Dear Mary,

My husband has had many health problems but until recently I was able to care for him at home. He is 83 years old, has Parkinson’s Disease, and dementia. He was hospitalized last month for a urinary tract infection and pneumonia. While in the hospital he contracted an infection called MRSA and was in isolation. He was transferred to a rehabilitation center two weeks ago and is still in isolation. The problem is, I am now told that he has reached his “maximum potential” for rehabilitation and long term nursing home placement is recommended. I tried to have him moved to a nursing home closer to me, but they refused to take him because of the MRSA. The long daily trip to visit him is killing me. How long will it take to get rid of this infection and how did he get it in the first place?

Let me answer the second part of your question first. MRSA stands for methicillin resistant staphylococcus aureus and is a penicillin resistant staph infection acquired in a healthcare facility. The staphylococcus aureus bacterium normally found in mucous membranes and on the skin is resistant to antibiotics by nature. An elderly, frail, hospitalized person, who is at high risk for infection anyway, is the perfect medium for the bacterium to flourish. MRSA is highly contagious and spread by healthcare workers’ hands, contaminated equipment, and other infected patients. Isolation is standard procedure to prevent its spread and powerful antibiotics and antimicrobials are used to treat it. Once two negative cultures are obtained from the infected site, isolation precautions are discontinued.

Now for the first part of your question: MRSA is hard to get rid of and re-infection is not uncommon. The time it takes for a “cure” is variable from weeks to months. I know it is difficult, but once your husband is out of isolation you should be able to transfer him to a facility closer to home.

Dear Mary,

I helped move my father and mother into an assisted living home 18 months ago. At the time both were mobile and able to share an efficiency unit. My father’s health has declined dramatically in the last six months and he is now in the dementia unit. He is 90 years old and failing rapidly. Mother is 88 and still active. Last week I received a phone call from the home telling me they could no longer take care of my father. My sister and I were shocked. We were assured our parents could “age in place”. The plan was to not make them move again. Now we are told he is too hard for the staff to handle because he needs help getting up, is incontinent, and has to be fed. The director said we should hire outside help or move him to a nursing home. If we move him, Mother will be devastated. What should we do?

You would hope that revocation of his license would be enough to put an end to a dangerous situation. But as you have discovered, it is not. The ability drive is the ultimate in independence. It yells “freedom” and is deeply tied to a person’s identity. The loss can be devastating and not put to rest easily.

Your father is at a level of care that cannot be provided in his current location. I know it is difficult to understand why you were told one thing and are now being told another, but assisted living facilities are coming under a lot of scrutiny today. Many are licensed to accept a higher level of care resident but do not have the staff to provide such care.

If you want to keep your father safe and where he is you will have to hire private aides. Another option is Hospice. Hospice is not limited to care in the home they will provide care in other settings, too. Talk to your father’s physician and get the bottom line on his prognosis. If nothing else can be done to improve his health, comfort care may be what is needed. Good luck.