First signs of trouble, concerns at MC

ghphotog

Was there at the MC checking on my DW and I noticed she had soiled herself so I took her to her room, cleaned and changed her but when I was cleaning her I noticed some fairly significant skin breakdowns between her cheeks. Her pants and shirt were wet so I went to change those and there were no clean clothes in her room so I found the cleanest dirty pants for her.

Also her ankles were very swollen and I've never seen that before. The head nurse was unaware of these things. They say they don't add salt to the diet, she's not that sedentary and walks around quite a bit. I'm wondering since everthing else seems to be getting mixed up that possibly her medications are getting mixed up with someone elses causing the swollen ankles. The head nurse had to tend to other matters and didn't return before I left.

Lorita

Get in touch with the nurse asap. These things should not be happening. They may be short staffed but there should be clean clothing in her room. How long has your wife been there? Visit at different times, be there at meal time and when meds are given. Is this the first time you've noticed these things not being as they should be? I'm sorry this has happened. Talk immediately to the nurse and the administrator.

ghphotog

https://alzconnected.org/discussion/comment/200563#Comment_200563

I spoke with the head nurse and she is very apologetic and cooperative in locating the missing clothes and said she is in contact with her doctor and will let me know. She's, my DW, has only been there about 2 weeks.

Caro_Lynne

It's a good thing you are there to advocate for her. I'm sure this must have been very distressing for you. Sorry to hear this and hope things get better. xo

trottingalong

I’m glad you noticed all that you did. Too many times you hear of residents of some facilities not getting the appropriate care. Not having clean clothing (or bedding) and not being changed if a person has soiled themselves, are complaints that are not uncommon. The swelling legs are also worrisome. It would be nice to know how many staff to patient ratio there is. So many are understaffed and also pay minimum wage. I hope this gets resolved immediately and it doesn’t happen again.

ghphotog

If this continues then I'll bring her home for the duration but I'll need a lot of outside help.

Nights and early mornings are the hardest so I'd be on my own at those times but maybe I could outside caregivers. IDK. Not sure I could take her back, she's too progressed for one man. I don't have a walk in tub so I'd have to have a remodel done. Well maybe a month is all the respite I need to pick up the ball again.

harshedbuzz

@ghphotog

Does your wife take any BP or cardiac meds? I wonder if the transfer of the prescriptions got messed up. When dad left the SNF to come home, the SNF doctor didn't transfer all his meds to the local pharmacy upon discharge-- he forgot the Seroquel. Then the pharmacy didn't have a record of dad (I moved my parents while dad was in the SNF for rehab; previously she used Publix in FL and Rite Aid in MD) locally, so they filled his prescriptions with those of some (dead) man in Sacramento with the same name and DOB. Mom's vision isn't great, so dad took some random man's meds for 10 days before we nearly called 911 on him.

Another thought about the lack of clean clothing and skin issues. Is the Norovirus where you live? Here is PA we're having a serious uptick especially in schools and congregate living facilities like SNFs and MCFs. It doesn't take long for a few bouts of diarrhea to tear up one's skin and dirty one's wardrobe. Dad had a GI issue while still home with mom; his skin was raw from it.

I hope you can resolve this soon.

HB

M1

Another thought is to make sure they haven't added or changed her meds without letting you know. The antipsychotic Zyprexa (olanzapine) and the antihypertensive Norvasc (amlopidine) are both common causes of edema.

Caro_Lynne

GH, you will know what you need to do xo

Ed1937

I had serious swelling of my lower legs and ankles while on Amlodipine. My doctor had the same issues himself. It's very possible they changed the meds without letting you know. I raised hell when that happened with my wife.

I hope you can have luck getting the lack of proper care managed without difficulty. As well as she took to placement, it would be a shame to have to move her.

ButterflyWings

DH had puffy feet and toes at the end of a respite week (his first). I never saw that before and could not get an answer as to why they thought that was. I just took him home without further attempts to get to the bottom of that.

Once home, he got back to baseline in a couple of days including the swelling disappeared. In troubleshooting things with his hospice nurse, we guessed it was possibly 3 things:

• Part dietary, as in maybe some salt or sodium in their food which we don't add (but seems odd for MC)
• Part sedentary lifestyle as he and all the residents were just sitting for hours. At home he'd be up and walking around at least some of the time, and when sitting his legs are elevated in his recliner
• Part dehydration possibly. Giving him more water back at home, helped flush things out of his system. The CNA and nurse said some of the facilities they visit patients in, limit fluids by mid afternoon to try and reduce some of the incontinence-driven laundry, toileting, and diapering.
• The thought of withholding liquids especially that early really irritated me, as it could be harmful to a PWD's health just for convenience's sake. Given the high cost of MC, just let them drink a healthy amount of water and change the darn briefs, chux, etc.