Is a rubber glove a restraint?

Mildred Wathen choked on a latex glove, but was it an illegal restraint? A judge said no, that the nursing home could use the glove stop her from scratching bedsores.

Robert Carter didn’t think his mother’s death was worth a fortune, even if she died horribly, choking on a rubber glove.

But to him, she was worth more than $201,000, the settlement he and his brother will get for dropping their lawsuit against the Brooksville nursing home where she died three years ago.

A ruling about the use of the rubber glove weakened the Carters’ case against the nursing home. It also could affect other cases that allege nursing homes illegally used restraints to prevent patients from moving around.

Carter and his brother Thomas Carter had sued Heron Pointe Health and Rehabilitation in Brooksville in Hernando County Circuit Court for negligence, among other charges, after their 82-year-old mother, Mildred Wathen, died there. Read the rest of this entry »

Pain Management Article

My surgeon did a marvelous job replacing my arthritic knees and, at the same time, straightening my terribly bowed legs when, at 63, I decided to have knee replacement surgery.

Although a class given at the hospital before the operation repeatedly emphasized the importance of adequate pain control, the surgeon and his helpers were not experts in treating prolonged, debilitating postoperative pain. Read the rest of this entry »

Constipation is the primary elimination problem among nursing home residents. Depending on the cause of the problem, constipation can be treated with surgery to remove bowel obstructions, medication, or bowel training programs, several of which we’ll explore today.

Bowel training programs are useful for people who have continual difficulty with constipation. They usually include the following measures:

Adequate intake of fluid. When waste takes longer than normal to pass through the intestines where liquid is absorbed from the material, it can become dry and hard. Intake of enough fluids to keep the stool soft is an essential part of a bowel training program.
Providing fibrous foods. This increases the bulk and size of stool, which assists in the movement of waste through the intestines. An increase in fluids is especially important when residents eat fiber-rich foods because fiber absorbs water. A full, well formed stool encourages peristalsis—the rhythmic muscular contractions that push food through the digestive tract.
Exercise and physical activity. Promoting movement of the abdominal muscles stimulates peristalsis.
Providing regular, private time for defecation. This helps residents develop a regular evacuation pattern. If we familiarize ourselves with our residents’ normal defecation patterns, we can better assist them in promptly responding to their toileting schedules.
Suppositories may be used to stimulate defecation. Laxatives and enemas, however, should not be used on a regular basis.

Unless there is a specific cause, such as disease or injury, relieving constipation is largely a matter of following good eating, fluid intake, exercise, and elimination habits. Encouraging residents to develop and maintain good bowel habits will help them avoid the general discomfort, straining, lack of appetite, and headaches that often accompany constipation.