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He is very limited in his movement due to advanced cancer. He basically sits in a chair at the kitchen table, in a lift chair in his living room, or is in bed. Due to his inactivity, he has developed a major ulcer/bed sore on his lower tailbone and on both heels. His home health care nurse bandaged them but he is uncomfortable sitting(even on a donut(rubber/vinyl). His OT mentioned air cushions are recommended with patients with ulcers/bed sores on their bottom. Has anybody used them? Are they effective? We have spent so much already on equipment that insurance won't cover. I don't have a problem investing in it if others have found them beneficial. Also, does anyone know if these air seat cushions are covered by insurance?

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Just because of my curiosity, How the Dr will take the decision that a device should be use in place. Is that after a proper skin evaluation with respect to a Braden scale or to a similar tool ? Or is it after the patient got a pressure ulcer; at least a stage 1 ulcer ?
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My father had the same sores. We had a hospice nurse bandage them. Actually, she taught me and I cared for them. They healed up with proper care. My suggestions: see wound nurse, check aging resources in your community as we were able to find a coccyx cushion(has hole by tailbone)so no pressure on tailbone,elevate feet by putting a pillow under knees so the heels don't touch anything), turn on side to keep pressure off tailbone(put pillow behind back). These were some things that worked for my father. Hang in there! He is lucky to have you!
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GardenArtist what is the reason for suggesting fleece fabric ? I thought it was warm and demotes the breath-ability to the skin.
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I am so sorry to hear your dad has ulcers. I took care of my mother for years until she recently passed away. Not sure why I haven't removed my name from this list. I guess it is my way of still dealing with her death.

I had so much success using alternating pressure mattress, rotating her at least every two hours and using a product called "Wound Care - Healing Formula" sold by Herbal Healer. My mother developed a sore on her heels and this worked wonders. I had her caretakers use it regularly if the saw some redness developing. She never got any more ulcers once we used the alternating air mattress and rotating her (at least every two hours) religiously. To help heal those quickly order bottles of Wound Care at only $20 per bottle. It will help give him the relief he deserves. The link is below;

herbalhealer/healingformula.html

God Bless and I hope you remember to take care of yourself, which will ensure your father will always be in good hands. Find other caretakers to give you a break and write a regimen and schedule so you will feel comfortable when others are caring for your father.

Grace
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I was a home care nurse for years. The best thing to do is purchase a pressure relief cushion at your local pharmacy. They look like a donut! Also use barrier cream to help protect the ulcers. If they look infected (red, purulent drainage, irritated). I would take him to a local wound care facility. Most hospitals have wound care specialists who work at a clinic.
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3. Heels off all surfaces. Again, wound nurse specialist to treat.
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1.. Cut out cushion so that coccyx does not touch it.

2. Have a wound nurse specialist treat the wound. Very serious injury and in-way for infection.

Treat his condition as an emergency!
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It only hurts if you try to flatten the angle of your feet as you do for walking. Go on line to FootSmart to see options. I bet you could come up with some of your own (a 45 degree angle that come against the sole of the foot for example).
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I have two layers of a 4 inch memory foam lopper cut to fit the chair. I also have a donut on top of that (MD recommended) I did not know donnuts came in sizes and Dad needed the large one rather than mom's old one. It is back to school time, and finding mattress toppers now should be easy. I would advise making one for the back of the chair separate from the seat and the back pulls down when Dad sits. Make a big pillow cover with a zipper that you can take off and wash once in a while. I also got water proof covers (pet proof) from Bryant Home. Get the reversible ones they don't slip as much. Dad gets sores on his butt vs. tail bone. I have been turning him on his side with a pillow behind his back at night. Even just a hour or two has helped him heal. If you can, maybe he can be on his side on the sofa to watch tv for part of the day, or turn his chair sideways and prop him sideways. As for his heels, again, no pressure. Elevate them AND use some sort of strap to keep his feet squared rather than pointed. You don't want his Achilles tendon to shrink up. When I have had some surgeries, they have used plain of Vaseline to cover the area, and a loose bandage. Vaseline stains terribly. I use Weleda Diaper Rash cream to heal dad's butt (zinc, calendula etc). The key to pressure sores is NO pressure.
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As ProvidenceLane says DO NOT USE A DONUT! It cuts down on the circulation to the center of the area in the middle of the donut.

The more that you keep him off his back the better. When sitting, a foam rubber cushion or egg crate cushion helps.It sounds like he needs to be turned every 2 hours faithfully. He should not sit in one position for long periods of time.

Good nourishment is important. With cancer, he probably does not have a good appetite. Hi calorie, hi protein drinks are good. Protein is important for wound healing.

The home health nurse should work out a program for you regarding turning and nourishment.
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DO NOT USE DONUTS
MUST position and rotate every 2 hours
Go to a Wound Care Surgeon and get them to pres the right care and Wound Care Team to help
Briggs HealthCare Medical Supplies has $79 REAL SHEEPSKIN but you wash them at least 5 times in machine to air out and Line Dry to complete air out
Ask Wound Care Doctor for proper type of Physical and Occup Therapist

We had a major disaster with your Occt T who did nothing but stare and get his paper work signed then told us to lift the button on the toilet seat to number 4 a transportation toilet seat and bucket, he should have measured our parent per the Fire Dept who came to help with a flood in bathroom due to the back of the toilet seat unit hitting the flush handle and now the house is flooded, major issue when the insurances claims agent sent these women in the middle of the night who placed to any wet vac and humidifiers in the house and the fire dept had to come back 3 days later and they screamed it is entirely too many units in this house and the house was so hot the computer drive battery burned out and then 8 days later my parent had a major pressure ulcer we then went to a Dermotologist and then a Wound Care Phy Surgeon who let his Physical Therapist debride our parent and she used a scalpel and went too deep which hit a nerve it has been a horrible journey the Wound Care Phy Therapis ordered the wrong type of wheel chair cushion and tried to get us to a spinal center which was really going to order the wrong chair and they all did not know what to do
We went to a Wound Care Surgeon and he and his team took over and the pressure ulcers got better and they took time to explain and train and offered detailed help and the Surgeon was helpful and his team noted what to properly use they specialized in Wound Care and Hyperbaric Chamber wound care
THEY did not advice and were totally against DONUT cushions which cause more pressure damages and we had gotten this expensive gel mattress overlay from the Phy Therapist which never worked but we researched nd found a REAL sheepskin and thought it worked
BUT you must rotate EVERY 2 HOURS for circulation and relieving pressure and keep WEARING GLOVES for treatment of the wounds and always ask for alternative options and positioning in beds, chairs, ask for exercise techniques IF you have in home care
PRAY and PRAY and HOPE and TRUST GOD
do not give up the search for help
THE MIRACLE is JESUS
Read Colossians 1:9-20
Matthew 15:13 Matt 7 ASK SEEK KNOCK
Prayer to all Caregivers taking care of your loved ones
PLEASE GET THE RIGHT type of help
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you have already tried the donut without sucess. if your dr will prescribe and alternating pressure matress you can move it to his recliner during the day. A soft piece of foam covered with real sheepsking for the chair at the table.
Now for the heels. bandaging will only keep them clean what they need is air. There are special pressure reliving booties that an equipment company can provide with a prescription. Failing that there are small donuts that you can set the heels in you could actually make these yourself. Take a piece of 4" thick foam and cut a square about 8" X 8" and round off the corners. Cut a small circle in the centre of the foam abour 2" across and measure to dad's heels. it should be slightly too small. Now take strips of cloth and wind them round the donut firmly but not so it is really hard. Test for size and make a second one. Place soft pillows lengthways under the legs and rest the heels on the donut. Again if you can get sheepskin a piece of this under the heels is comportable on it's own or over the donut. Getting the sheepskin may be difficult but if you have thrift stores close by they some times have sheepskin coats you can cut up. Fleece is not a good substitute.
As Elena says donuts to the bottom have fallen out of favor because it is thought that the outer edges taking the pressure can cause additional sores.
Don't feel that you are failing because dad has developed sores. they are very common at the end of life whwn nutrition and mobility decline. all you can do is follow the advice you are given to keep clean and change position frequently. if you don't already have hospice now would be a good time to have them come in. they can provide any equipment you may need and a caneer diagnosis is usually sufficient for admission.
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Donuts are no longer the standard go-to treatment for the prevention and treatment of pressure ulcers. Most are very firm and offer no relief from pressure on the tailbone. An inflatable donut is better as it has more give. Even sitting in a chair with no donut of any kind is better than a firm donut.

But while your dad is on the inflatable donut make sure that you shift his weight every 2 hours while on the donut. A rolled up bath towel works great.
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Recliner, lift chair would be the best option for the day. Air mattress is a must. "Zero gravity" position is the best and he has to be moved as often as possible. "Doughnuts" will help you. Indeed, good doctors advice against those.
Most important it not even putting bandages, but cleaning/healing those wounds and preventing new ones. Use organic oils to clean and prevent bedsores. I usually put couple drops of Lavender for healing and Purification for preventing infection. Check with Young Living company for the best therapeutic pure grade oils. Do not buy any oils which are not recommended to swallow. That means it's not really pure as advertised.
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I remember, after childbirth, using a Doughnut type thing to sit on. It kept the pressure off the tender spot, so to speak. This item was wrapped in a towel, so it looked like just a round pillow. Check with a local drug store like Walgreens. I would bet they are still available.
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You have to get his heels off the bed, bandaging is not enough. Place a pillow or rolled up towel, etc under his ankles so his heels are not touching the bed. Un bandaged is better so air circulation can help healing process. As for the spine, we finally got a gel mattress, they called it. It looked like an egg crate design. It has made all the difference. Can he lay on his sides? Put pillows between his knees and ankles when laying in either side to keep back alignment. You have to relieve the pressure on these spots to get them to heal and to prevent new bedsores from forming. If you can't reposition him often. You have to make sure that special care is taken to keep the pressure off of these trouble spots. Ask your OT for the special booties for the heels. They look like big triangles with lambskin inside of them for his feet. My MIL is in SNF and we fight this constantly as she is totally bed ridden. God bless you.
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You might ask the home care nurse if you can get a hospital bed with an alternating pressure mattress. This would give him a more comfortable place to sit, recline and sleep and the mattress would shift his position to help avoid bed sores. He's probably uncomfortable moving, so the mattress would move for him.

The nurse could check to determine if Medicare would pay for it; it did for my father.

You might also try a fleece throw; you can get a yard or so of fabric at Jo-Ann Fabrics and Crafts, double it over and let him sit on it. Alternately, soft fleece blankets might help as well.

I don't have answers to your other questions, but am also wondering if in his advanced stage of cancer he might be more comfortable in hospice, where these aids could be provided for him.
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