that he was sitting in his own urine--wet and cold, and at time his own feces.

I called a meeting and declared I was going to discharge him early, and take him home to recover which I did. He did better at home when he could actually use the bedside commode--and I had physical therapy come to the house. He walked into the surgeon's office for his post surgery follow up using only a cane.

mommyandme (m&m)

These things can definitely happen due to neglect. Depending on the actual issues, they may also happen with the best care possible, where no neglect has taken place.