- Pressure ulcers, also called decubitus ulcers or bed sores, are one of the biggest problems in nursing homes. If your loved one is confined to a bed, ask the staff what plan is being followed to prevent pressure ulcers. Specifically, is there a schedule for turning the patient several times a day? How often is the patient’s skin inspected for breakdown? What is being done to keep the skin clean and dry?
- Ask if the patient needs a special bed, mattress, heel protectors and foam wedges that can further reduce the risk of bed sores. A physician can order these items. However, there is no substitute for frequent turning (generally every two hours). Also ask about kinetic turning beds that allow continuous rotation.
- Ask that staff clean their hands immediately before touching your loved one. This is the single most important way to reduce infection. Put a bottle of hand sanitizer on the bedside table, and a sign saying “Please use this before touching the patient.” Cleaning hands at the entrance to the room is not sufficient, because once staff members touch the bedrails, open drawers, or touch another surface in the room, their hands have picked up bacteria that could make your loved one sick.
An infection called Clostridium difficile, or C. diff for short, causes severe diarrhea, dehydration, and other life-threatening complications. To help avoid it, make sure your loved one’s hands are clean before they touch their food, and avoid putting utensils or food on any surface except the plate. Consider bringing a box of prewrapped hand wipes for the patient to use before meals.
C.diff germs invisibly contaminate many surfaces around the bed, including bedrails, call buttons, over-the-bed tables, and door knobs. When you visit, bring BLEACH wipes and wipe down these surfaces around your loved one’s bed.
Patients with indwelling urinary tract catheters have a fairly high risk of infection. Ask caregivers frequently whether the device is still needed. The tube is hidden under the sheet, where it’s easily left in too long. Inquire whether male patients can use an external or condom catheter, which has a lower risk of infection and is often more comfortable.
- Daily oral care reduces risk of pneumonia, one of the biggest killers in nursing homes. Ask specifically whether the patient is having his tongue, mouth, and teeth cleaned daily. It’s a time consuming process, and sometimes overlooked by busy staff.
Also ask about pneumococcal vaccines. The vaccine is safe, relatively inexpensive and recommend for routine use in individuals over age 65. And ask about influenza vaccines for both the patient and nursing home staff – both should be vaccinated annually.
If your loved one is in a nursing home for physical rehabilitation after a hip or knee replacement or other orthopedic procedure, be aware of the germs lingering on exercise equipment. The patient should bring a canister of bleach wipes to rehab and wipe each mat or weight before using it. The once a day cleaning of these items (we hope) is enough to prevent infection.
- Don’t visit if you have a cold or other signs of illness. Don’t bring small children to visit. They are walking germ machines. And don’t put a purse or bag on the floor then the patient’s bed.