Bedsores - Any tips and tricks?

Someone else may have more specific information, but if a pressure sore is the same as a bed sore, mom had the beginnings of a pressure sore right by her tail bone. She could hardly sit down. The pain was exquisite.

The visiting nurse told us to put liberal...LIBERAL...amounts of Lantiseptic on it. It's an extremely effective moisture barrier. The pain was gone in a couple of days. The sore (it hadn't opened up yet) was gone in a week.

I would call his doctor in a heartbeat to see what he recommends. If he's relying on the doctor at the nursing home, I would want to speak to him personally. (If it's like the nursing home mom was rehabbed in, the nurses try to shield the doctor. But he can't hide from meeee. ;)

I wish you good luck. Pain is a horrible thing to live with and good on you that you are asking questions and watching out for him.

Air and sunshine are good for it. He might get a chuckle out of the sunshine suggestion. A thick piece of sheepskin fur helps too, to take pressure off. He probably can only lie on the unbroken hip, though, so tuck the sheepskin under there to prevent any more.

My wife was under hospice care here at home. the suggestions listed are excellent. but what really solved the bedsore problem was getting one of those mattresses that continually pump air in and out. That way there is no body pressure point always in contact with the mattress

It is important to keep pressure off the sore. There are many kinds of dressings that can be placed on the sore if it is appropriate. They are very expensive. ASK the facility.
It is very important to change positions every 2 hours & to keep the pressure off the sore.
There are several kinds of apparatuses to keep the pressure off the area.
Ask for assistance in the facility.

My wife has suffered from a pressure sore over 2 years. She went to Wound Care center at two hospitals for treatment. Nothing worked. My wife is paralyzed and in a wheelchair or bed full time. She did all the things asked but it has never healed. We use Mepilex bandages and some fungicide ointment for moisture. Exposing to air had not helped at all. The only advice given is always "just stay off of it" .- hard to do when in a wheelchair. And she cannot lay on her side continuously. She does have an alternating pressure mattress pad that gives her come help. But I really have nothing to suggest that might help. I am sorry about that.

This pressure sore also known as a decubi needs attention fast as they tend to break down the skin more and more. There can get really nasty and infected. Turning every two hours is standard care for bedridden/chair bound patients, however, I would request the doctor look at it and order more frequent turning, and more antiseptic dressings. These can quickly get out of hand and you need to be vigilant about watching how much they spread. Yes, air would be nice, but when a patient is in a nursing home, unless there is one-on-one private nursing, well, I'm afraid their isn't enough staff to watch it every moment. Speak to the doctor, staff and see what other arrangements can be made for your father-in-law. Best wishes!

Applying Aloe Vera gel straight from the plant! It heals just about any sore or burn and once the gel is dry, it forms it's own seal. If you aren't in an area having access to a living plant, purchase only 100% pure aloe gel from health product stores. All the above answers are wonderful. Mine is just an adjunct to the others. Best Wishes!

THere is an earlier post on this topic about 4 questions up -- so check on those answers too. Suggest contacting wound care center (have dr advise and refer them over if possible) to manage the wound. My FIL has one that won't heal or go away (pressure wound); they have done all the things suggest above and he is under wound care mgt -- after still not healing after several months; they are going to try a "silver nitrate" patch this week. Maybe that is something you can ask the dr about for your father.

Good luck.

A simple AND effective, low cost home remedy is to mix Betadine and Milk of Magnesia equals parts and apply as often as needed. It will dry up the area and start the healing process. My sister who is a private care giver has used this often in the past and we used it on our mother. It works! The hospice RN was pleasantly surprised to see how effective it is. We tried to get the constantly moving air mattresses for her but all the ones (three) we tried were mal-functioning and pretty worthless. We ended up putting her on a standard air mattress from WalMart and just kept turning her as is mentioned above.
There is a powdered product that you can get online called Decubamine. You add it to their food or smoothies and it also speeds up the healing process. It is expensive but worth it.

You won't believe this, but IT WORKS: put maggots (!) directly on the wound and leave them eat away all that dead flesh. Nothing else does as good a job.

This is a hospital remedy in New Orleans. Sounds awful, but it does a good job! Even your MD will need to research this! persist for good job.

BACKGROUND:
Fly maggots have been known for centuries to help debride and heal wounds. Maggot therapy was first introduced in the USA in 1931 and was routinely used there until the mid-1940s in over 300 hospitals. With the advent of antimicrobiols, maggot therapy became rare until the early 1990s, when it was re-introduced in the USA, UK, and Israel. The objective of this study was to assess the efficacy of maggot therapy for the treatment of intractable, chronic wounds and ulcers in long-term hospitalized patients in Israel.
METHODS:
Twenty-five patients, suffering mostly from chronic leg ulcers and pressure sores in the lower sacral area, were treated in an open study using maggots of the green bottle fly, Phaenicia sericata. The wounds had been present for 1-90 months before maggot therapy was applied. Thirty-five wounds were located on the foot or calf of the patients, one on the thumb, while the pressure sores were on the lower back. Sterile maggots (50-1000) were administered to the wound two to five times weekly and replaced every 1-2 days. Hospitalized patients were treated in five departments of the Hadassah Hospital, two geriatric hospitals, and one outpatient clinic in Jerusalem. The underlying diseases or the causes of the development of wounds were venous stasis (12), paraplegia (5), hemiplegia (2), Birger's disease (1), lymphostasis (1), thalassemia (1), polycythemia (1), dementia (1), and basal cell carcinoma (1). Subjects were examined daily or every second day until complete debridement of the wound was noted.
RESULTS:
Complete debridement was achieved in 38 wounds (88.4%); in three wounds (7%), the debridement was significant, in one (2.3%) partial, and one wound (2.3%) remained unchanged. In five patients who were referred for amputation of the leg, the extremities was salvaged after maggot therapy.
CONCLUSIONS:
Maggot therapy is a relatively rapid and effective treatment, particularly in large necrotic wounds requiring debridement and resistant to conventional treatment and conservative surgical intervention.

Bedsores are ugly, stink, and get very deep! Make sure the person is turned every 1 to 2 hours, keep the area dry and clean, after debri the doctor might suggest putting a "vacuum" to continuously keep it clean and free of dead skin, etc.
My Mom just passed away from the deterioration to her back side. The Doctor made me look at the opening and it was not a pleasant sight to see all the way though to her pelvic bone, etc. He suggested a feeding tube, a tube for eliminating bowel excrement, a catheter, and many other keep her alive type equipment.
I told him NO for that is not the quality of life she would want to be hooked up to machines - she just wants the "little white pill" to prevent her from pain and suffering to join her beloved husband.
She rallied her last day with Hospice informing me this was not the proper setting for Mom because she was sitting up, talking, eating her pureed food. As night came she told them she was very tired and wanted to go to sleep, they asked if she was in pain and she retorted "My butt hurts!." So they gave her a pain reliever and nightly sedative to ease her into sleep-the "little white pill".
When they checked on her at midnight they found she had peacefully passed over in her sleep. They listed her death as dementia, not the complications of diabetes, bedsore, or loss of will to live. But she is now with her beloved husband and other family and friends that went before her to make her passing easy and special. Mom and Dad are now dancing together to the oldies/swing era music they both so love. Thanks for the great, stable, positive, and fun, upbringing you gave to us. Love You Mom and Dad.

Bedsores, pressure sores or decubiis ulcers are all the same very nasty condition and extremely difficult to treat. All I have to offer extra is the "Duoderm patch which is placed over the ulcer and left in place for 5-7 days then replaced as needed. they are very expensive but he temptation to change too frequently is very great because as the debride the wound there may be nasty leakage and often a futher dressing has to be applied over the top.
As with everything else prevention is the best cure. If the patient is not incontinent as Pam suggested lying on real sheepskin not some nylon fake does a lot of good.
Unfortunately it can't be washed. I don't understand why because sheep don't shrink in the rain!!!!!!!

I've also just read about maggots as a treatment method and they're pretty danged successful. They're just doing what nature intended for them to do. I'd investigate it, if my loved one had a non-healing bedsore/pressure sore.

Pressure sores mostly need pressure relived as full time as possible. Whether you put honey or Mepilex on them, they need blood flow to heal - more than you would need just to prevent one. You must also have good vitamin and protein status to rebuild tissue. Common mistakes in pressure relief include being in positions that put pressure on the sore - e.g. lying flat on back with head of bed up and the sore is over the sacrum or over the tailbone, or sitting AT ALL if the sore is on the ischium, or too tight of a packing or padding that does not actually allow for good blood flow. If a person cannot help but lie on a sore part of the time, a low air flow bed like a Clinitron is one of the few ways to get away with that. A prone cart is one way to mobilize a person who cannot sit, a lot of places may not have one though.

Some other factors are how deep is the sore and is it good and pink or does it have yellow, black, brown, or grey "slough"? Debridement with special dressings, whirlpool, enzymatic, or by hand by the doctor or APN might be needed. Do the edges undermine? - if so, surgery may be needed, but maybe a Wound Vac could still work.

Your father needs to be under the care of a specialist wound nurse. Ensure that he is seen.

Discuss this with the visiting physician, your Dad's PCP, the chief nurse, the nurse director, and the chief administrator. Never take 'NO' for an answer.

Two hours is two long for a patient at risk to be in one position without a ripple mattress.

In each of these discussions you do most of the talking and mention 'lawsuit' often and loudly.

I have read the cures above. However, it is essential that you understand that no cure is possible of the cause of the pressure sores is not addressed and eliminated.

Prevention is better and easier than a cure, but no amount of curative therapy will work if the underlying cause is not removed and removed PDQ!

The cause of pressure sores is ischaemia. This condition exists when a patient has insufficient muscle or fat tissue over a bony protuberance where that protuberance rests on the bed, chair, or other surface.

The weight of the patient's body or limb compresses the flesh over the place where it rests and squeezes the blood vessels that feed and nourish that part of the body, so the devoid of nutrient the tissue dies, much as does heart muscle in a heart attack, which is an ischaemic episode in the heart, resulting in death of some of the heart's muscle tissue.

If the ischaemia is not immediately relieved, the condition will persist abnd could result in gangrene of such an extent that the patient will die.

All maggots do is eat dead tissues and also, one hiopes, take away any germs that have lodged in the would. But maggots will not cure the sores because they do not address the aetiology of the condition.

So, the first objective is to remove the causative factors. Then, seek restoration by whatever keeps the wound dry, infection free, and maximises the restoration of healthy tissue so that recovery takes place.

Open wounds on which patients are bearing weight and on which they continue to bear weight are extremely painful. Therefore, sufficient analgaesics must be administered regularly.

The appearance of pressure sores in bedridden or chair bound patients is ALWAYS a sign of criminal neglect.

Someone has to take notice, remove causes, apply proper remedies, including fail-safes, and restorative therapies. No delay is permissible or forgivable.

Twenty-minutes, thirty-minutes at the most, is long enough for an at-risk patient to be in an at-risk position.

Ok, we all know what causes bed sores/ pressure sores, but as the surgeon who treated my mother said " it is impossible to turn a patient very two hours 24/7". Not only can the care giver(s) not keep up the schedule, the patient can not tolerate it either." My mothers sores started in the nursing home. When my sister and I defied our step-father and brought her home the process had already begun. We were able to heal one of them but the ones on her poor little hip bones were too far gone. Even surgery that cleaned out and cut her to the bone did nothing to "cure" her. Weekly trips to the wound care center only caused her more pain and accomplished nothing in the long run except for the hospital and clinic getting money from insurance and Medicare.

The surgeon is out of order. He is wrong.

To save a patient's life, turning much more frequently is not only necessary, but to fail to do that is negligence amounting to criminal negligence, since the failure to do it can lead to a patient dying!

Surgeons and their hospitals charge enough to be able to afford a higher staffing level and so they should provide adequate coverage.

BTW - you are not correct when you say "We all know what causes bedsores."
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There are a lot of people that do not know that. Do not stifle the spreading of valuable and life-saving information.

I cannot conceive of anyone defending this kind of inefficient and uncaring nursing attention. Special beds and mattresses and pads are readily available to prevent the very consequences you accept as inevitable.

Perhaps you have given in too easily. That is a mistake for which our loved ones will pay.

But mine will not because if I have to I will do it myself, as I have done for literally hundreds of post-stroke and paralysed patients during my years as a nurse.

I have seen lazy careless doctors and nurses and not allowed them to continue their sloppy careless ways to the detriment of patients.

Caring for the sick is a sacred duty that demands our very best at all times.

You can have a wound care nurse visit your patients at home if transporting them would cause more damage. There is a way to treat patients, and then there are better ways, but finally there are the BEST ways, and that is what we have to put in place in spite of all the naysayers and 'I-know-betters' in the world.

Give them the very best, and do not be satisfied with anything less.

I wish you well.

Perhaps you did not read my earlier post where I mentioned trying to get those special beds.....we had no luck getting one that worked properly. We were told that our mother would be getting the same type of bed she had in the hospital that was run on air and constantly moved but that is not what we got and the ones that were delivered never worked properly. I take offense at your lecturing me. You may indeed have taken care of hundreds of patients but you were not here when things were happening to my mother, we did the very best we could for her and no thanks to the medical profession who gave up on her. My sister and I took care if her 24/7. Hospice came in to my home to oversee her final days and they were very surprised at the level if care we were giving her. Too bad you are not here for everyone, my apologies ahead of time but you sound rather pompous.

Let's play nice kids. Doodle and Ronnie, gloves off, OK? We can all disagree without being disagreeable. Some people like MOM some like maggots and some let the dog lick their wounds. Whatever works.

Mom had spent about a month in the hospital. When she came home, she had this bedsore on her right buttock. Prior to this, I thought bedsores were these pimple-like rashes. When she came home, it was a sore with a hole. Quite gross. And I was expected to clean it. Uhm.... I don't think so. Instead, when I changed her pamper, I changed the dressing. When the home care nurse came, I asked her about it because the hole was sinking in deeper. She cleaned the wound and said she will bring some Duoderm. We spent several weeks using this. One sheet cost $10.00. We spent over $100.00 on it. Every 3 or 4 days, I would peel it off (per the nurse) and change it with a new one. I can see that the hole was slowly healing back up.

Then this year, my bedridden dad got his bedsore. I saw it start as an abrasion. To a washed out color skin. To a pimple. Then it had a hole. I kind of panic when I would change the gauze dressing and his blood would literally drip down. Mom's bedsore didn't bleed like that. Hers oozed with yucky gooey stuff. Dad's was the blood dripping down. I mentioned to the home care nurse about it. When she was in the states, she specialized in wound care. So, she showed me how to clean the hole with gauze and qtips. Then how to stuff dad's hole with the gauze. Then she covered it with the gauze.

She explained that it's very important that dad stay off the sore, change position.
She said that the wound must be cleaned and kept dry (hence the gauze inside the hole.
She said that it's very important he takes in protein (helps his body heal faster), etc... I can't believe with her ministrations (without using Duoderm), the hole started healing back to normal. FYI, I just could not stuff a gauze inside the hole. Made my stomach queasy.

With mom, the air mattress worked well. My dad hates his. So it's off. What I've done was buy these chair pads and insert it beneath his butt. It has helped a lot with preventing bedsores since my dad refuses to turn positions 24/7. He is 99% always on his back - day and night.

To pamstegman,
Yes ma'am. I got too ruffled. We took great care of our mom. I took offense at being chastised by someone who doesn't know me nor anything about the care we gave. This is a great forum and we are here to help one another not criticize. I am now caring for my MIL and learned a lot from caring for my mom. I was not aware if this site eight years ago when mom was still alive, it would have been a huge blessing to hear what others are doing/going through.
I read this site everyday now and have for the past two years. It has helped me in a lot of ways. I apologize to the community here for being rude.

Sorry Pam I refuse to play nice.
I can trump Ronnie's 30 years of nursing with another 20.
I do agree there are lazy and incompetent nurses all over the place and the issue of a patient getting bedsore through criminal neglect is absolutely right. Vstefens is a physician as well as being a caregiver and in this case as always i respect her postings. One thing she did not mention was that the real cause of a bedsore is a lack of adequate blood flow to the area. In the majority of cases this is caused by inadequate relief of pressure to the area.
Towards the end of life the blood flow slows down and all the turning in the world will not prevent some sores on a skelital patient. The poor old heart is just too tired. So I do not want anyone to feel guilty when they have done their best and followed all the appropriate instructions if their loved ones do get sores. Some people just are not able to let go and pass over and their bodies seem to start the decompasition process before they actually die. Horrible as that sounds it is not the fault of the caregiver. I have even seen a sore on a patients nose in addition to others all over his body.
So Ronnie get off your high horse please I am sure you were an excellent nurse and an exemplary caregiver.
Doodlebug calm down you are doing all the right things and getting into this kind of argument is not helping the original poster who was looking for help with her current predicament not the history of maggots. Shall we move on to leeches too I hear they are making a comeback.
Doodlebug why did you choose that name? Do you know what a doodlebug was? It was an unmaned flying bomb that the Germans sent over England in WW11 in massive numbers. You could see them coming and as long as you still heard the engine you were ok but if it cut out you only had seconds to find shelter. Just as frightening as the shelling in the Middle East must be.

Try using an egg crate foam under sheet to relieve the pressure.

Veronica91, I did not "choose" the name, it was given to me many many years ago by my sisters....it has nothing to do with the moniker you are referring to. When I was about six years old I was "helping" a tumblebug or as we called them doodlebugs, move it's pile of doodle. Hence the name "Doodlebug". Also I tend to "doodle" as in draw or doodle as in try a lot of different things.....:-).

I did post the positive things we did for mom, those seem to be overshadowed by my taking umbrage to Ronnie, again I apologize.

I concocted a smoothie that my mom enjoyed that helped with her healing. It was between 1500 and 2000 calories and she could sip on it as she felt like it.
High protein drink, a scoop of ice cream, a container of yogurt, a cup do half and half, a scoop of the Decubamine, and sometimes a candy bar. Puréed together in the magic bullet. Maybe not " healthy" but she loved it and often other than breakfast it was all the nourishment she would take. Towards the end of life sometimes the rules must be thrown out the window. I cherish everyday she was here and it was truly a blessing to be with her.

Doodlebug your name is forgive,. it just brought back bad memories for me.
You don't need to apologise for taking umbrage at Ronnie. He hit a nerve with me too as you may have guessed!
You are quite right at the end of life being or shall I say eating 'healthy" is of no consequence. nor really is anything else as long as it does not impact the quality of the patients final days.
This forum is about supporting each other not critisizing or making them feel bad or guilty when they have done something others consider to be "wrong".Pointing out a better or alternative way is far kinder. I don't think anyone comes here who is deliberately treating their charge cruelly or neglectfully. They don't need us they know plenty of bad things. No, everyone is trying to do their best with the rescources and knowledge they currently have available. Your best is always good enough that is why people ask questions to see if someone else knows of a better or different way. Sometimes there is not anything else you can do and that is alright too as long as you have used all the help there is out there. AIl you can do at times is accept the inevitable. You have learned a great deal and will continue to learn as you continue on this journey.
By the way I don't think Pam was scolding you. I read her post as somewhat tongue in cheek. As you have gathered Pam is a woman of few words but each one does count. I have never disagreed with anything she has posted (I wouldn't dare) so all is forgiven not that there was ever anything to forgive. Blessings

Veronica,
Thank you. It is a hard journey. I appreciate the sharing of knowledge,tips, anecdotes etc.
I'm sorry for your bad memories. I am blessed to have never been exposed to war in my own back yard.

LOVE, not War!

//smile.amazon/Flora-Manuka-Honey-8-75-honey/dp/B004P8FYOU/ref=sr_1_2?s=hpc&ie=UTF8&qid=1410959313&sr=1-2&keywords=manuka+honey

We had a resident come in with a stage II bedsore and was told to try this natural remedy - Manuka Honey. It not only cleared up the bedsore, but works on skin tears too!
Good Luck! Kathy