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Hi everyone.


The RN at my dad's nursing home told me they have been treating his Incontinence Associated Dermatitis but it was not getting better so they are going to call a wound care nurse to look at it. Then the Nursing Manager tells me that he has a bedsore that they are going to start treating by keeping him in bed and turning him and changing him every two hours. This is the first I heard that he has this!


Are Incontinence Associated Dermatitis and a Bedsore the same thing? Both nurses called it something different. Is this bad? My dad is 92 and hardly eats anymore and goes from the bed to the wheelchair and back again. He is at end stage now but once in a while he will seem to perk up. Now I know why he keeps fidgeting around in his wheelchair.


Thank you.

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They are two separate things but one can lead to another and both can be a sign that his skin care needs to be stepped up and depends need to be changed sooner after soiling. You might consider hospice care for your dad; hospice care can supplement his care in the nursing home. If he is in end stage, he most likely will qualify. Medicare pays for these services. My mother benefited from hospice care while living in a nursing home. Her hospice CNA cared for mom for about 1 hour a day 5 days a week. I requested she come around noon time because I knew how busy the nurses at the facility were at that time of day. During the CNA's visit, she gave mom a sponge bath, washed her hair, helped her with what little she could eat, etc. Additionally, her hospice nurse visited once or twice a week and would assess mom's needs; she ordered an air mattress for the bed and a special cushion for her chair as well as worked with the facility doctor regarding meds. With the added care, her skin stayed in a healthy condition and she didn't develop bedsores during her last 3 to 4 months. I was so grateful for the care she received.
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Reply to lynina2
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A wound care nurse can be the best thing to happen to a LO because that is all they do - the one at my mother's place calls me if she has an issue & takes a pix - this was invaluable when she went to dr as they then could see how fast things developed - hospital drs were very happy to see the pix as then they had a better grasp of the timeline
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Reply to moecam
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Well this was almost 30 years ago but when i was a nurse aide we would massage the area around ... NOT on ... a reddened area and also give a short backrub ... about 45-60 seconds ... si night to our hospital patients.

of course i dont know how good all that was since they didnt stay that long.
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Reply to Betsysue2002
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As others have said incontinence dermatitis is diaper rash, and the skin needs to be kept clean and protected. Bed sores as said are from pressure. Frequent position change is the best prevention. However, even with the best preventive measures they can occur. Poor nutrition, poor circulation and immobility are the 3 big factors to their formation. It sounds like he is being cared for. As these are extremely hard to cure, having a wound care nurse is appropriate. As far as the 2 hour position change that is standard care, by stating it is special to this patient is signaling to staff, to be checking more frequently than the 2 hours. This was my understanding when I was an nursing assistant.
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Reply to fantasmagorical
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I discovered the hard way that my mother's dermitis was caused by incontinence but exacerbated by two things: not being changed fréquently enough and by irritation caused by the cleanser that the nursing homes used.

My mother often complained to me about "itchiness" in the génital area and on her buttocks. I made it a point to watch the changing procudure every time I was at the nursing home (almost daily). I learned a lot about the CNAs' process. After a lot of discomfort and suffering, I learned that the cleanser that was being used was actually the cause of the itching and blistering. I started purchasing a mild cleanser for the CNAs to use. Her condition improved substantially. I don't remember the name of it right now but I bought it from an on-line supplier. They delivered it directly to my home and I brought it to the nursing home as needed.

Also, do NOT believe the nursing home when they say they will change your parent every two hours.....They just don't do it .....and they don't keep any written records to supervise the CNAs....I had my mother in 3 different nursing homes....The last one was the best but they still needed supervision from me. Some CNAs are better than others and some are just unacceptable. It is shameful.

My mother was not ambulatory. So she too went from bed to wheelchair. She wore adult diapers 24/7. Sometimes, they kept her in bed with the diaper very loosely wrapped to give her skin a chance to "breathe". Please be observant. If bed sores develop, they can be extremely painful. The skin can appear to be "torn". All of it is preventable if the proper care is given......

My final advice......be alert. Keep good notes and bring your concerns to the attention of the nurses, supervisors, and administrators. Be the best advocate that you can be for your parent. I am not a CNA. I always told the administrators that I expected them to do a better job than I could do because THEY are the professionals. Having a parent in a nursing facility is difficult and it is a full-time job. Nothing is more painful than watching an elderly person suffer when it is just not necessary.
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Reply to Cinderella5001
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Different things.
The "incontinence dermatitis" is a "diaper rash"
A "pressure sore" or "bedsore" is caused by the particular area not getting proper circulation.
A pressure sore can be anywhere on the body that there is pressure. Heels, calf, buttocks area, shoulders. Caught early they are pretty easy to stop and to heal. But you have to be very vigilant about position changes, removing the pressure from the area. Left for too long they can be very difficult to heal.
A pressure sore can seem to pop up in a matter of hours.

Side note I find it odd that NOW they are going to change him every 2 hours. That was standard in our house, I instructed the caregivers I hired as well, My Husband was changed every 2 hours, or at least he was checked, if he was dry his position was changed by at least getting him up then in another hour they were to check him again. Usually the change of position seemed to allow the kidneys to function better and he was usually VERY wet within an hour.
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Reply to Grandma1954
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If he has a bed sore on the base of his spine he should probably be sitting on a RoHo cushion. It uses air and has separate little pillows. He also should have an air mattress.
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Reply to JoAnn29
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It is possible to have both at the same time. My mother's 1st nursing home was treating what they told me was just "diaper rash" but when she arrived at her permanent nursing home it was revealed that it was in fact a pressure ulcer which the other place tried to cover up.
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Reply to cwillie
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Hmmmm...  thank you.  I just wonder why each nurse called it something different.  I'll have to find out what it is.
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Reply to LindainCT
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Ahmijoy Aug 28, 2018
Well, it might depend on what they were taught to call it in school, but it’s pretty much the same. This incontinence dermatitis can be controlled, but at least in my hubby’s case, not completely “cured”. But like I said, the bedsore needs to be looked st by the wound care specialist. Those can go very deep and get very nasty.
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Actually, “incontinence dermatitis” is a medical way of saying diaper rash. My husband has it too. Unless he’s changed and washed hourly, it’s difficult to avoid. I use things like Desetin, Pinxav, and a barrier cream from Walgreens I really like.

A bedsore is also known as a pressure sore and comes from laying in one position continually. If these aren’t treated, they can become infected and that’s very serious.

It it sounds like the staff at your father’s facility are on top of his treatment.
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