How much do you know about bedsores? You will be surprised to learn that at some point in your life you will hear these words.
Here’s my story.
My mum was bedridden after a stroke for 5 years. I was the primary carer and she lived next door to me in our apartment complex. I had a carer to assist her as she needed full time care. Since there was this fear that she would fall over, I got a hospital bed for her for safety and equipped the room and bathroom all user friendly with wheelchairs and commodes and pampers and the like. For entertainment I had a small TV hung on the wall for her to watch her favourite Tamil series and I plastered the room with laminated photos of her children and grandchildren to remember them as she was suffering from dementia too.
BUT………… my greatest fear was - How am I going to prevent bedsores from creeping in during this prolonged bed stay?
I did my research and found that the ripple/pressure sore mattress was the best bet and bought one and attached it to the bed. I also arranged for 2 nurses to teach my carer how to move my mother around so that she does not get bedsores and I made sure to check her body constantly for any impending signs of early onset of bedsores. I’m proud to say that my mother did not have one bedsore even as she passed away at age 88. The anti pressure sore mattress and the “CARE” definetely helped.
Here’s more about Bedsores and how we can alleviate them.
What are Pressure ulcers/bed Sores?
Bed sores or pressure ulcers as they are sometimes called range from skin irritations to open wounds prone to infection. We have heard this word amongst those who are bedridden – a very common and serious problem amongst the Elderly who are frail, bedridden, or otherwise immobile.
They are injuries to the skin and underlying tissue, primarily caused by prolonged pressure on the skin from lying in bed or sitting in a wheelchair for long periods of time. Are they painful- Yes they are and are difficult to heal? This can happen to anyone and once a bedsore develops, it can take days, months, or even years to heal. It can also become infected, causing fever and chills as the infection spreads through the body.
For example, when we sleep, our body is normally in constant movement as we shift positions and unconsciously adjust ourselves while watching TV, working at a desk, and even lying-in bed. However, when the mobility is reduced especially in the elderly or when you have just had some surgery or illness like arthritis, these movements may stop. So, if you do not regularly readjust the body, the pressure of an immobilised body can reduce the blood flow and damage the skin.
Common bedsore sites are at the tailbone (coccyx), shoulder blades, hips, heels, and elbows. They form in areas with little padding from muscle and fat, near joints or prominent bones.
Most elderly and nursing homes are aware of their inmates being exposed to pressure sores but it’s important to know what are the factors that contribute to elderly bedsores so that steps can be taken to prevent its occurrence.
The main ones are as below.
The continued pressure on a body part can reduce blood flow to the tissues. The tissue and skin need blood flow to deliver oxygen and other nutrients and without these, they become damaged and may deteriorate. For seniors with limited mobility, this pressure often happens in areas without much muscle or fat, leading to bedsores.
Care must be taken when seniors are repositioned as the moving and rubbing can break down skin. When adults get older, their skin gets thinner and more fragile. It is best to avoid rough clothing and sheets, as these can be bedsore causes
Shear occurs when the skin moves in one direction while the bone moves in another or stays still. For example, slowly sliding down a bed may cause tailbones or shoulder blades to move while skin remains in place. This can cause the skin to stretch and tear.
The 5-step process to prevent bedsores.
One of the best ways to healing these pressure sores would be to relieve the pressure, to keep the wound clean and to take antibiotics to ensure these sores get better. If you have loved ones who are bedridden and cannot shift positions on their own, they are the ones most at risk of developing bedsores. We must be mindful that this minor annoyance can quickly develop into a major health problem for frail elders. Paying heed to the 5-step process can alleviate their symptoms.
1. Constant regular movement
Have a plan to reposition the elderly regularly every two to three hours in bed. If a person is wheelchair bound, then it is every 30 minutes. Carers need to be trained to do this around the clock and so they need help and must work in shifts.
2. Inspect the skin daily.
Inspect the skin daily to see for warning signs for bedsores as this is necessary for bedsore prevention. You may feel uncomfortable or invasive to inspect your loved one’s body so closely, but it’s necessary to catch them early.
3. Special mattresses and supports.
This is a MUST. Ripple/anti pressure sore mattresses that is made of foam, air, gel, or water can be readjusted on a regularly and change the pressure on the body. However, with the advancement of technology new discoveries were made where the world of fabric technology showed a significant growth where polyester fibres could support the body without the need for pumps as a possible solution.
A fabric that could be pressure mapped below capillary blood flow at just 28mm Hg was created allowing a steady blood flow at even under the most direct pressure points of the body when lying on a normal bed. This breakthrough and revolutionary fabric called the Treat Eezi Community Pressure Ulcer Overlay not only heals but prevents bed sores.
4. Incontinence management and care.
If the patient has incontinence, do everything you can to prevent exposing the skin to moisture and bacteria. This includes regularly scheduled help with urinating, of making diaper changes and putting lotions on the skin. Skin becomes more vulnerable when it’s exposed to urine or stool, even for short periods of time.
5. Nutrition and physical activity.
Choosing a healthy diet for the elderly and keeping their skin hydrated with sufficient drinking helps promote skin and bone health in the prevention of bedsores. Find out how much to drink and learn the signs of poor hydration so that you can stay on top of things. Try encouraging mild movement and stretching to increase the blood flow and certain low impact stretches that can be safely performed in a bed or wheelchair.
Are bed sores scary? Absolutely. Are they too much for caregivers to manage? Not at all. With prompt attention from medical professionals, as well as proactive actions like repositioning, staying hydrated, and maintaining a healthy weight, you can keep your older adult bedsore-free for good. For more information about the tools and equipment needed to help with pressure soreness, feel free to get in touch with us.