Another day in paradise. 🙂
After a busy and productive day at work, I got some respite: a visit with mom. 😉 She is still happy, eating well, taking her meds and following her routine. The rest of the Sweet 17 were doing pretty well too although one of my favorite ex-teachers had a fat lip from an unknown thump and one of my other favs is in “time out” in the behavioral health hospital while they get her meds worked out better.
One concern nurses told us about is that mom has developed from being in her wheelchair in all waking hours is pressure sores/ulcers on her “sitting” area. We talked to the charge nurse about this new situation and about her need to have some physical therapy time to hopefully get out of the chair.
For those new to memory units (or nursing homes in general), bedsores/pressure sores are a big deal. They cause pain (that the patient can’t easily express but that comes out in other ways), restlessness, sleep difficulty, and other inconveniences….at first. As they get worse and advance in stages, they can get infected and, often, lead to sepsis and death. In short, they have to be treated carefully and diligently now and not later if they don’t just go away.
How do you prevent these menacing sores?
- Hydrate. Lots of water. Good for anyone, but especially for these patients. Increase protein and other skin-enhancing foods.
- Reposition the patient at minimum every 2 hours…more is better if you are a professional
- Watch toileting issues closer and change them often
- Be sure they are dry after bathing and kept dry (and not too hot, causing sweating)
- A thin layer of corn starch on the bed reduces friction although be careful to limit fall risks
- Egg crate padding on the mattress. Calf supports, not heel supports, to prevent heel sores. Foot cradles or foam at the end of the bed can help as well.
- Replace bedding and pads often with clean, wrinkle-free replacements. Use natural fabric like cotton and linen when possible.
- Avoid tight bedding and tight-fitting clothes.
- Avoid skin-on-skin (prolonged) contact where possible.
- Use special mattresses and pillows as needed to reduce pressure on the sores so they can heal.
- In a wheelchair: Position then correctly with hips in the middle (centered), buttocks against the back and feet supported or on the floor, but not swinging. Use a small, flat pillow for added support and comfort, as needed.
- Avoid unnecessary pressure/friction by lifting instead of dragging and patting instead of rubbing in the bath. Their skin is quite fragile in this condition.
- Snag the physical therapist and get his/her help in the case. Can the patient get more exercise or perhaps walk occasionally to increase blood flow?
- Use specialized barrier lotions and creams as needed.
- Use mechanical lifts (or multiple lifters) to reduce pressure in and out of the chair.
- Check often for sores whether in a chair or not.
- Pay Attention for non-verbal signs that something is worse.
If you have more tips or wish to correct mine, please comment, post on digitalcornbread.com or email me at firstname.lastname@example.org . I am not a nurse nor a 24/7 caregiver, but these are solid sources that would give good, general advice. That being said, I happily will submit to and welcome your edits.