This wasn’t the worst, but was pretty bad. I entered the home to evaluate a patient’s eligibility for Hospice. The home was somewhat of a dilapidated place on the south side of town. It had once been a beautiful place, I imagined. It had good bones about it! Sometimes the outside belies what is inside, but today that wasn’t the case. The stench hit me in the face as I climbed the stairs to the wide solid porch. I put on my best professional face and knocked on the door. A child answered. 3–4 years old, thumb in mouth, dirty T-shirt, filthy sagging diaper, and he was covered with dirt and bites of some sort. He had been crying and the tracks of his tears were evident because of the dirt on his little face. My heart dropped.
I entered and a young mother came around the corner of the hallway with a baby on her hip. A toddler was behind her, also in a sagging diaper and was just as dirty as the little boy. The poor mother was apologetic for not answering the door herself. The smell of the urine and feces in the home was overwhelming, but when you are living in it, its not as noticeable.
The patient was the young girl’s great-grandmother. She was in a room off the kitchen at the back of the house, and this is where the smell was coming from. There were bags and bags of dirty, wet diapers filling 1/2 of the room!!The patient lay in soaking sheets, and the blanket covering her was also wet. She did not have a diaper on because they “didn’t have any”. I pulled back the wet covers, with gloves on, and was basically horrified to see deep decubitus ulcers on the patient’s bony hip, and coccyx. The bones were easily seen. The girl stated that “it looks just like that on the other side”.
I asked for clean sheets, and knew they didn’t have any before she even told me. I asked if she had diapers for the kids? No. Food? A little. Pajamas or warm clothes for the kids? No. It was winter and the big old house was warm, but drafty. The girl herself was wearing shorts so I asked about her too. She started crying. She told me her story.
She had recently gotten out of an abusive relationship and left with little or nothing for her or the kids. She moved into her Gr.-grandmother’s home. Her Grandmother, the patient’s daughter had been staying there “taking care” of my patient (because that is how I already thought about her). As soon as the girl (I’ll call her Jasmine), moved into the house, the Grandmother took all the money and left!
Jasmine was maybe 20. She was trying to provide for four other people all with high needs all by herself. The neighbor had come over, had seen the situation and called us! So, in essence, the Grandmother had neglected her mother terribly and left poor Jasmine to deal with it! They also currently had no running water for two days! So no laundry meant no clean clothes, sheets etc.
As an RN, I am a mandatory reporter, meaning I had no choice but to report this to DFACS. However, it made me angry to think that Jasmine would have her children taken away because of a set of horrific circumstances, and none her own fault! I KNEW she was telling me the truth.
So, I decided to fix what I could! First I called our Hospice Medical Director and got the patient admitted to our service so that I could treat her wounds etc. I then called our Social Worker to make a visit the very next morning! I then called our Aide Supervisor and asked for a specific Aide to be cleared from her last two patients so that she could come work with me! She would also bring all the supplies the patient needed. With that in place, I called the water Department and paid enough to turn the water back on. I then called our Chaplain, whose church had a food bank! He would bring food. I left for the store where I bought children’s diapers, a few warm outfits for the littles and a bathrobe and slippers for Jasmine. I also bought some sheet sets and some warm fuzzy blankets.
All in all we made things infinitely better that day! With the help of others, so much more was provided over the next few days and weeks. The bedroom was cleaned out as was the whole house! Jasmine got food stamps eventually in place. Plus child support. Plus clothes and toys for the kids. We took care of her Great-grandmother who chose to stay in her own home and she and Jasmine were infinitely happy with each other! Her wounds never healed fully, but they were getting better and she was eased from pain with a hospital bed with a special mattress, good care to her wounds and the right medications. Her appetite improved. This started out as awful circumstances, but when you work with awesome people, miracles can be accomplished!
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