Okay, my father has the beginning of what seems to be bed sores. The staff in the nursing home will turn blue in the face and tell us they are not. Being not a physician I went on line to see a picture of bed sores, well it's a bed sore problem for my father.
What in fact should be our next steps? We have requested a wound nurse. I have 3-5 times. I have never heard back from them. They recommended a dermatologist but it is in a basement of a building with no elevator. My father is confined to a wheelchair. What should we do next? We are thinking about a hospital visit? Please tell us what to do next in regarding this manner. This is so wrong, in so many ways.
Pressure sores are much easier to prevent than they are to heal, besides which, once the skin is broken down it is an open invitation for infections to enter.
If they argue with you till the are blue in the face, then you have to argue right back until you are purple in the face!
Make them do what needs to be done and never take 'no' for an answer.
You and your father have rights. The staff at the nursing home have responsibilities. It is not your responsibility to diagnose your father or to come in and provide medical care for him or to be there to turn him every two hours.
The coverage for supplies and equipment varies; some plans cover these things including medicare and medicaid depending on diagnosis. don't rule out options before checking it out.
These broad responses about things on this blog are not helpful. It often sounds as though patients and families have no power or rights and that is just simply not the case - though it can be very frustrating don't give in to the nursing home line that they are simply understaffed, overworked and that your parent is a problem patient. Its nonsense. There are laws that regulate their actions and responses and in particular mandatory bed sore prevention and treatment.
You can go and find and buy air cushions for him to sit on and then you go and secure it to his wheelchair & any other chair in his room with velcro. Michaels craft stores has adhesive Velcro precut that works great for this. If he is really heavy, you may have to replace these very often too. This will not be a covered expense by Medicare, Medicaid or other insurance either. You private pay for this and install them. Also you can get a flowing "air-matress" installed on his bed. Now Medicare & Medicaid will pay for these if medically necessary. My mom is totally bedfast in a NH and on hospice. The hospice group ordered this the first day they came on too. But I imagine that dad is not at this point of his care, so if you want this, then it's up to family to private pay for this. The NH will have the name of a provider that brings in private pay equipment routinely at the facility.
Now the doctor can order that a dermaplast or other specialized bandage be placed on the area daily. I'd speak about having this done. This is pretty routinely done. Also the doctor can order that he get turned every 2 hours or so when he is lying in bed. Now these sort of orders are sticky in that if dad is still good on his ADL's, then he is expected to be able to shift his weight and do some things to prevent the bedsore on his own. If he is the obstinate type who just won't do simple things for himself and can, the NH is in a tough spot as to just what all they can do. When you have his next care plan meeting @ the NH, you need to discuss all this in detail so that everybody is on the same page as to what is happening, what is covered under Medicare & Medicaid and what is expected of him and nursing staff in all this. Everybody needs to work together on all this, if you are coming across as telling them they have to do everything, it is not going to work in your or dad's benefit. Understand? Good luck.
There must be a dermatologist somewhere in your community where there is access. I'd have this diagnosed by someone not involved with the nursing home. Then, if it is a bedsore and they won't admit it, you can take it to your ombudsman at www.ltcombudsman.org. Type in the Zip code of the nursing home for your contact. This is your representative.
Good luck,
Carol