Hard lessons from a long hospital stay.

This narrative is related in the alternating voices of the two authors. One author, a 55-year-old man, quadriplegic from primary progressive multiple sclerosis, describes the 10 weeks he spent in four facilities for treatment of a stage IV ischial pressure ulcer. The other author, his friend and health care proxy, describes the advocacy and personal assistance she gave him in the face of often inadequate care that at times threatened his safety, comfort, and emotional well-being. The authors describe their differing perspectives on this care, which involved a transfer onto his open wound, frequently missed meals, and poor bowel management and personal hygiene. They believe that inadequate staffing and insufficient training and supervision of nursing assistants, among other factors, underlay these problems.