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An elderly man died in hospital of a perforated intestine after being in respite care at a nursing home. The nursing home company has been found to be in default due to poor care.
A nursing home has been asked to apologize to the family of a man who died after being languishing, unable to move, due to a perforated bowel.
A report released by Deputy Commissioner for Health and Disability Rose Wall on Monday found that a nursing home company violated the patients’ rights code for “unacceptable” failures in the care of the man, known as Mr. B, for two days in 2016.
Mr. B, in his 80s, was in remission from metastatic melanoma and his abilities were declining. He found it difficult to walk, he was short of breath and depended on his wife to prepare his meals and do household chores, according to the report.
After being evaluated by his District Board of Health, Mr. B was admitted to the unnamed nursing home to give his wife a break. Upon admission, a registered nurse evaluated him and prepared his plan of care.
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The HDC discovered that there was no documentation that his plan of care was reviewed by a registered nurse.
The morning after he was admitted, Mr. B complained to a caregiver that he had abdominal pain and was unable to move.
He also refused to go to lunch.
The caregiver consulted the only registered nurse (the nursing home clinical director) about her refusal to go to lunch, but did not mention her pain.
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The report said that Mr. B’s condition was not recognized until his daughter came to visit him.
Later in the day, the nurse left the facility without having checked on Mr. B.
In the afternoon, Mr. B’s daughter visited him at the nursing home and found him “clearly ill and in pain,” according to the report.
He was taken to the hospital by ambulance, where he was diagnosed with a perforation (hole) in his small intestine.
He continued to deteriorate and died the next day.
Wall said he was concerned that aspects of Mr. B’s care were “inadequate” and that there was a “poor pattern of care,” including his admission and the fact that the staff did not escape their pain to a registered nurse.
Silence Naidoo
Deputy Commissioner for Health and Disability Wall said Mr. B’s aspects of care were “inadequate.”
The lack of monitoring and escalation on the second day meant that staff did not recognize Mr. B’s condition and the degree of impairment, which the staff apparently did not know about until Mr. B’s daughter came to their attention, Wall said.
She said this was “unacceptable”.
There was also a “missed opportunity” for Mr. B to be evaluated by a registered nurse, he said.
Wall also criticized the registered nurse for failing to confirm the man’s admission documentation and for failing to review it before leaving work.
Wall said the events “underscore how susceptible residents of nursing homes are to rapidly deteriorating condition.”
She recommended that the nursing home company make changes to its practice, including reviewing its assessment, management and monitoring of pain policies, and counseling training.
Wall also recommended that both the registered nurse and the nursing home company apologize to Mr. B.
