Initially, we were happy with the care. My mom arrived on a Friday evening and the night nurse did a complete and thorough total body assessment of my mom and she found bed sores that the hospital staff where she was previously had not found.
That was the extent of the good part of the facility. She had been in the hospital for nearly a month with 2 surgeries, one resulting in an ileostomy. The physical therapist at Horizons worked with her to get her up walking to the toilet. After a week, this strengthening was the extent of her improvement. While the nursing staff was nice and professional, they did not have the wound care nursing skills we were told Horizons would have. Upon arrival, my mom had an ileostomy bag and an open surgical wound that needed periodic dressing and fixed to a vacuum pump as instructed by the doctor. When she arrived, the bag and wound were healing fine. However, after the bag was changed on the second night, the bag leaked (from the top of the appliance) every night, several times a night, for each night she was there. The nurses had to continue to change the ileostomy appliance and clean up the wound as the output from the stoma (feces) would leak into her open wound. After days of this, my mom's stoma and surrounding skin was so raw and irritated, she would cry out when the nurses changed her dressing and bag. My mom is not one to cry at all or ask for pain medicine. However, despite her obvious pain, she was not given pain relief until it was out of control. She did not sleep well during the week and felt completely defeated after 5 days.
My mother has stage 4 pancreatic cancer and diabetes. It was obvious to us the staff did not know this diagnosis when she was admitted and we did not feel they were as sympathetic as they could have been. She was not given a diabetic diet, or a low acidic diet as indicated with an ileostomy. In addition, the main reason my mom wanted to go to a rehab facility was to learn how to take care of the ileostomy bag. That never happened since those who changed it did not know how to do it correctly to prevent leaks.
Other issues we encountered were the lack of response to her call button during the night. She had to wait over an hour to go to the bathroom. It was not until our family raised our voices to the staff that this wait time was reduced.
I am not faulting the individual nurses for the problems we had. They treated mom with the skills they were provided. They also addressed our concerns when we raised them. My biggest concern with Horizons is the lack of the type of care we were told would be provided. The hospital mom was at before Horizons employed wound care specialists for the type of issues my mom had. A regular RN or technician did not provide the wound care in the hospital. I do not believe Horizons employs wound care specialist like those employed by the hospital. If they did, mom would not have been in pain or have a red and raw stoma and skin from the ongoing problems she encountered.
Now that my mom is home, her wound and ileostomy is healing. After 4 days at home, the stoma and skin however are still very raw and tender, therefore she has to keep the stoma out in the air, without a bag, to allow it to heal. This would never have happened if the proper care was administered to begin with at Horizons.