If you provide care for a loved one who is medically complex and requires skilled medical and nursing care for one or more chronic illnesses, you may be looking for practical solutions to managing bedsores at home. Don't miss these expert tips:
Acute attention to any changes in skin color or appearance is a must for catching bedsores before they become dangerous. There are four stages of a bedsore (or pressure ulcer) including:
Stage 1 – a pinkish or reddened discolored spot appears on your loved one's skin
Stage 2 – skin breaks open forming a shallow yet painful sore
Stage 3 – the ulcer expands into deeper layers of soft tissue forming a crater
Stage 4 – tissue breakdown has reached deep layers of muscle and possibly even bone
Bedsores form from prolonged contact of a bony part of the body with a surface like a mattress or chair cushion; they are most common among bed and chair-limited patients. Without much movement, these vulnerable parts of the body start to lose blood supply from the pressure of the bone in their tissue. Skin can become macerated and crack, tear, or break. Contaminants make their way in, and as deep layers of tissue die, an infection can spread and lead to life-threatening complications.
Addressing Stage 1 Bedsores at Home
Caregivers must pay close attention to bedsore-prone areas near bony protrusions like their loved one's tailbone, hips, elbows, heels, or shoulder blades. In the event that you do see the start of a bedsore (discoloration but no broken skin yet), take the following precautions:
Check for blanching – to see if blood is still flowing to the spot of tissue, press lightly with your finger and watch to see if the spot goes white and then flushes red again. This simple test indicates that the live tissue is still receiving blood flow.
Apply a barrier cream – protective barrier creams go directly on your loved one's skin and help to keep out excess moisture and contaminants which may cause skin break down.
Show your doctor – make your loved one's doctor or home health nurse aware of the potential start of a bedsore so they can examine it and make recommendations for care.
Reposition your loved one often – every 2 to 3 hours, change the position in which your loved one is lying or sitting to alleviate pressure off bedsore-prone regions of their body. Use pillows, bed wedges, or other soft cushions to tilt them from one side to the other.
In the event of recurring bedsores, you may consider getting a different type of mattress for your loved one's bed. Memory foam, gel, and alternating air pressure mattresses can help prevent painful lesions and ulcers from developing by better distributing your loved one's weight when they are lying down or reclining.
If you discover that a bedsore has progressed from a stage 1 to an open ulcer, seek medical attention immediately. Call your loved one's doctor or home health agency for an evaluation. They may recommend a wound specialist examine your loved one to measure the region of the bedsore, make a diagnosis on the stage, and train you, the caregiver, in its proper care and treatment with wound dressings. Depending on the state you live in and your loved one's health coverage, Medicare may cover intermittent home health care for assistance in managing a bedsore.
Bedsores progress rapidly so it is critical that caregivers take quick action when they notice one developing so that their loved one's health is not compromised.
Preventing Bedsores at Home
In addition to frequent re-positioning and upgrading the mattress or seat cushions your loved one uses, you can also take these easy steps for preventing bedsores at home:
Practice good hygiene – if your loved one experiences incontinence, they are at increased risk for developing a bedsore, especially around the tailbone and bottom area. Make sure to properly clean and dry them after a diaper change and apply barrier cream as needed.
Focus on nutrition – vitamins and nutrients that promote tissue repair and strong blood flow may help strengthen your loved one's skin against bedsores. Vitamin C, zinc, protein, potassium, and calcium are a good place to start – think milk, oranges, broccoli, bell peppers, lean meats, nuts, eggs, beets, and sweet potatoes.
No smoking – bad habits like smoking negatively impact blood circulation in your loved one's body putting them at increased risk for bedsores when they are mobility-impaired.
Body checks – if your loved one experiences cognitive impairment associated with diseases like Alzheimer's, Parkinson's, or multiple sclerosis, they may not be in a position to let you know when something hurts or doesn't feel right. Keep a keen eye out and check in with them frequently about comfort levels.