If your loved one isn’t able to move very often—or uses a wheelchair to help with mobility—you need to be aware of the dangers of pressure sores.
Pressure sores, which are also referred to as bedsores, decubitus ulcers, or pressure ulcers, are a problem that develops when there is insufficient blood flow to the skin. The most common cause of pressure sores is insufficient mobility, such as when blood vessels are squeezed between a bone and surface of a bed or chair. Because the skin is being squeezed, it can’t receive proper nutrition and develops a sore. Additionally, pressure sores can result from the friction between a person’s skin and a sheet or from prolonged skin contact with moisture (perspiration, urine, or stool).
Pressure sores occur in four stages:
- The skin becomes warm and red in the area covering the bone. This redness does not disappear after 15 minutes of pressure relief, and there is no break in the skin.
- An open wound appears in the form of a blister, which is red and painful.
- The skin breaks and the wound drains through the top layer of skin. The area surrounding the wound or blister is red, but the sore is no longer painful.
- The wound opens down to the muscle or bone and continues to drain. If the wound is not open, it may be covered by a black scab. The area around the wound will continue to be red.
You should help your loved one to move around if you find Stage 1 sores. If Stage 1 sores develop into Stage 2, or if you find Stage 2 sores, contact your loved one’s doctor.
Preventing Pressure Sores
Preventing pressure sores is important as they can be very painful and are difficult and expensive to treat. Preventing pressure sores can be as easy as helping your care recipient to change positions frequently, eat a well-balanced diet, keep his or her skin free of moisture, and maintain clean and dry skin.
- Help reposition the care recipient every 2 hours
- Encourage your loved one to sit up or in a chair for a few hours
- Monitor your loved one for early signs of pressure sores
- Apply a thin layer of cornstarch to sheets to reduce friction
- Keep bed linens dry and wrinkle free
- Place 3–4 inches of “eggcrate” or similar foam padding over the bed mattress
- Place pillows or padding under your loved one’s head, shoulder blades, elbows, sacrum (tailbone), hips, knees, ankles, and heels
- If your loved one is incontinent:
- Do not use plastic-backed incontinence pads directly under the skin—these retain urine and body heat close to the skin
- Use artificial sheepskin over a plastic incontinence pad to reduce pressure and drain urine
- Use soft drawsheets rather than sheepskin for a care recipient with bowel incontinence
- When your loved one is on his or her back:
- Keep his or her heels flexed at 90 degrees to reduce pressure in the heel—try using a pillow under the calf, but not the knee
- Position knees and toes upward by placing a thick blanket or towel along the outside of the leg
- Position arms away from the trunk by placing pillows between the arms and trunk
- Position the hand in an open fashion by placing a rolled washcloth inside of each hand
- When your care recipient is on his or her side:
- Place a pillow between the lower legs to keep the legs from touching
- Make sure that your loved one’s weight is on the flat of the shoulder blade and that the bottom arm is not caught under the body
- When your loved one is sitting in a chair or wheelchair:
- Center hips between the armrests
- Align buttocks with the back of the chair—if the chair is too deep, place a small pillow behind your loved one
- Rest his or her feet flat on the floor or on footrests to decrease pressure on the back of the thighs.
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