If your loved one has become bedridden due to illness or infirmity, it is important to take steps to prevent bedsores, also known as “pressure ulcers,” which are areas of broken skin caused by the pressure of lying in one spot too long without moving. Bedsores themselves cause pain, but worse than that, if left untreated bedsores are prone to becoming infected. In severe cases, the infection spreads from the skin to the blood, and even the bone.
In extreme circumstances, bedsores can be deadly. According to an article on the British news site The Daily Mail, bedsores kill almost as many hospital patients as the “super bug” called MRSA (methicillin-resistant Staphylococcus aureus).
According to the Mayo Clinic, bedsores can move through four stages of development very quickly:
- Stage 1: Closed wound. The skin appears red (on fair skin), or ashen, bluish, or purple in people with darker skin. The site may be painful, and may be either warmer or cooler than the surrounding skin.
- Stage 2: Open wound. The outer layer of skin is damaged, making the ulcer look like a shallow divot, or like a large intact or ruptured blister.
- Stage 3: Deep wound. The ulcer starts looking like a crater, possibly with some yellowish dead tissue.
- Stage 4: Large-scale loss of tissue. The would exposes muscle, bone, and/or tendons. The bottom of the wound may look dark with crusty dead tissue.
Treating bedsores can be difficult, which is why prevention is so important. Whether your loved one is at home, or in a nursing home or hospital, here are some steps you can take to prevent problems before they start, from Dr. Anthony Komaroff (AskDrK.com) and the Lake County News-Sun:
- Relieve pressure on vulnerable areas. Move your loved one every 2 to 4 hours—from lying on the back, to one side, then the other side, then the back again. According to Dr. Komaroff: “When she is on her side, she should be only partly on her side (about a 30-degree tilt); if she is completely on her side, her hip bone will push down hard on her skin.”
- Use pillows to keep vulnerable areas from pressing into the mattress.
- Reduce irritation. You know how a tiny pebble in your shoe can feel like a jagged piece of glass after walking on it for awhile? To the skin of a bedridden person, tiny irritations can cause big pain. Keep sheets smooth and not bunched… don’t allow books or other objects to remain in the bed when not in use… make sure crumbs are caught or cleaned after eating.
- Inspect sore-prone areas at least once a day.
- Get prompt medical care if you see suspicious areas of skin irritation.
- Encourage good nutrition. If you have any doubts or questions, talk with a nutritionist to make sure your loved one gets enough calories, protein, fats, vitamins and minerals.
- Encourage movement or exercise. Even stretches or simple arm or leg lifts can help the blood circulate, which can keep the skin healthy.
- Keep skin clean and dry. Wash with plain water and very gentle soap (when in doubt, ask a nurse for recommendations). If sweating is a problem, use absorbent pads to keep moisture off the skin.
- Communicate with nursing home staff about your bedsore observations. If your loved one lives in a nursing facility, ask what steps they take to prevent bedsores. Let them know if you discover early signs of problems. Ask if they have any recommendations about items you could purchase that might make your loved one more comfortable. If you work as a team, your loved one has a better chance of staying healthy!
