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She has declined so much and has been bed-ridden for months now. She doesn't eat anymore nor take in anything of nutritional value.


Her skin has started to break down on her feet. It is very painful for her when the Wound Care Nurse goes to treat her wounds. We know at this stage they will not heal and she will continue to get more.


My question is, Should we continue to treat them?

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Sores on the feet that hurt a lot could be venous stasis ulcers or due to arterial circulation. You could make an argument to just put on what is called an Unna boot (its actually a wrap) and let it be. With poor enough nutrition, people get edema and skin become super fragile. Sorry you are going through this.
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Caregiverhelp11 May 24, 2019
Thank you.
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Your post had me searching the web and I found an interesting article on treating wounds at end of life - it's long and a little dry but it lays out some reasons to continue treatment

https://www.nursingcenter.com/cearticle?an=00129191-201304000-00003&Journal_ID=260877&Issue_ID=1521073
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Caregiverhelp11 May 23, 2019
I wasn't able to access the article when I copied and pasted the link you provided, but I will try and find the article. Thanks.
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**SOP stands for Standard Operating Procedure**
First does she have the proper mattress? ..I just saw that she now has an air mattress..good!
Second is she being turned/ re-positioned often enough?
Third.. are her legs, feet elevated and suspended so there is no pressure on the area?
When they come to change the dressings she should be medicated prior to the dressing change so she is not uncomfortable or in pain. If the Wound Nurse is not having this done she/he should be.
**side note** the critical "pressure sore" that you should watch out for is a Kennedy Ulcer. These appear rapidly often within hours.

In this case I would have a talk with the Nurse and see what her honest opinion is taking all other symptoms into account. No one has an "expiration date" stamped on their body so there is no way anyone can give a time or date but Hospice Nurses have pretty good instinct for this.
Hospice primary goal is comfort and symptom management. Let that guide you.
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Caregiverhelp11 May 22, 2019
Yes, most of that is being done. But I was wondering if she should continue being treated if we know they have no chance of healing at this stage of her life. I've heard that if they become infected that can spread throughout the body and cause death. I don't know if that would cause more pain or if she might pass sooner with an
infection. It's a horrible dilemma to be in, for sure.
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Pressure sores can be deadly because they can get infected. Should you Tx them that is a hard question to answer. What does your mom want? Is mom drinking any water? Is she done with this life? She sounds like she might be.

I am so sorry for what your mom and you are going through, but this question is so personal and we don't know your mom's history, meds and prognosis. Have you thought about hospice? Maybe it is time to ask her what she wants if you can. This has to be difficult for you. Maybe someone here will have a better answer for you.


Hugs!!!
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Is the patient at end of life now? Are they on Hospice care and getting comfort meds? Has Hospice advised you on SOP for this? Can her nurses or doctors make sure she gets meds to relieve the pain when the Wound Care Nurse treats the sores? It is really hard to know what to do with a situation like this.
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Caregiverhelp11 May 22, 2019
My mother is on hospice and is getting meds. I don't know what SOP means? Hospice nurse said she will continue to get more pressure sores since her skin is breaking down. I talked to the nurse today, and she is suppose to increase the pain meds a little.
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I don’t know how it is for your mom. My mom has pressure sores from sitting too long. Her home health care nurse treated hers with Duoderm bandage, she also uses a special pillow to sit on and is now supposed to walk every hour. The bandage healed it in a fairly short time. My mom is 93! There is a cream they put on surrounding skin as well. That helps preventing new sores. Look into these products with nurse.

I am not not sure how it is handled with bedridden people. I know one NH that I visited had beds with special mattresses that moved. Had never seen that before.

I am so sorry that you and mom are dealing with this issue. Hugs!
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Caregiverhelp11 May 22, 2019
Thanks. Hospice has exchanged her mattress to an air mattress, but I've been told by Hospice Nurse that she will continue to get pressure sores since she is not eating anything nutritional and hasn't for many months now. She is really skinny now. It's difficult t see her become more uncomfortable as the days go by.
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