RALEIGH -- When a pest control company visited Lake Wheeler Family Care Home early last month, employees encountered an increasingly common sight in state-licensed homes for older people in Wake County: "Extreme amount of bedbugs (thousands) noted throughout entire house," an inspection report said. "Heavy amounts of fecal matter and cast skins also noted."
On March 25, Wake officials ordered the home for four to six older people to come up with an acceptable plan for getting rid of the infestation or face daily fines of $400.
At least four larger adult-care homes have had to ward off infestations, a particularly difficult task in centers where people may lack mobility and the ability to communicate clearly about the pests.
"In a secure Alzheimer'sunit, sometimes the residents can report bugs," said Gail Holden, Wake's director of adult services. "Or they have trouble telling you what's going on. Or if they can talk, you may be able to understand the words they are saying, but not what they mean."
Bedbugs have become a growing problem in motels, apartment complexes and other congregate living situations in recent years. There's even a user-driven website, bedbugregistry.com , where one can check out reports of infestations across the country.
In a situation where the residents almost by definition move slowly and have trouble communicating, bedbugs can make quick inroads and be tough to evict.
"They will follow you, they will follow the food, they will follow the blood meal," said Catherine Goldman, a county human services senior practitioner. "They travel five to 20 feet."
Watching for signs
Bedbug bites don't cause serious disease, but produce tormenting itching and possible secondary infections from scratching. Some facilities have been aggressive in conducting the sort of cleaning, heat treatment and other techniques proven to eliminate the pests. Others who are wary of expense try to go it alone.
"They are not well informed of how you eradicate bedbugs," Holden said. "They think that bleach or something else will get rid of them, but it takes a variety of chemicals."
Facilities can react quickly by watching for such characteristic signs as bites on residents, droppings, eggs and trails of blood excreted by bugs. Administrators need to realize the bugs are there and get professional help eradicating them. Increasingly, some homes are taking pre-emptive steps that were once unnecessary, Goldman and Holden said.
"There are facilities where they won't allow them to bring in their own furniture," Goldman said, noting that the practice was once recommended because residents felt more at home surrounded by their familiar belongings.
"You have to be careful about anything from Craigs list, from secondhand stores and anything you see left by the side of the road," she said.
Hardy insects
Since last year, Goldman has led the monthly PALS - Partners in Assisted Living Solutions - group giving regulators, other social services specialists and employees of centers a chance to work cooperatively on problems facing residents.
The best-attended session so far was on bedbugs, led by Jung W. Kim, an environmental senior specialist in public health pest management for the Division of Public Health.
"It went on for two hours and could have gone on longer," Goldman said.
The hardiness of the bugs has taken on almost legendary proportions. As an experiment of sorts, Holden recently kept a bedbug in a plastic cup on her desk for more than a month.
The bug, whom Wake Human Services staff named Hermione, eventually died, but not before giving birth to a new litter of pests.
"She lived almost four weeks with very limited air and had babies," Holden said.
