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It would be extremely hard to nail the hospital for neglect. There are a number of factors that play into this and its 1. age 2. health condition. 3. length of his stay and what he had done at the hospital. Tough one to prove, besides your energy needs directed towards him and his care now at the SNF.
A LOT MORE information is needed to make any sort of educated statement about your situation.
Your dad is 96 years old & he lived with you prior to his hospital admission. What was he admitted to the hospital for? What was his activity level before being admitted to the hospital---was he independently ambulatory, did he use a cane or walker, was he chair/bed bound? Since he was in the hospital for 4 weeks, I have to assume it was for something rather serious. Was he in the ICU, on a ventilator or any other life support measures? How much did he weigh when he lived with you, prior to be admitted to the hospital & how much does he weigh now? What chronic illnesses does he have, if any? Your account says that he has Alzheimer's/dementia. What was his level of mentation when he was admitted to the hospital & what is his level of mentation now? What was his nutritional status before being admitted to the hospital? Does he have a g-tube now? Did he eat food while in the hospital, or was he receiving IV fluids/TPN/g-tube feedings? Was he aware enough to eat? I can't imagine that he doesn't have a g-tube after a 4 week hospital admission.
Quite honestly, for a 96 year old man to survive a 4 week hospital admission with only a stage 3 sacral sore is pretty good, actually. Stage 3 has a very good prognosis for complete healing. You say that he has "multiple bedsores"---where are the other bedsores? Was your father on a special mattress in the hospital? I find it nearly impossible to believe that the sores were not noticed by any of his caregivers in the hospital. How often did you visit your father in the hospital? What was your level of communication with his caregiving staff at the hospital? How often did you speak with them? Did you speak with them face to face or over the telephone? Nutritional status has A LOT TO DO with skin breakdown. I assume because he was hospitalized for 4 weeks, he lost weight because he wasn't eating, which causes the bony prominences to stick out more, making them a prime target for bedsores. Over the course of 4 weeks, an elderly person can lose A LOT of weight, making them prime targets for bedsores to develop. Sometimes, the staff can bend over backwards to try to prevent bedsores but they form anyway despite their best efforts.
Did you visit your father while he was in the hospital? Did you notice any of the bedsores forming? A stage 3 bedsore can form in less than a week. Perhaps the hospital staff was already treating the sores & they were improving. You don't give enough information to establish that. And, just out of curiosity, did your father have a DNR order, or was he a full code? Did he have to be coded while he was in the hospital?
At this point, I think you are better served with the mindset that your 96 year old father actually left the hospital, alive, after what I can only assume was a serious & acute illness. The bedsores are the least of your concerns at this point. A stage 3 bedsore is skin breakdown and it can be healed with proper wound care. I don't know why your priority right now is getting a lawyer---your priority is to make sure he is getting proper treatment to rehabilitate him from his illness & proper treatment for the bedsores. Bedsores would be a risk for any 96 year old person facing a 4 week hospital admission for an acute illness. Bedsores would be a risk for a person half his age facing a 4 week hospital admission. With a diet that provides your father adequate protein in his diet, the prognosis for the bedsores is excellent, I think. Your father needs your support to get better at this point---he doesn't need you to be ready to go to war with the hospital, because it is a war you won't win. Things happen despite things that caregivers do to try to prevent them from happening. Instead of immediately wanting to blame the hospital staff for causing bedsores, you should probably be thanking them for saving your father's life. To be quite honest, as a healthcare provider myself, your post angers me because the people that took care of your 96 year old father worked very hard to save his life & get him out of the hospital, and all you can do is point your finger and accuse them of causing him to get bedsores. Did you go to the hospital to visit him & did you ever observe the staff turning & positioning him? Did you sit by his bedside for the entire day to witness exactly what the staff was doing to take care of him? If you did stay by his side all day & you didn't see anyone turning & positioning him, why didn't you question that? To be quite honest, your post sounds as if you didn't visit him in the hospital, since you say the bedsores "were found by the wound care nurse". I find it hard to believe that if you had visited him in the hospital & spoke to the staff taking care of him that they didn't make you aware of the bedsores. Furthermore, what was your communication with his doctor(s) like? Did you ever speak to them? If you're out for a quick money grab, that isn't going to happen, so you can forget it. No attorney would even take something like this, a 96 year old man getting a bedsore after a 4 week hospital admission. Please, give me a break. An attorney would tell you the same thing I did---that you should be grateful the hospital staff saved his life, that he was discharged alive, and to put your energies someplace else. Sometimes I just can't believe how people think.
Maybe--I think Country Mouse has a lot of good things to say. Just being angry and bringing in a lawyer signals you are ready to "fight" and perhaps that's not the best first line of defense. People can so quickly develop bedsores, even with great care. The skin of the elderly and very sick simply cannot bear the weight of the body--grandma had a stage 5 sacral sore that never healed (from tub bathing--even though she was supposed to shower only!) Luckily she had no pain, but wow, it looked so scary. My FIL, during his EOL, would brush up against a wall and the skin would simply peel back in sheets. He was unaware of this. I'd go one morning to check on him and get breakfast for him and find a pool of blood and a large debrided wound--and he had no clue. At the very end, he was swathed in gauze and tape. I am not aware of bedsores, but he was mobile until the day he died. Sometimes, bedsores are simply impossible to keep from happening. I'm sorry you are dealing with this. Let the hospital have their say. Then move forward. Don't be surprised when the hospital staff closes ranks on you---they likely will. Good luck.
This is terrible, I hope someone is found accountable if there was neglect. As for suing, some people think (after watching ambulance-chaser commercials) 'woo-hoo,we will sue! - a big payday!'. If Medicaid is involved, any monies collected (IF any are) after a successful lawsuit will go to lawyers and Medicaid.
My husband has been in 3 facilities for the past 6 weeks, 1 hospital and 2 rehabilitation facilities. Because of his lack of mobility, the skin on his buttocks, back of his thighs and his crotch area was seriously degraded and all this started at home. All 3 facilities sent their wound care staff to examine and treat him. At his current facility, the wound care is not the quality of the other 2. I noticed yesterday that the bottoms of his feet are dry and the skin is peeling. Today, I plan to phone his case manager and ask what can be done. There are a few other things I want to discuss with her concerning his personal care. I will go through channels, keeping a close eye on whether or not my requests are carried out. Threatening legal action, which is what would be implied by bringing in a lawyer, should be the last resort. Once I did that, it would be me against them, with my husband in the middle. Consider your options carefully. There is no excuse for your Dad having to suffer like that, but do give the facility a chance to explain before you bring in a lawyer.
I know the frustration you feel about this. My wife suffered a high level sci from an accident and was hospitalized for a couple months before being transferred to inpatient rehab. Upon their inspection they found a stage 5 sacral ulcer. The black dead skin was the size of a softball and tunneled all the way down to the bone causing osteomylitis. This poor girl who is now paralyzed from the chest down had to deal with 6 months of IV antibiotics which than caused C-Diff and over a year of wound care. I won't get into it anymore but the point is I contacted a lawyer out of anger and frustration that the hospital didn't do anything to prevent this. Their records showed all the proper documentation for skin management, turning etc etc along with a statement that "unfortunately evening using best efforts and prototcall cannot always prevent these things from happening". I then took the position that allowing this to progress AND be discharged without informing us or treating was a completely different and unacceptable scenerio which of course they "apologized". It would have been a game changer if they at least began treatment when it was a stage 2, 3 or even 4. It seemed criminal putting my wife through this but when it was all over and done and the attorneys looked at all the records they concluded it would be a very long and difficult case to fight in court. I just couldn't afford (time and money) going down that road while also fighting insurance and care for my wife and basically rebuilding our (her) life. One of the hardest things for me was feeling responsible for trusting these strangers to protect her and I soon became very involved in every aspect. I was furious at them and wanted someone to pay for what they did (allowed) to happen but getting the care for your loved one needs to be your focus right now. I'm very sorry you have to deal with this but you have to be his strongest advocate and his voice.
Thebeach, about whether or not you need legal advice *before* your interview with the hospital - I'd say not, for this reason and guideline: you will be there to hear what they have to say; they will be doing the talking; so it's not as if you'll have to choose your words carefully - they will!
By all means take somebody with you, and if possible record the conversation. Also, get your questions ready beforehand, and with each question decide what information would provide a satisfactory answer.
E.g.
"There is no record of skin integrity checks having been carried out on [date]. Could you explain this, please."
Unsatisfactory answer: "All patients are thoroughly checked for pressure areas on a strict schedule, we take this very seriously."
Satisfactory answer: "We noted the lack of a record and have spoken to the staff concerned. In fact your father was checked, but the CNA was uncertain about her findings and wanted to refer him to her supervisor. Unfortunately she wasn't able to do this and so that set of checks went unrecorded; but she is able to recall that the areas were borderline and certainly not ulcerated at that time. She did return to finish dressing and reposition your father correctly."
So: an unsatisfactory answer is one which just sends out chaff, blather, hot air and shows that they have no interest in understanding and addressing your concerns. A satisfactory answer is one that shows that they have made a sincere effort to find out what, if anything, went wrong - bearing in mind that they could have done everything humanly possible and *still* failed to prevent pressure sores in a very sick, immobile, frail patient.
Since you didn't say for what reason your dad was in the hospital (4 weeks is a long time) or how they are rehabilitating him, I can only make a guess. Have you heard of Kennedy Terminal Ulcers? They come on very suddenly and in spite of the careful turning and positioning. In fact, sometimes as a result of it. Look it up. It's good info to have even if it doesn't apply in this instance.
I am in the process of getting my Dad's medical records from the hospital and the rehab, before I go to speak with the Administrator of the hospital or the Ombudsman. Just wondering if I needed to see a lawyer for advice before talking to the hospital. Thought, maybe, someone had been in this situation and how they had handled this. My husband and I are the caregivers for my Dad, who has lived with us for 2 years.
Pamstegma...my 96 year old Dad lives with me and no, he did not have bedsores and never has, before entering the hospital. He was in the hospital for 4 weeks and on Jan.11, went directly to a rehab facility. The Wound Care nurse did a body check upon his entering and found multiple bedsores...the most painful one is a Stage 3 on his sacrum. He has been receiving treatment since 1-11-17.
What did you mean by...I would need a lawyer, but "not for the reason you think." ???
Each hospital has an Ombudsman, maybe on staff? Otherwise, call the Ombudsman for your State or County, report the incidence to that person. That office must make a visit, perhaps and including other patients in the previous hospital. Of course the priority is getting the doctor, and ordering the wound treatment care needed, even if an infection control nurse has to visit. I have read that sometimes patients are seen in the E.R., so don't wait.
I'm so sorry to hear what happened to your dad. I would definitely talk to the hospital administrator for patient care. And file a complaint about what happened. How did this get missed? Why didn't they check your dad properly? And depending on how the hospital responds to your complaint, you still might want to consult with a lawyer. Your dad deserved a better quality of care than he received. I'm glad you are acting as his advocate.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
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APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
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If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
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You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Hugs, Bella
Tough one to prove, besides your energy needs directed towards him and his care now at the SNF.
Your dad is 96 years old & he lived with you prior to his hospital admission. What was he admitted to the hospital for? What was his activity level before being admitted to the hospital---was he independently ambulatory, did he use a cane or walker, was he chair/bed bound? Since he was in the hospital for 4 weeks, I have to assume it was for something rather serious. Was he in the ICU, on a ventilator or any other life support measures? How much did he weigh when he lived with you, prior to be admitted to the hospital & how much does he weigh now? What chronic illnesses does he have, if any? Your account says that he has Alzheimer's/dementia. What was his level of mentation when he was admitted to the hospital & what is his level of mentation now? What was his nutritional status before being admitted to the hospital? Does he have a g-tube now? Did he eat food while in the hospital, or was he receiving IV fluids/TPN/g-tube feedings? Was he aware enough to eat? I can't imagine that he doesn't have a g-tube after a 4 week hospital admission.
Quite honestly, for a 96 year old man to survive a 4 week hospital admission with only a stage 3 sacral sore is pretty good, actually. Stage 3 has a very good prognosis for complete healing. You say that he has "multiple bedsores"---where are the other bedsores? Was your father on a special mattress in the hospital? I find it nearly impossible to believe that the sores were not noticed by any of his caregivers in the hospital. How often did you visit your father in the hospital? What was your level of communication with his caregiving staff at the hospital? How often did you speak with them? Did you speak with them face to face or over the telephone? Nutritional status has A LOT TO DO with skin breakdown. I assume because he was hospitalized for 4 weeks, he lost weight because he wasn't eating, which causes the bony prominences to stick out more, making them a prime target for bedsores. Over the course of 4 weeks, an elderly person can lose A LOT of weight, making them prime targets for bedsores to develop. Sometimes, the staff can bend over backwards to try to prevent bedsores but they form anyway despite their best efforts.
Did you visit your father while he was in the hospital? Did you notice any of the bedsores forming? A stage 3 bedsore can form in less than a week. Perhaps the hospital staff was already treating the sores & they were improving. You don't give enough information to establish that. And, just out of curiosity, did your father have a DNR order, or was he a full code? Did he have to be coded while he was in the hospital?
At this point, I think you are better served with the mindset that your 96 year old father actually left the hospital, alive, after what I can only assume was a serious & acute illness. The bedsores are the least of your concerns at this point. A stage 3 bedsore is skin breakdown and it can be healed with proper wound care. I don't know why your priority right now is getting a lawyer---your priority is to make sure he is getting proper treatment to rehabilitate him from his illness & proper treatment for the bedsores. Bedsores would be a risk for any 96 year old person facing a 4 week hospital admission for an acute illness. Bedsores would be a risk for a person half his age facing a 4 week hospital admission. With a diet that provides your father adequate protein in his diet, the prognosis for the bedsores is excellent, I think. Your father needs your support to get better at this point---he doesn't need you to be ready to go to war with the hospital, because it is a war you won't win. Things happen despite things that caregivers do to try to prevent them from happening. Instead of immediately wanting to blame the hospital staff for causing bedsores, you should probably be thanking them for saving your father's life. To be quite honest, as a healthcare provider myself, your post angers me because the people that took care of your 96 year old father worked very hard to save his life & get him out of the hospital, and all you can do is point your finger and accuse them of causing him to get bedsores. Did you go to the hospital to visit him & did you ever observe the staff turning & positioning him? Did you sit by his bedside for the entire day to witness exactly what the staff was doing to take care of him? If you did stay by his side all day & you didn't see anyone turning & positioning him, why didn't you question that? To be quite honest, your post sounds as if you didn't visit him in the hospital, since you say the bedsores "were found by the wound care nurse". I find it hard to believe that if you had visited him in the hospital & spoke to the staff taking care of him that they didn't make you aware of the bedsores. Furthermore, what was your communication with his doctor(s) like? Did you ever speak to them? If you're out for a quick money grab, that isn't going to happen, so you can forget it. No attorney would even take something like this, a 96 year old man getting a bedsore after a 4 week hospital admission. Please, give me a break. An attorney would tell you the same thing I did---that you should be grateful the hospital staff saved his life, that he was discharged alive, and to put your energies someplace else. Sometimes I just can't believe how people think.
People can so quickly develop bedsores, even with great care. The skin of the elderly and very sick simply cannot bear the weight of the body--grandma had a stage 5 sacral sore that never healed (from tub bathing--even though she was supposed to shower only!) Luckily she had no pain, but wow, it looked so scary.
My FIL, during his EOL, would brush up against a wall and the skin would simply peel back in sheets. He was unaware of this. I'd go one morning to check on him and get breakfast for him and find a pool of blood and a large debrided wound--and he had no clue. At the very end, he was swathed in gauze and tape. I am not aware of bedsores, but he was mobile until the day he died.
Sometimes, bedsores are simply impossible to keep from happening. I'm sorry you are dealing with this. Let the hospital have their say. Then move forward. Don't be surprised when the hospital staff closes ranks on you---they likely will. Good luck.
I won't get into it anymore but the point is I contacted a lawyer out of anger and frustration that the hospital didn't do anything to prevent this. Their records showed all the proper documentation for skin management, turning etc etc along with a statement that "unfortunately evening using best efforts and prototcall cannot always prevent these things from happening".
I then took the position that allowing this to progress AND be discharged without informing us or treating was a completely different and unacceptable scenerio which of course they "apologized". It would have been a game changer if they at least began treatment when it was a stage 2, 3 or even 4. It seemed criminal putting my wife through this but when it was all over and done and the attorneys looked at all the records they concluded it would be a very long and difficult case to fight in court. I just couldn't afford (time and money) going down that road while also fighting insurance and care for my wife and basically rebuilding our (her) life.
One of the hardest things for me was feeling responsible for trusting these strangers to protect her and I soon became very involved in every aspect. I was furious at them and wanted someone to pay for what they did (allowed) to happen but getting the care for your loved one needs to be your focus right now. I'm very sorry you have to deal with this but you have to be his strongest advocate and his voice.
By all means take somebody with you, and if possible record the conversation. Also, get your questions ready beforehand, and with each question decide what information would provide a satisfactory answer.
E.g.
"There is no record of skin integrity checks having been carried out on [date]. Could you explain this, please."
Unsatisfactory answer: "All patients are thoroughly checked for pressure areas on a strict schedule, we take this very seriously."
Satisfactory answer: "We noted the lack of a record and have spoken to the staff concerned. In fact your father was checked, but the CNA was uncertain about her findings and wanted to refer him to her supervisor. Unfortunately she wasn't able to do this and so that set of checks went unrecorded; but she is able to recall that the areas were borderline and certainly not ulcerated at that time. She did return to finish dressing and reposition your father correctly."
So: an unsatisfactory answer is one which just sends out chaff, blather, hot air and shows that they have no interest in understanding and addressing your concerns. A satisfactory answer is one that shows that they have made a sincere effort to find out what, if anything, went wrong - bearing in mind that they could have done everything humanly possible and *still* failed to prevent pressure sores in a very sick, immobile, frail patient.
The Wound Care nurse did a body check upon his entering and found multiple bedsores...the most painful one is a Stage 3 on his sacrum. He has been receiving treatment since 1-11-17.
What did you mean by...I would need a lawyer, but "not for the reason you think." ???
That office must make a visit, perhaps and including other patients in the previous hospital.
Of course the priority is getting the doctor, and ordering the wound treatment care needed, even if an infection control nurse has to visit.
I have read that sometimes patients are seen in the E.R., so don't wait.
If you're not satisfied, then go and see a lawyer. And on a personal level, I certainly hope somebody gets their ears boxed for this.
I'm so sorry to hear what happened to your dad. I would definitely talk to the hospital administrator for patient care. And file a complaint about what happened. How did this get missed? Why didn't they check your dad properly? And depending on how the hospital responds to your complaint, you still might want to consult with a lawyer. Your dad deserved a better quality of care than he received. I'm glad you are acting as his advocate.