My mom was picking at her butt and now has an open wound. Could it be a bedsore?

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Nursing home not saying this? My mom has been in and out of hospitals and nursing home sub-acute wing for 3 weeks.

Yesterday we received a phone call from nurse asking if mom can sign a paper to bring in a wound doctor because she has an "open wound" on her butt. Said she was scratching it.

Mom has a sling on her broken arm and a broken pelvis. She has been drugged up for pain with morphine and dilautin. I cannot imagine how she reached around her body and "scratched her butt" due to her condition. I am thinking the nursing home is saying this to cover themselves for her getting bedsore.

I haven't seen her put in different positions much at all which could have to due with her arm in sling and pelvis which were so extremely painful.

I have a meeting with the staff and want to address this situation. Opinions?

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I'd keep the meeting as friendly as possible but make it clear that you are wondering about bed sores (which could be a possibility for sure). The idea of not using protective cream, as Bonniepages mentioned also makes sense. Certainly a wound doctor is a good call so I give the NH credit for that. Some would ignore it. Make it plain you expect that this won't happen again.

Good luck to you and your mom,
Carol
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As a nurse, positions are normally re-positioned every two hours, however, having a fractured pelvis requires the patient to remain stabilized with a V-block between one's legs. Lying in that position would create a decubi (pressure sore) on the sacrum area. You only mention one arm in a sling. Does she have another arm? She could still reach her buttocks with that arm/hand. Also, being heavily medicated she might be having hallucinations. My suggestion would be to bring in the wound doctor because you don't want the tissue exposed down to the bone (which I have seen). Not good...Also, stop trying to find fault with nursing staff/home which is probably doing the best for your mother since you chose them.
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All the above is good advice, and wound care very important. Just so you know, bed sores can be very easy to get. I have had 3 joint replacements in the past 6 months and developed a nasty one within two days of the first hospitalization - common with harder mattresses, plus I was on my back, and weigh less than when previously in the hospital. Nurses applied a protective ointment and special patch, and used foam wedges to alter my position a bit at regular intervals. It took a couple weeks to heal, but knowing how easily it can occur prepared me for the next two hospital stays. Getting mobile helped, too, and hopefully your mom will heal quickly and be up and about soon. Best wishes!
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My Mom got hers by staying overnigjt in urinales dispers WITHOUT triple paste aceran protector. It doesn't necessarily have to be from not moving. And my mom is at home with me 24 /7. I just stopped using it for one week when she had her rectum exposed.
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Ditto what everyone said, except for calling the health department. Mobility - or lack there of -, age, and skin fragility all play a factor. My mom has had a couple of bed sores over the years. A week ago one of her in-home helpers noticed the redness starting right at the tailbone. Sure enough I could see one starting. Regular cleansing with a good skin integrity product, then applying a bandage with padding can stop the formation. But if there's an actual break in the skin, a wound nurse should be involved. I agree with ferris1 - be glad they brought it to your attention and are calling in the wound nurse. Side note: it just amazes me how quickly these can develop even in people at home with some mobility. For future reference someone should be checking her skin regularly, particularly at pressure points - heels and elbows included, although they typically form in the hip/bottom area. Good luck!
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My Mom had a open wound on and off on her hindend for the last couple of years she was alive.I took good care of her and kept her clean,but she was incontinent and wet her depends and as soon as it would heal,a new spot would appear.The best thing that helpedher were dermagram patches and Medihoney.It took constant daily effort on it for sure.The heating pad didn't help either,I'm sure on that area but it was a comfort to her.I'm sorry you are having to deal with this...it's a tough one.Good Luck and take care,Lu
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I know someone who was getting very good care at home and got a bedsore. They were placed in a nursing home to try to help and it didn't. Sustained treatment did not seem to help, so it's not always someone's fault when they occur.
I have read that if there are a lot of medical issues, it's not uncommon to get them.

Dtrinfl2, is your mother on Hospice?
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Bed sores can develop anytime someone is laying on back, pitting pressure on the sacrim, or buttocks area, and in you mothers case, it may be very difficult to reposition her due to the pelvic fracture. The sooner you gey help from wound care the better, as these types of sores can get out of control and grow really fast, even overnight, and can get deep under the skin to the bone, as ferris pointed out. At this stage, they are very difficult to treat! It will take persistence to heal, and to prevent it's return, probably for the rest of her life, as these tend to reoccur. Always check her behind, every day, and with bathing. Once healed, a good barrier cream will be nessesary! Good luck!
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I am a care giver for my wife and now dealing with this issue. The problem originated from the stiff stitching in a commode type sling used with an overhead lift. Bacitracin, Xeroform, Vaseline and soft gauze pads helped initially, also an Allevyn butterfly bandage but now that the wound seems dry a barrier cream is working better. I take pictures every day to monitor progress and have a nurse visit twice a week.

My wife has been bedridden for almost 6 years and this is her first bedsore problem. I believe the use of a high density foam mattress is what prevented other types of bedsores. Incidentally, I also use without problems a full body mesh sling to help raise my wife off the bed to re position her up the bed and change the sheets.
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First of all take a look at it with your own eyes and as pam suggests take pictures and keep for comparison. Going to the health dept is your choice but unless the NH has many signs of inadequate care perhaps hold off on that.
getting a wound care nurse in would be an excellent more.
The other thing to be really concerned about is proper cleaning after a bowel movement. That means getting right down to the anus with a wet washcloth or wipe and getting the cream right down there. Apart from the obvious reasons if feces is not properly cleaned off the area becomes extremely sore and itchy. It is possible this happened and she did in fact scratch down there because she could not stand the itch. Check her fingernails! (Personal experience - the best teacher)
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