Paying attention to bedsores

Mr. Gary LeBlanc is a health columnist specializing in dementia care.  He has authored over 350 articles on the subject.

When a person ages, the skin becomes thinner. Thus, when some elderly people become bedridden, bedsores, also known as pressure sores or decubitus ulcers—easily occur. These sores are a result from sustained pressure to a body area which prevents normal blood flow. Without adequate circulation the impaired skin dies.

The severity of pressure sores can be observed in four distinct stages. Stage one is where the wound is an irritated red patch of skin that usually dissipates after a short period of time once the pressure is relieved. The irritation can become worse until finally reaching the fourth stage, which results in a large area of skin loss, possible damage to the muscle and even bone. Such sores can be a caregiver’s nightmare and cause unimaginable suffering to their dear loved one.

While taking care of my father, we battled this dilemma daily throughout the last couple of years of his life. The less mobile he became, the more attention I had to pay to his skin condition. Sadly, I went through the exact same thing the last six months with my mother.

If your patient is wheelchair-bound, you may think your only concern will be bedsores on his or her bottom. But in fact, you will also need to pay close attention to the shoulder blades, the spine and the back of their arms. If bed-bound, you also need to keep an eye on their ears and along the back and sides of their head, actually any point where the body pressure occurs.
Prevention will always be a caregiver’s best defense. Examining the skin while bathing should become a daily ritual. Once he or she has become incontinent, your constant vigil becomes even more critical. The skin staying moist only enhances the risk of bedsores creating a higher contingency of infection.

If sores become open they can take forever to heal. They must be attended to every day. Your loved one’s doctor can design a plan for you to follow, but the first step of treating any bedsore is to relieve any pressure that caused it. If they cannot reposition themselves, someone will have to turn them throughout the entire day possibly up to every two hours. Be sure to watch out for things like wrinkled sheets, the plastic of incontinence pads or any materials that could be restricting circulation.

Current technology has brought forward some great devices to assist with patient care; air or water-filled cushions, specialized mattresses, skin care salves and many other helpful products. See if you can get some of these products prescribed by the attending physician as most insurance policies will cover the cost. One rule that should always be followed is to contact his or her doctor immediately if you notice the sore had broken open. This is where the wound becomes extremely vulnerable to infection.

When visiting loved ones in a nursing home or hospital, don’t hesitate to check their skin. If anything concerns you, talk with a member of the nursing staff or the facility director. Inform them you’ll be back daily and will check on their condition.

During my father’s final days, it seemed no matter how often we turned him; we couldn’t prevent his skin from breaking down. It’s a tough and heartbreaking battle. Just show up every day ready to do the best you can.

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