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lindaz Asked December 2014

My mom has started developing bedsores. Any ideas?

My mom is almost 92 and in the final stage of Alz. She is completely bed bound, cannot move on her own, incontinent and non-verbal. She has started developing bedsores, the worst is on her butt, but now has one on her hip and starting to get them on her heels. We try to change her position as much as possible but she is in pain on her side and always falls back to lying on her back. We are using patches, med.ointment, position changing and keeping her clean and dry. She also seems to have trouble breathing on her side as she winds up getting face down on the mattress or pillow - we use props to keep her in place but again she still winds up face down. We are using an air pillow to relieve the stress on her butt, but now she is developing sores on her hips (lying on her side) and on her heels. She cannot move her arms or legs so we do that for but her joints are freezing up. Any ideas of what we can do to help her? Her nutrition is poor as she no longer wants to eat, so we keep her hydrated with home-made smoothies (yogurt, fruit, juice and her meds) as this is something she will take. Does anyone have any ideas of what else we can do for her? She is at home under hospice care.

Diannegpb Nov 2017
I have used some squares of mesh with a foam bandage over the top. NO ointment with bedsores per the wound care center. You cut out the metal, I think it's copper but will find out for sure, to the size of the wound and apply the bandage over the top with the thickest part over the wound. You leave it there for 3-4 days and then change the metal piece and bandage. It's important it doesn't get wet. I'll get you the name of the metal product and bandages. This really works for us and I hope you'll give it a try. After the 2nd or 3rd application, sores should be healed. You might ask hospice about wound care and see if they can get someone in there to evaluate the sores. Praying you try it and it works for your mom. 🌻

Dad_Was_Robbed Aug 2017
It sounds like she may actually need a pressure relieving mattress. Even if you can't get insurance to cover one for you, you can still go to places like Walmart and get her one of those nice 4 inch or more thick memory foam mattress toppers. They're more expensive but well worth it. In fact, you'd be surprised to hear this, but earlier in the year, a friend of mine actually found one on the curb in pretty good shape, and it was clean. It came from a house where the people seem to be pretty well-to-do because the quiet neighborhood where I live is a pretty nice one. If you ever want to find something for nothing, go curbside shopping in the good neighborhoods because you never know when someone will actually toss something, especially from a college house. 

Getting bedsores to heal

Getting bedsores to heal requires restoring circulation and for the open wounds, making sure they stay clean and dry. If bedsores are just starting, the best time to catch them is early. The earlier the better. Don't let them get infected, and definitely don't let them get too deep! If the bedsore is a pretty bad one, your best to have the patient admitted to the hospital so the pros can take care of this. If you can take the patient by car, you can save a ton in transport but make sure you tell the receptionist and your intake nurses that you need a thick enough mattress to actually conform to the patient so that it acts as a pressure relieving mattress if this is in the ER. With enough patience speaking up about gurney mattresses that are too thin and cause even more problems on an already existing underlying problem such as arthritis and in your case, bedsores among other things, we can raise awareness and make "backboards" and "yoga mats" a thing of the past. I'm glad some hospitals are actually listening, because if you yourself have never been on some of the gurneys out there, it's very hard to understand what the some specific types of patients are going through if you yourself have never been in their shoes and if you yourself have never been on some of the nightmare gurneys and even some of the exam tables and some of the rooms at some of the hospitals or doctors offices. A hard table or gurney actually intensifies and already pre-existing problem whereas thicker mattress of about 4 to 5 inches or more lessen the pressures on the  body, especially in certain specific areas like hips, backsides and shoulders. These are actually some of the most common areas to get a bedsore or even trigger pressure induced arthritis pain that radiates deep into the joint and sometimes beyond. 

Another thing to help with preventing and even healing bedsores is to pay special attention to reposition patients more often. It's nice if a patient can reposition themselves if you give them one of those overhead things they used to use in hospitals that has a grab bar with reposition assist. If the patient can't re-position themselves, then someone needs to go in and turn them every so often but this should be done with the help of an assistant or two so that it goes more smoothly. In fact, there's  even a new type of bed that does the turning for you with the push of a button by an assistant. I'm not sure if they're out on the market just yet, but anything new I heard usually starts in California and works its way across the US. You might want to look into this type of bed, it looks like they may be very beneficial. If they are not yet available, they may still be in development and testing mode.  Modern technology is beneficial for not just lifting and transferring patients, but also for helping with those who are bedbound since they also need just as much help as anyone else. Not turning the patient often enough causes bedsores if they're left in the same position long enough to start developing even the warning signs of bedsores when they can't reposition themselves turn themselves. The problem is quickly enhanced if the patient is without a pressure relieving mattress. Years ago even I had to start using a pressure relieving mattress because I not only had pressure point problems, but also my body was misaligned allowing urine to not get to my bladder in the night, which would cause my kidneys to hurt, which would wake me up. As soon as I got up, the urine immediately dropped to my  got up, the urine immediately dropped to my bladder. The Tempur-pedic bed I sleep on actually helps with this particular problem as well as pressure point pain and even arthritis/bursitis

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grzmot98 Jul 2017
My 97 yr old Mom recently developed bedsores on her heels and just above the butt. CURE:sheepskin heel cups and a massaging bed layer. I forgot what cream was used, prescribed by hospice and/or her doctor, but they were cured within 1 -2 weeks.

Veronica91 Jul 2017
Bed sores or pressure ulcers are caused by the blood supply being restricted to areas of the body. I beg to differ about the constant repositioning. It used to be the practice to gently massage the area when the patient was repositioned but this seems to have fallen out of favor. There are all kinds of special boots available at great expense to keep the heels safe.

If you take the pressure off the affected area it will allow the blood to return to that area and help prevent further breakdown. 

Hospital beds and alternate pressure mattresses can be helpful but sometimes at the end of life there is no way of preventing them. There are dressings whose name escapes me right now that can be placed over the sore to aid healing. They work by encouraging the dead tissue to slough off and healthy tissue to form underneath. I have seen bedsores even on the ears that were in no way due to a neglectful caregiver.

Some people will yell "Call a lawyer" if their loved one in a nursing home developes bed sores. I say "Not so fast" First find out if your loved one has been receiving proper care. This does include getting out of bed but not being left sitting in a chair in the same position all day or waiting hours for a diaper to be changed. 

Spend 24 hours with your loved one and you will soon discover the type of care they are receiving.

Moelish1 Jun 2017
Home Health And Hospice nurses will keep track of her skin conditions and address the bed sores. They also will bring in a hospital bed with a air mattress that regulates air flow on one side, then the other. All this is covered by Medicare. Talk to your momsdoctor first about the skin issues and he will write out an order for Home Health And Hospice, hospital bed, and air mattress, etc. Regular beds, constant repositioning, etc. does not help bed sores.

vstefans Jul 2016
Gma1954 is right. Also there is something called GeoMatt that is a little better than egg crate and sheepskin, and alternating air mattress overlay if you can get one is good idea too. The poor nutritional status probably without enough protein on board is a big contributor to this. You have to turn often, even quarter turns, to let blood flow get to different parts of the skin and if that is not enough, then you really are nearing the end. There is even a term for this - Kennedy terminal ulcers. See www.ncbi.nlm.nih.gov/pmc/articles/PMC3478915/. It sounds very much like you are giving her the best care you can.

Veronica91 Jul 2016
At the end of life there is often little you can do to prevent bedsores so don't feel you have been neglectful if your loved one does develop some despite your best efforts.
The circulation begins to slow and does not reach areas where there is pressure, and deprived of a good blood supply the tissue begins to die. I have seen sores even on noses and ears! Your hospice nurse should be on top of this so follow her advice.
Real sheepskin is wonderful but unfortunately can't be cleaned. The synthetic stuff is pretty worthless you need the natural oils from the sheepskin.
I have seen lawyers looking for business state that bedsores are always a sign of neglect. Not true they can happen with the best of care. As someone mentioned they do take a long time to heal. Make sure the patient is not suffering pain from the sores or other causes. I would rather be pain free and sleepy than suffering. So if hospice offers medication use what ever you feel comfortable with for your loved one.

sherry1anne Jul 2016
My mother used a sheep skin for my grandmother.

megan2014 Jul 2016
Hospice should be taking care of the treatments for the bedsores and they can teach you how to do the dressings etc. He should have a special air mattress. Floating heels to reduce pressure is an excellent idea. Perhaps they can give your mom some ensure/ pro-mod ( for protein supplement), and Vitamin C and zinc. All of these things are usually indicated when someone has bedsores.

Grandma1954 Jul 2016
Hospice should provide the heel protectors. But with a pressure sore the only thing that I was advised to do was "float the heels" Not sure what to do with the back and hips.
Can you ask if the mattress can be changed to one with alternating air chambers. This will take the pressure off all areas for a short period of time as the chambers empty and the fill.
Hospice should provide all the covers that are necessary as well as any ointments.
At some point I think the sores are inevitable as the body can not heal itself well enough to keep up with the decline. The body is working as hard as it can keeping the heart, lungs and brain functioning. the skin takes a back seat to "the important stuff". the pressure sore that my husband had/has on his heels took a long time to get better, one is gone the other getting better but this is after almost a month. The body just does not heal fast enough to keep up.
These are not your fault! Even with the best of care I think they can not be prevented completely.

Silke1 Jul 2016
For my husband, we had :
- An air mattress (monthly rental),
- Two foam pillows : one under his legs and an other one between his feet and the bed end, in order to avoid that his heels rub on the bed sheet,
- Silicone gel adhesive hydrocellular dressings to apply on bedsores ("Allevyn" from Smith & Nephew),
- High protein sip feed with fibre -Apricot-Peach, Chocolate, etc...- ("Fresubin"),

These products (buy the pillows) were prescribed by our general practioner and / or the nurse visiting us at home and were paid directly (air mattress) or reimbursed by our Social Security (we are in France).

reallyworried1 Jan 2015
Having just been through this.....talk to her...tell her how much you love her..which I am sure you have been......play some of her favorite music....

If she stops eating and then drinking as my mom did...make sure hospice uses those stick sponges to help clean out her mouth and make it more comfortable for her...
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And with hospice I had them make sure they called me when I was resting when the signs of her breathing were starting to indicate the end was near...this way I could be by her side as she passed. It was truly an amazing experience. You truly feel the love...and almost have your life with them go before your eyes as it happens. Hugs...she will be okay......concentrate on your being okay and the rest of your family...

homecare1 Jan 2015
I am sorry, your mom stopped eating because her body is trying to die and the bed sores are the physical reasult of nutrition depleasion. As hard as it may be; talk to hospice about getting a comfort care kit to keep her comfortable and stop all nutrition and let natrual processes take place, sounds like they are already taking place and the little supplement she is getting is only prolonging the process. I am truely sorry.

twiceasnice2014 Jan 2015
there is an ointment that Rite aide carries, Its called Calmoseptine, its a thick pink ointment and you have to ask for it as it is a special item that they carry and not on the shelves, it is in the pharmacy. It worked wonders on sores after we had used a more expensive brand, Desitin, 40% and it didn't work. Also I have padded booties for heal sores, if you need them for your mom they are wonderful and cost a lot but your welcome to them if you would like them, for free- Hope this helps

Ela0123 Dec 2014
Try sudocrem I used that to my employer, the patches does not work

lindaz Dec 2014
Hi this is Lindaz, and I wanted to thank ALL of you for your good suggestions, prayers and helpful talks here on agingcare. You will probably not know how much you have helped my Dad and I with all of your comments. Maybe even you have helped others with the same problems we are having. I cannot thank you all enough. Please know that I will pray for all of you and for the loved ones that you are taking care of. There are too many people who will critize us for what we do and what we do not do, but they will not realize this until they too are caretakers for an invalid. My Dad and I love my Mom so much...and at 85 he is one of the best care-takers I have ever had the honor to know. They have been married for 64 years and he is in it for the long run. Not many people can say that. He wanted to keep Mama home as he felt we could give her the best care. I signed up with him because he is my hero....may you all be blessed for all that you do for the ones you love. You are the unspoken heros in this world and I hope that God blesses you, I certainly do! Thank you ! Thank all of you for what you do! Linda

Momcare8223 Dec 2014
I concur with Veronica91. From what you're describing, it sounds like the time is near to start preparing yourself for the final stages of her life. As a culture we have become quite unaccustomed to observing what is 'normal' for a person who is dying. And it's also 'normal' not to want to let go. Things that are done in hospitals often reflect an unrealistic expectation that 'life' can be prolonged for an indefinite period of time, but when we observe that, it appears so unnatural and even (to some minds) cruel. Since your mother is home (as mine is) we have the ability to prevent them from being stuck with needles and tubes, we can let them slip away peacefully. On their time, not some arbitrary schedule. I'm trying to prepare myself (and my 2 brothers) for this eventuality. Many times I've gone into her room and had to really look, to make sure she is breathing. Mentally, I brace myself for finding her 'still' but that hasn't happened, yet. I'm trying not to expect that we will all be lined up by her side, holding her hands. It might happen, but we might not get the chance to do that, and it will be okay if she ultimately breathes her last breath in the night when we are asleep. This is what I'm telling myself. We don't know how or when 'it' will happen, we only know that it will happen, if we don't interfere too much. Meanwhile, we let her know with our voices and hugs and touches, that she is loved. I've been working on funeral preparations for several months to avoid having to make those decisions all at once, and that's been a relief. It's not a happy process, but it can be a comforting one, to know you're going to see her through to the end of her life.

xxxxxxxx Dec 2014
What Veronica91 said.

Bless you.

Veronica91 Dec 2014
Do not give IV fluids. not that hospice will do this anyway. Giving IV to the dying just puts an extra load on the heart and kidneys and does not make the patient more comfortable. Dehydration is thought to release natural endorphins which are thought to be comforting.

Momcare8223 Dec 2014
Lindaz, the response from Veronica91 sounds right on, that is just what I was thinking, then I read her reply. Do keep talking to her and keep letting yourself have short breaks. Now would be the time to say goodbye to her, while she can still hear you. It's also kind to let her know that you will be all right, that it's okay to 'let go'. When my father was nearing the end of his life, I was on the West Coast (we live in Mass) and he couldn't talk, but I was able to talk to his nurse, and asked her to tell him I was on my way home, but that he didn't need to wait for me. He actually passed away when I was halfway back, just hours after I spoke to the nurse. I wish you peace and the satisfaction that comes from knowing you are doing a wonderful thing for your mother. Bless you both.

sherry1anne Dec 2014
You can buy a sheepskin. Medicare might even pay for it. Take action. She needs IV fluids.

Veronica91 Dec 2014
Lindaz the black stools suggest she has bleeding somewhere in her intestinal tract and the very dark urine of course is from dehydration. Nothing to be done about either. get some dark towels by the bed incase she has a huge Ibleed eith vomiting or by rectum. It is very distressing to see but she won't suffer and quickly become unconscious if she isn't already. If it is from the mouth turn her on her side so it just drains out. you are doing the best thing you can which is loving care. keep talking to her even if she seems not to hear as hearing is the last thing to go. Blessings

lindaz Dec 2014
We don't have the sheepskin rugs but they sound like a good idea. She does have the air mattress which goes up and down and that seems to be helping. I think she is nearing the end of her life as she barely eats, urine is is a dark tea color and sometimes she has black stools....she also can no longer move and almost appears frozen. Her face has really changed and she really doesn't look like herself...all of her wrinkles are gone and her skin looks like parchment. I just don't want her to be in pain. It is so sad.

sherry1anne Dec 2014
Honey has been used for centuries on all kinds of wounds. Also, bee propolis is a great dietary supplement for all of us, especially the elderly. Bees are really challenged right now with GMO and insecticides in the "round-up ready" crops, so hopefully we will be able to continue getting good quality organic honey..

Reverseroles Dec 2014
I just wanted to mention on the coconut oil that I too went crazy for it, and I dont like coconuts either, and started to get diareahea so I cut down. I then went for my annual physical and my cholesterol lipids (supposed to be under 150) were 633. Be careful, my total chol was well over 300 . I cant say that was why, just fyi to all.

Twin01Kathy Dec 2014
Years ago, after suffering a ruptured brain aneurysm that required three months of hospitalization and rehab, I developed Sepsis and later terrible bed sores. Three times daily, nurses were required to apply a creamy mixture of equal parts of baking soda and zinc oxide. It worked miracles and cleared the bed sores...but better yet, prevented further infection. Check with your physician...it should be worth the try!!! Bless you for your efforts!

Veronica91 Dec 2014
grace that was a wonderful post you have found natural things that are working for your mother. These and a huge dose of love are keeping her safe and comfortable. God bless you both

Grace3 Dec 2014
For smoothies experiment on how to add needed nutrition and calories. For my mom I use Raw Protein by Garden of Life and/or Manitoba organic Hemp Pro can be purchased online or at Whole Foods Market). I experiment adding choices of less than 1/4 cup of old fashion oatmeal grinned in a coffee grinder or cooked.spinach/kale/collards ; ,banana/mango/wild blueberries these can be bought frozen for time saver; 1/4 to 1/2 avocado/ 1 to 2 tsp flaxseed grinned in a coffee grinder; 1 to 2tbsp smooth peanut butter; etc. not all in same smoothie of course. It is extremely important to use organic fruits, vegetables, etc in smoothies as well as variety, not limited to the above. The Garden of Life prevents/resolves constipation problems. The hemp protein claims to help with protein albumen. Be careful with oatmeal, too much can make stools harder to pass so start small and increase to level of comfort. The banana is my favorite for sweetness. Medjoole dates(one or two mashed) are also good for nutritional and sweetness. Medjoole dates can be mashed and pureed with food and one spoon of honey instead of two. (Note in other foods with honey, I sometimes use a full tablespoon it all depends on food and taste. The most important use for smoothie in my opinion is to be sure to get vegetables and fruits into the diet then consider need for proteins, fats, calories, taste and weight issues. You can find excellent help on line with smoothies recipes,etc.

23swtheart Dec 2014
i don't think there is anything else one can do .. but instead of giving her 'home made smoothies' one can try to give her some meat ... i think your mum is a liquidized diet... i know it is It is so hard to watch her decline but at least you can keep her comfortable during her weak age.. so try to do a liquidized mix with some meat . regarding the booties not every type of booties are adequate for her especially when she has an air mattress ... but one more important question is your mum at a home or where? and is she is being ambulated during some hours of the day ?

Grace3 Dec 2014
I learned by watching a home nurse tend to my mother's bedsores and have had no problem since. He used a patch that had honey as the healing ingredient. So that was the last time I needed him to come. I now keep organic raw honey using it every day in each feeding (2 tsp per cup of food with added organic stevia as necessary to get the sweet taste that mom likes). I read on line that when the elderly stop eating it us generally because of the tastelessness of the food and that you need to use honey and certain seasoning for tastiness. She will not eat her food unless it is pureed to the consistency she likes, seasoned with 1/4 tsp sea salt, dash red pepper but not too much, and cinnamon, and sweetened to her satisfaction. Then I may have to coax her to eat with loving conversation and encouragement. For the bedsores, the use of raw organic honey is amazing. No more problems with bed sores. If I am careful to watch for and use the honey on large band aids (from targets) at first notice it works like overnight or two. If I somehow miss the very beginning it may be 2 to 4 days but never nearly as many days that the honey patch used by the home nurse took. Check on computer for the health benefits and healing qualities of honey. Regular honey does not have the same nutritional value or healing quality as the raw organic. I also use organic extra virgin cold pressed olive oil on moms body from head to toe to keep her skin soft and healthy with special ongoing attention to the butt area and private area to also provide a barrier to protect again moisture from wetting. Both the honey and olive oil are safer antibacterials. These truly work. Back to food for a moment. I also find that using premier virgin unprocessed oil (can be purchased from The Premier center in Santa Monica, California or from Dr. Bob Marshall in Texas. I watch to buy on specials and purchase enough to get free shipping.i have not found any other coconut oil that compares with the taste of this one. I sometimes feel addicted to it, love the taste it adds to certain foods. I use it every day every meal (at least 2tsp per cup of food) for both nutrition and added taste. Again search via computer why coconut oil should be used for anyone with dementia/ Alzheimer's or for everyone as preventative nutrition. Coconut oil can also be used on the body from head to toe. I try to keep organic butter and olive oil in the daily loop as they are also important. Use the olive oil on the heels daily. I personally find that the more I depend on God and believing prayer and love on mom with hugs, kisses, conversation and speaking health and recovery and encouragement to her the better everything works. For pain control, I have found that using MSM 1000 mg capsules by MRM as recommended keeps the pain away. A computer research on MSM can reveal all the marvelous things it died for the body. Whatever brand needs to be as free as possible from heavy metals and added ingredients. I buy MRM from Whole Food market. It can also be purchased on line and probably cheaper. Have not fully researched its purity compared with other brands. These things I have discussed have been truly helpful and effective. It is always good to search on line for home remedies for any problem you encounter and for online reviews of any medications before using. Forgive any typing errors as this is too long to easily edit.

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