JimFormation

“He wasn’t feeling well, so he went to the hospital” is how the old lady’s story started. Her husband didn’t have a fever and no obvious signs of infection. Still, as a precaution, his doctor started him on a broad-spectrum antibiotic. This might have been the keystone to his death.

She was in her early-80′s. Healthy. “So was he, until 4 months ago,” she confided. “We were living the life. We’d go out a couple of times each week. Our children and grandchildren lived close by. We walked on the beach. Held hands. Now it’s gone, and I don’t know what to do.”

While in the hospital, he started having diarrhea. Foul-smelling, copious diarrhea.

A stool sample confirmed: C. Diff.

C. Diff or clostridium difficile is a bacterial infection, often called a “super bug”, that is usually acquired in hospitals and nursing homes. C. diff hits the elderly hard, knocks them for a loop, and often kills them with alarming frequency.

C. Diff didn’t kill her husband. But it did make him so weak that he couldn’t go home. Instead, he was transferred from the hospital to a “sub-acute nursing facility” (aka, a nursing home). The plan was for him to get sick, improve his strength, rehabilitate, and return home with his wife.

In the nursing home, he developed a pressure ulcer — a bed sore — on his sacrum. It eroded the skin and muscle down to his sacral bone. “It was the size of a saucer,” she said. And it became infected. He was readmitted to the hospital.

“He was so weak. He was like a kitten,” she told me.

The infection didn’t 100% resolve at the hospital, but they did get it under control. He was started on a new round of antibiotics and discharged, once again, to a sub-acute nursing facility.

“But I didn’t trust that old nursing home. I had him sent to a different one. He never got any better. He didn’t even get out of bed. He got worse. The nursing home sent him back to the hospital. And he died.”

In my experience, this isn’t that uncommon. An elderly person goes to the hospital, gets sicker in the hospital than s/he was before getting there, is discharged to a subacute nursing facility, and never gets home. A little more than 10% of people admitted to a nursing home for short-term rehabilitation either stay long-term or die trying to get home. (These are my statistics, and you can trust me, my mortgage depends on me getting numbers like that right.)

I’m not saying, “Don’t send Grandpop to the hospital.” I’m just telling a story.