Violet Madden worked as a home health care provider until she was 82.
"She worked for Homestead Senior Care taking care of patients in their home so they wouldn't have to be put in a facility," says her daughter, Sharon Althaus.
But when Violet's health failed, she had to be placed in a nursing home. Sharon says it was one of the most difficult decisions she's ever made.
"She'd broken her wrist. She could not be home alone anymore... It's heartbreaking, it really is."
Equally heartbreaking, Sharon says the care and conditions inside the nursing homes were sub par. After being placed in two facilities, Ramsey Village and Genesis Senior living center, both in Des Moines, Sharon brought her mother home.
"But unfortunately at that point there'd been so much dependency on the other wrist, that that wrist started acting up and back to the hospital we went," says Sharon.
In addition to the wrist problems, doctors told Sharon her mother suffered from dementia. Violet was then placed in The Rehabilitation Center of Des Moines. Sharon wasn't pleased with the care her mother had received at Ramsey or Genesis, but she says things went horribly wrong at The Rehabilitation Center of Des Moines.
"Twice I found her lying in her own feces," says Sharon.
But according to Sharon, that wasn't the worst of it. Violet suffered from a condition called lymphedema, requiring leg wraps to reduce swelling. Sharon says she'd wrapped her mother's legs for three years without a problem. But when the nurses at The Rehabilitation Center of Des Moines started wrapping Violet's legs, she ended up with sores on her legs and feet.
"I would come in and her legs would be in spasm. They were just quivering and she was crying in pain and I thought, I've been told I shouldn't touch these legs. I finally shut the door and I would take the wraps off. They were wound so tight on these legs that they were cutting off her circulation. The toes were cold," says Sharon.
Sharon says a month went by before a doctor - a new doctor requested by Sharon - treated Violet's legs. By then, her mother was seriously ill.
"He took one look at her labs and he immediately sent her to the emergency room for kidney, renal failure. Her potassium was so high, she could have had a heart attack."
We asked an administrator at The Rehabilitation Center of Des Moines to comment on Sharon's allegations, but he had no comment. What we do know about The Rehabilitation Center of Des Moines is that it is owned by a holding company called Skilled Healthcare Group. It owns or leases nearly a hundred skilled health care and assisted living facilities in seven states. In 2010, it settled a lawsuit for $50 million dollars. The lawsuit alleged Skilled Healthcare Group failed to maintain minimum staffing levels at several facilities.
Medicare, which ranks nursing homes nationwide, also gave The Rehabilitation Center of Des Moines an overall rating of "below average," just two out of five stars. The same goes for Ramsey Village, Genesis Senior Living Center and Prime Nursing and Rehabilitation Center, the nursing home where Violet currently resides.
"Since August she was in the hospital three times and because of what the facility had done I just could not bring myself to put her back in that facility," says Sharon.
The ordeal has taken a toll on Sharon.
"It's just been horrible... This right now, what I'm having to experience with my mother is, I think, the most dreadful thing anyone can have to go through."
Sharon has developed an ulcer and questions whether the most difficult decision of her life, was the right decision.
"I feel like I'm murdering my mother."