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My spouse, is 69 but has the life of someone 20 yrs older. He has Multiple Systems Atrophy, diabetes and is now in AL, needs assisting with all transfers, fully incontinence, has a good memory but has executive function brain issues due to this disease.
His facility is a continuing care facility that has IL, AL & Memory care. They are not a Medicaid facility and this is private pay for him.
My question is, what have others seen done for treatment of pressure sores / wounds? Due to his diabetes, his skin is susceptible to breaking down, and his immobility leaves him sitting in chair, wheelchair except for bed for sleep. He developed a pressure sore on one hip from sleeping, even though there is foam padding on mattress. Staff at facility states they are not licensed to care for wounds. The Dr ordered wound care at a wound care facility and that was a huge fiasco to get him there and required a lift to even get on exam table. Treatment would be weekly at least. We have now asked Dr for Home Care Wound care order, and that should be covered by Medicare since he is home bound.
I was surprised the AL doesn’t treat pressure sores - surely that’s something that happens with immobile residents.
My caregiving days are about to get more intense, as my beautiful 31 yo daughter of 2yo twins, was just diagnosed with stage 3 breast cancer. She will be having chemo, surgery and radiation to fight this. I need to be with her and help as much as possible, but she lives 3 hrs away, yet I have my spouses care to over see as well. He has no one else, his children are not involved. I do have to work part time to live, so can’t consider moving temporarily to be closer to her.
I’m feeling very divided and overwhelmed.

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When mom developed a pressure ulcer on her lower spine, Medicare sent in a wound care nurse a few times a week to attend to it in memory care AL. The wound took a couple of months to heal. The physical therapist recommended a gel wheelchair cushion which helped as well. Mom was not diabetic.

You do not want the staff at AL caring for this wound as they are not specifically trained to do so. If dh has a PCP caring for him in the AL, s/he should write the order for the wound care nurse to visit him.

I'm sorry for your daughter and her diagnosis and all you have on your plate these days. Wishing you the best of luck with a difficult situation.
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I am actually thinking that your husband would be better in a Skilled Nursing facility where he would more likely be repositioned on a more regular basis. Generally in AL if a staff person "asks" a resident if they want to get up, move, and if they say "NO" the staff do not push the issue. In your husbands case moving him at least every 2 hours is of utmost importance.
AL will not do "wound care" as it is a very specialized medical procedure.
If he were on Hospice the Hospice would have a Wound Care Nurse come to him and care for the wound(s) as often as is needed.
(If this matters, if this would help in most cases Skilled Nursing would probably be covered if it is medically indicated where AL is not)
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NeedHelpWithMom May 2023
You have a point. I know two women who had husbands that had declined past being able to live in their assisted living facilities.

The facilities advised the wives to move their husbands to skilled nursing facilities, which they did and now their husbands are receiving care for their issues.
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DME is durable medical equipment ordered by physician which requires paperwork and visit by ordering physician. find a doctor that will do this for you if fscility will not or csnnot. yes covered by medicare. call medicare direct for doctor to serve you and order it from a DME MEDICARE APPROVED company, depends on state of residence too. they usually use inflatable pillows or wraps to elevate appendage and these include orders for body rotation and are included in MARS med admin record to document when it is done. pressure sores do not heal once open, need meds ointment antibiotic woynd care constant care all covered by medicare but if on hospuce they will jyst do comfort care not treat it.
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Riverdale May 2023
That is not true. My mother just passed away after 5 months on hospice. They oversaw the most recent treatments of her bedsore and actually did treatments along with nursing staff assistance. This was in a SN facility. An AL facility is not the place for a resident needing this care and I am surprised they are keeping him there. My mother's bedsore was treated once or twice a day every day and it improved only to worsen over time. She had it for a year and a half.
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Ugh, pressure sores can be hard to deal with. I cared for my mom in my home.

She developed a pressure sore. She didn’t tell me about it. I bathed her but the sore was in a spot that that made it invisible to me and she always bathed the private parts of her body herself.

Later on when she had aides to help her bathe, they didn’t notice it either because it was in a spot where it wasn’t visible.

I was fortunate to have a home health nurse who worked in wound care prior to home health.

A person needs to be trained in wound care to help in this situation. Why can’t his assisted living send someone trained in wound care to treat him? It makes more sense to send a wound care nurse to him rather than your husband having to be transported elsewhere to receive wound care.

The fact that he has diabetes complicates matters even further. I’m so sorry that he is in this situation.

So sorry to hear about your daughter’s cancer diagnosis. You certainly have a lot to deal with. Sending hugs your way. I hope that things will improve soon for all of you. Keep us updated on your husband, daughter and how you are coping with everything. We care.
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