As C. Diff Month Draws to a close

A lonely grandmother gazes at the photo of loved ones.

I’m William Beerman, author of the book, “Mary Regina’s Nursing Home.” In recognition of C. Diff Awareness Month (November), I am sharing the following from my personal life experience.   

The disease C. Diff (Clostridioides difficile) is the most common healthcare-associated disease. It generates a half million infections a year and elderly persons in nursing homes are especially at risk. 

I manage a Facebook page called Nursing Home Monitor, so of course, I’ve known for months that relatives of nursing home patients were banned from visiting their loved ones because of the COVID-19 virus.

But I didn’t expect to see the heartbreak of the nursing home personal visitation ban dramatized right before my eyes.

As I was delivering election information to a nursing home in Las Cruces, NM on October 27, 2020, a patient on a gourney and her daughter were checking in at the front desk. When they were finished, an attendant wheeled the patient away, and I heard the daughter say quietly, “I am so sad I cannot go with my mother.”  The check-in host answered, “Yes, it is very sad.”

A transfer from a hospital to a nursing home is stressful enough these days. But it can be worse with the serious complication of C. Diff, an antibiotic-resistant bacteria that causes uncontrollable diarrhea.

The admission of the patient October 27 reminded me of the day I admitted my own mother to a nursing home in Pittsburgh in 2011 after she had a short stay in a hospital for repair of a broken hip. The nursing home turned out to be a bad one. But we could not get my mother transferred out because she came down with C. Diff.

C. Diff is contagious and requires the patient to have an isolation room. Medicare paid only a few dollars more for an isolation room than it paid for a semiprivate room. So any nursing home that accepted my mother would lose a lot of money because it would have to devote a room for two to just one patient. Nursing homes that we called while trying to transfer my mother said they had no isolation rooms available.

C. Diff played a big part in the death of my mother, who had been living independently before she broke her hip. She was an excellent candidate for rehab. But she died 30 days after being admitted to the nursing home, with C. Diff and a half dozen other afflictions.

The nursing home told me my mother had probably gotten C. Diff because the hospital had given her a heavy dose of antibiotics just before releasing her. The theory was that the dose wiped out benign bacteria and cleared the way for the antibiotic-resistant C. Diff to run rampant through my mother’s bowels without competition.

You can read about a lot of ways to fight C. Diff at the Peggy Lillis Foundation website https://cdiff.org, or  https://peggyfoundation.org/ , or at the C. Diff Foundation website: https://cdifffoundation.org/  They are trying to raise awareness of C. Diff, and the fact that antibiotic use is the most common risk factor for C. Diff. The Peggy Lillis Website cdiff.org has a petition you can sign.

But one way to fight C. Diff that appeals to me is for the hospital patients being discharged to nursing homes to discuss the issue of antibiotics and C. Diff with the hospital staff.

This year the government Centers for Medicare and Medicaid Services — CMS — issued a rule that requires hospitals to provide discharge planning consultation for patients being released to nursing homes and other settings. You can discuss use of antibiotics with the hospital staff and select a nursing home that is appropriate for you. You are less likely to end up in a poorly rated one by accident.

Check out the guidance about selecting an appropriate nursing home and making your antibiotic treatment preferences known through the new CMS discharge planning rule at CMS’ Discharge Planning Rule Supports Interoperability and Patient Preferences | CMS.

Help Fight C. Diff

Help fight Clostridium Difficile (C. Diff) by supporting the Peggy Lillis Foundation. You can make a donation in honor of, or in memory of, a loved one.

C. Diff is a cause in 9,000 nursing-home deaths per year, and the seventeenth leading cause of death in people 65 and over.  It is responsible for 500,000 infections per year.

The Peggy Lillis Foundation is building a nationwide C. Diff awareness movement by educating the public, empowering advocates, and shaping policy.

One of the healthcare-associated superbug infections, C. Diff infections result in $8.2 billion in hospital costs annually, according to the Peggy Lillis Foundation. The average cost for a C. Diff hospital stay is $24,400 versus $18,200 for congestive heart failure, $10,500 for acute myocardial infarction, and $9,300 for pneumonia. American deaths from C. Diff (29,000) outpaced HIV/AIDS (17,000), and drunk driving deaths (10,000) combined.

Home Page for Mary Regina’s Nursing Home

New Mexico Governor Candidate Has Interest in Fight Against Superbugs

Acting as a member of the Peggy Lillis Foundation’s Advocates Council, I presented Congresswoman Michelle Lujan Grisham (D-NM) with an information packet about the superbug Clostridium Difficile (C. Diff) and other healthcare-associated infections (HAIs).

by William J. Beerman, Sr.

I recently had an opportunity to present gubernatorial candidate and New Mexico Congresswoman Michelle Lujan Grisham (D-Albuquerque) with an information packet about an anti-superbug campaign being waged by the Peggy Lillis Foundation (PLF). Rep. Lujan Grisham responded that she would “take a personal interest” in the matter.

Rep. Lujan Grisham expressed concern about superbug Clostridium Difficile (C. Diff) and other healthcare-associated infections (HAI) during a brief meeting with me in Las Cruces, NM, where she took part in a public forum for New Mexico Democratic gubernatorial candidates on May 1.

The PLF is named for Peggy Lillis, a teacher and mother who died from C. Diff in 2010 at age 56.

A former cabinet-level state health official, Rep. Lujan Grisham said she is familiar with the problem of antibiotic-resistant bacteria such as C. Diff and other healthcare-associated infections.

“I am a care-giver myself,” she commented. She co-founded the bipartisan Assisting Caregivers Today (ACT) Caucus in Congress. Her experience with caregiving for her mother was outlined in a November 2017 article published on Forbes.com.

Once went undercover in a nursing home

Formerly the New Mexico Secretary of Health and the Director of the New Mexico Agency on Aging, Lujan Grisham went undercover in a nursing home in 1997, posing as a stroke victim, to investigate conditions there. A 2016 campaign ad about her 3 days undercover in the nursing home, where she saw abuse and she herself was neglected, is archived on You Tube.

The information packet I presented to Rep. Lujan Grisham contained information about Senate Bill 2469, which was introduced by Senator Sherrod Brown (D-Ohio) on February 28. Brown’s bill, named the STAAR Act (Strategies to Address Antibiotic Resistance), calls for various actions to address the growing crisis in which an estimated 2 million people get sick each year with antibiotic-resistant infections.

Besides the human suffering, antibiotic resistance takes a toll on the U.S. economy estimated at $20 billion a year in excess healthcare costs and as much as $35 billion in lost productivity.

Another New Mexico member of Congress, Ben Ray Lujan (D-Santa Fe), sits on the Energy and Commerce Committee’s Subcommittee on Health. He helped develop the 21st Century Cures Act, which overwhelmingly passed Congress and was enacted in December 2016. The law allocates $4.8 billion in funding to the National Institutes of Health (NIH) for cutting-edge scientific research on treatments and cures. The STAAR Act would complement the 21st Century Cures Act by improving the existing surveillance, data collection, and research work to prevent bacteria from developing resistance to current and future antibiotics.

PLF is concerned that many cases of C. Diff go unreported, and the organization wants to make reporting of C. Diff mandatory, including on death certificates.

The STAAR Act facilitates national Center for Disease Control partnership with state health departments through CDC’s Prevention Epicenters Program. Lujan Grisham said her interest will continue if she is elected governor and she foresees roles in fighting HAIs for government agencies and institutions in New Mexico.

PLF points out that C. Diff is the most common cause of infectious diarrhea in healthcare settings. It caused nearly 500,000 infections in one year, and 29,000 deaths. Seventeen percent of C. Diff cases occur in nursing homes and 22 percent in hospitals. Only 7 percent are completely unrelated to health care.  In nursing homes, the infection interferes with residents’ rehabilitation therapy and recovery as it causes uncontrollable diarrhea, fever, nausea, abdominal cramping, dehydration, loss of appetite, and death in some cases. Ninety percent of Americans who die from a C. Diff infection are 65 or older.

More information is available in blog posts on my website about nursing homes, https://wbeerman.com and at the following PLF websites:

www.Makecdiffcount.org

https://peggyfoundation.org/