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My Mom caught C diff while in rehab following a broken, pinned hip. Several long term care facilities flat out said they would not take her since she had had this infection. She was considered an asymptomatic carrier; always tested positive after the infection but stopped being sick. Can ALFs and Alzheimer's care facilities decide who they will take based on their history of a disease? For example, suppose she had AIDS and they denied her entrance. That would be illegal, I think?

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Yes active c diff comes under skilled care.I had same problem with placement.
It is facilities responsibility to secure placement. Do not let them buffalo you into taking her home.
While active c diff bedside comode is best.Easier to bleach and contain contaminated area dribble trail or out and out blow out. Better in the pot than on the skin very caustic and irritating.
They changed a while back antibotic vancomyacin tx for c diff.
After diagnosis one time treatment. Will keep getting a positive. And repeated adm of antibotics gets caught in cycle with flare ups nonbalance of gut flora.
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C diff is a natural aerobic inhabitant of intestine. Liken a overgrowth to an alge bloom that produces red tide.
When sick often not eating can get air in intestine if empty
Antibotics especially that for use in encelopathy can have side effect of immune supression resulting in c diff overgrowth causes ordr you will never forget. Expanding the gut with bulk keeping gut full helps frequent small snack meals.
Found Lactolose helps, expands and coats gut lining. Easily absorbed helps if brain meed craves simple sugar. Since simply whole liquified sugar cane. We replaced the antibotic which caused c diff everytime administered for the TBI encelopathy with lactolose.
My snigif other used it as sweetener in his green tea. One way of getting dose. Lactolse can also be used for constipation since it is a bulk fiber, so use must be watched.
I have been a nurse for 27 yrs
Trust me C Diff and MRSA is all in the USE and propper HANDWASING BEFORE AND AFTERANDINBETWEEN AND USE OF GLOVING TECHNIQUE.

Actually its all in the USE of handwashing.
To To often do I see it skipped all together And hand sanitizer used. Does nothing for C diff but give it to someone else and MRSA.
C diff is also a plague with puppies and livestock. So if your comprimised person is sensitive to the bacteria don't handle puppies etc.
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Saccharomyces Boulardii is a beneficial yeast which helped my mother recover very quickly from C-diff. It's available at the health food store.
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I am a retired NH/AL administrator. This particular AL facility probably has a well defined, well thought out list of those diagnoses and resident types that it can handle in a professional, responsible manner. Many ALs do not accept residents with c. diff. because it is easily transmitted and requires "contact precautions", which means any contact or potential contact with the feces needs special training and the use of personal protective equipment. In an AL facility this is best achieved by totally isolating the resident in a private room with a private bathroom.The training and cost involved may be too much for an AL to take on, but it can be done. Even though the risk of taking residents with infections like c. diff. can be greatly controlled, it is certainly better for a facility to make this determination on the side of safety for its residents than to take on the responsibility if the administration believes they may not be able to provide total compliance with the necessary protocols involved with c. diff. By the way "c. diff." stands for clostridium difficile, because it is both "difficult" to treat and difficult to minimize transmission to others. Go to this CDC link for more info: http://www.cdc.gov/hai/organisms/cdiff/Cdiff-patient.html
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My mom had Cdiff for months. She was in the hospital the sent to a nursing home, then home and withing a week back in the hospital. This went on for most of last year and turned out that neither the hospital, nursing home nor her primary care doctor was using the correct protocol for coming off the drug used to treat it. They had her on a strong antibiotic and just stopped it when she was done with the bottle. She would be symptom free for a few days and then it would come back again. When we took her to a new gastroenterologist, he told us that she had to be stepped down from the drug and then she would not get it back. That irked and she hasn't had any bouts since.
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If your mother is in rehab and they want her out. They will find a facility to take her. Refuse to bring her home.
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Yes, that is what I read, its contagious. An aide could carry it to other patients. The Aide could get it. AL is just protecting themselves.
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C Diff is contiguous. She probably caught It from being on antibiotics in the hospital before going to rehab. This is one of pit falls of being in the hospital. This is just something that happens in people with compromised immune system. Demented patients can pass it to another by touching their feces or there bottom and touching surfaces. Chronic C Diff can be handled appropriately by having a private room with private bathroom or if they have a roommate they would have to use a commode. There are precautions for staff to follow. It should not affect staff who have a healthy immune system. I can see Assist living refusing admission because they do not provide this level of care and they are private pay. There are many patients in nursing homes who have C-Diff. I don't think nursing homes can refuse admission because most are 95-98 percent funded by the federal government. I would contact Elder Abuse in your area for help.
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If AL isn't sufficiently equipped to deal with C-Diff, tell them to get off their asses and do it!
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I work in a AL and currently have a new resident that has contracted C diff. It is scary for staff because we don't want to catch it, or transmit it to not only our other residents or somehow bring it home to our families. Some say it all in the precautions that take and others say its just takes a fluke to spread it to other despite our precautions. Either way its very scary.
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C-Diff poses many many problems for any facility. For AL -since it is not skilled nursing care - admission can be denied as AL are not designed or staffed for CDiff medical& skilled nursing care. For NH it's a bit different in that although they do skilled nursing care, often the protocol for highly infections diseases is for isolation room placement. The NH may not have isolation rooms or wards. So if they don't then they will not accept a C-diff, MRSA or other highly infectious or contagious resident.

But even if they do it can still be a probkem. My moms 2nd NH had a wing adjacent to business office and central supply, that had a few isolation rooms - mainly with residents who got pneumonia (not just the flu), had more serious wound care or were hospital discharge from CDiff. But they would not accept MRSA. Older NH tend to have been designed with isolation rooms.

CDiff with advanced elderly seems to turn into a revolving door of readmissions to the hospital. Please keep in mind that if your elder is still hospitalized, placement primarily is a problem of the discharge coordinator at the hospital & you should not be the one having to find a facility. BUT If you take them to back to your home or to their home, then it totally becomes your problem to find a facility.
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Thanks for your insiders view, MATSTRAZZ. Very helpful to all of us.
Carol
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I live at Susan Balis assisted living in Boston. i have AIDS but have had c diff in the past. the reality is about 10% of people in long term care places have had c diff. I think the places that turned you down might not be places that would be good for her. keep looking. There might be other reasons they do not want her, and they are using the c diff as an excuse.
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I'm so sorry that this happened to your mom (and you). C-Diff is contagious enough for the AL to be concerned about it being passed on to staff and other residents. I would think that if your mom receives the proper course of antibiotics, she should then be qualified for readmission. Likely you'd need a doctor to confirm that.

Take care,
Caro
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An assisted living facility can decline admission to anyone who they do not feel is appropriate for whatever reason they choose. They are acting in the best interests of the people who live in their community. It is not a nursing home. It is a residence where people who are otherwise healthy live who need assistance with activities of their daily living. They can suffer from moderate dementia, or need help with getting in and out of bed or to the bathroom, for example. Assisted living is based on a Social model, not a Medical one. If your Mom is a carrier of C-diff toxin, she brings risk to the other people living in the facility. This is unacceptable. She requires a different level of care than can be offered by assisted living.
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AIDS isn't as contagious as c-diff. AIDS doesn't live on surfaces like c-diff does. Where there is one outbreak of c-diff in a facility there will likely be more because it's that contagious for elderly people and is usually spread via staff from one resident to another.

As for whether a nursing home can deny your mom admittance because of the c-diff there's probably a statement in the contract somewhere about denying admittance at the discretion of the facility.
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