One of the things I find most heartbreaking is when we get an elderly person who lives alone and has fallen and laid on the floor for hours or days. Unable to get up, reach a phone they lay there alone, cold, scared. Unable to get up they are eventually force to urinate or defecate where they are - their soiled skin burns. Unable to get up they grow hungry and thirsty. The pressure of the hard floor causes their skin to break down into bed sores. The pressure of the floor causes their muscles to break down, the molecules from their broken down muscles clog up their kidneys causing them to fail. Once they are found and brought to the ER they are usually critically ill, partially from a broken spirit I suspect.
Imagine how it must feel to lay on your own floor cold, thirsty and hungry - lying in your own bodily wastes wondering how long it will take you to die.
All alone.
If you have an elderly neighbor that lives alone take the time to befriend them - check on them regularly, keep this from happening. It's a very simple, very human thing to do. The rewards you get in return might surprise you.
Monday, October 6, 2008
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One thing people (relatives) can do is talk to their elderly about some of the systems (Life alert?) that can be contacted at the touch of a button. The time to do it is while the person is reasonably healthy, not after an accident takes place. I'm only in my mid-50's, but I think if I were ever living alone, even now, I'd consider having one. There've been times when I've almost slipped in the shower when no one else is home and it would be good to know I could alert someone without trying to drag myself to a phone.
My father saved the life of my grandmother on two different occaions by checking on her. When she didn't answer the phone both of those times, he became concerned and went to her house to find her in that condition. Had he not taken the time to call and go to check on her, she would have died. Though she is no longer with us, I truly believe my father was instrumental in saving her life on those occasions. Thank you for posting about this - it's something people need to be aware of.
I'm so glad you posted about this topic. I'm a brand new ER nurse and I received a patient in a similar situation - her story nearly broke my heart.
M
PS: I'm glad you're back! Your blog is great!
The number of patients we get.... one had numerous sores all down one side from lying for 2 days, another excoriated skin from urine burns. No-one should be left alone like that!
My elderly mother (age 86) and I just had a conversation about this. She had a friend who died recently after falling and lying alone in her apartment for several days before found.
And then I had the elderly mother of a family friend who was looking after his 10 year old daughter while he was away. She fell sometime after 9pm, and would not let her granddaughter call EMS because she hadn't broken anything and she didn't want to go to the hospital. She wouldn't let her granddaughter call me because it was too late. So she did have a pillow and a blanket, but she did stay on the floor for over 12 hours. I got there, a little before noon, and helped her up, which wasn't easy.
I made her promise to let EMS be called if that ever happened again, because they could help her up, and she could still refuse transport.
I made her granddaughter promise to ignore her grandmother and call
EMS if it ever happened again, because if I hadn't had my cell phone on me, she would have been down at least another two hours.
About once a month or more, I receive these types of patients.
Great advice!
such good advice - after I graduated from college, i lived in a little duplex and was out of town when my next-door (non-duplex) neighbor fell, and my duplex-mate went to the neighbor's to check in because her dog was barking. She'd fallen and had managed to drag herself to the dog bowl for water... Then I was out of town and came back to find that the LOL neighbor had come over to check on my duplex-mate because they were supposed to have tea and found the duplex-mate passed out because our heater had malfunctioned and she was suffering from CNO poisoning!!!
One good turn! Fortunately, we're all safe and sound. And I look after my LOL friends.
This happens to my cancer patients (particularly with brain or bone mets) several times per week.
Also, a distant elderly cousin of mine just entered a nursing home for the duration of her life because she laid on the floor in her home for nearly three days before she was found.
Great post!
I am a nursing student and I have learned so far that one of my "loves" is the elderly. I enjoy your blog and this is such a great post.
Life Alert is a god-send.
We have an elderly (elderly in this case meaning 96!) man living next to us. He's a sweet little old man, and very aware and active. He's out in his yard daily watering his flowers and putting around doing this or that. Enjoys spending time with our children, making them laugh, and enjoying sweet tea on our deck when we BBQ. We see him at least every other day, and when we don't, we get worried and go check on him (to find out we usually missed him puttering and tinkering around). He has no family NEAR that we know of. He has a PCA come once a week to take him shopping and clean up around the house a little. Other than that, no one that we've ever seen. We keep watch on him because of this... We'd hate for something to happen and no one know when there are so many people in our neighborhood that love and care about him. We consider it a "community" effort to look after him.
I just found your blog and look forward to reading all of it. I am considering a career change and I'm thinking ER nurse is where I'd like to end up. Great information/ stories on here. Thank you for sharing openly.
Had this the other night...elderly lady, OCD-horder who lives alone; son has tried to help her but she refuses to leave her single-family house in which she lives alone. "Pushy" according to her son.
She had fallen because she was "dizzy"; stated she was down for 8 days; son said he saw her 4 days prior. She's soiled in urine and feces with a BP in the 80's, and she's screaming at me to give her water as I'm gowning up because she also has a history of MRSA (as well as diabetes, htn, etc).
ISTAT lactate is above 4, she's in rhabdomyo, has skin breakdown to her back/buttocks, cellulitis in her legs, and bruising to both shoulders. And, she is still screaming at me to give her water (meanwhile, I'm at bedside playing with her pressures - ironically, she wants CPR should she need it but she can't comprehend why I'm trying to raise her blood pressure when she NEEDS WATER NOW). We place a foley and yellow-green pus starts to collect in the bag...so far we're uroseptic and in rhabdobyo with a BP in the toilet.
I get a call from lab - CKMB is up. 30 seconds later I get another call from lab - troponin is 4.8. Now we're dealing with urosepsis, rhabdomyo, and possible MI. Did she get dizzy from the MI, fall, and develop urosepsis? Or did she have a UTI, fall, develop urosepsis, and have an MI as she laid on the floor? So we've got urosepsis, rhabdomyo, post-MI, hypotension, and I'll add kidney failure into the mix just for fun.
But dont forget the water! We need to round things out to make sure to hit aspirational pneumonia, right?
Side note: I did swab her mouth for 5 minutes but I then gave up to go push adenosine on a pt with SVT - each time I'd remove the swab she'd say "MORE, MORE!" I told her that no amount of swabs would fix having to go 4+ days without water. She settled down on the oral swabs once she found out she was going to ICU and we were going to place a triple-lumen central line for CVP monitoring.
You all are super fantastic crazy knowledgeable and funny/realistic. I am a nursing student who has done nothing else then live, eat and breathe nursing for the past year. In my first ER clinical experience a 81yo F was brought in via ambulance, she was found on the floor of her 2nd story apt. by her grandson. Once the rest of the family was reached, they had said that no one had heard from her in over a week. Turns out that this poor woman had been lying on a hard wooden floor for 6 days. By the time she arrived to the ER she was pretty much gone. I will never forget the condition she was in! Her toenails had grown through her socks, her teeth had a slime over them that I can only compare to a mossy rock from a rivers bottom and she had feces from her umbilicus to her sacrum. It was a fact that she had been lying helpless on the floor for 6 days, but the neglect had been in place for god knows how long! She ended up dying that evening, and I can honestly say that I will always think twice about keeping intouch with anyone who lives alone!
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