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My grandmother is 93 years old and is on hospice she has developed a pressure ulcer it hasn’t opened up yet. The bed sore is located on her right bottom.

my mother, 92, also had a pressure sore. She lives at home still and gets around with walker.  She does wear adult briefs.  The doctor said to use something like zinc oxide to keep it covered over until it heals.  It has finally healed after 3 or 4 months.  However, hers was only surface sore, it was in what they call stage 1......I am not sure how to handle the ones past that stage but the people on hospice should know or a doctor. best of luck.
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Reply to wolflover451
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The best thing to do is.... KEEP HER OFF OF IT. I know.... a lady I took care of had one in same area. It was not draining yet but... soon would be if something was not done. She would complain about it hurting but... the only time she was not putting pressure on it... was when on the toilet. She slept on her back.. never on her sides. Don't rub it. Pat it. Put some heat on it for 20 minutes at a time. Increases circulation. Of course, keep her bottom clean and dry. I love to apply the "pink cream". Don't remember the name of it but it is calamine lotion and zinc oxide mixed together. (what you put on baby's bottoms) The thing is about that stuff is the way it is put on.... a very thin FILM. A film. So it does last a long time. When you make a film of it on the skin, it becomes very dry, not sticky... and also keeps the skin dry and protects it. This stuff is amazing.
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Reply to DonnaF777
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Waterbed
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Reply to shad250
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My mom was prescribed "Calmoceptin" or something similar. It's an ointment like desitin.

You have to be super diligent keeping the affected area dry because they get bad very fast.

Charlotte
They also had her lay under a light sheet without anything on her bottom for as long as we could manage it, as well as moving her often and relieving the pressure points.
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Reply to CharK60
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I use a small amount of Clorox in my moms bath water and rinsed with clear water which worked wonders. Afterward, I would use peroxide to flush if skin was broken and apply wound cream to affected area.
I also used only bed pads so that the wound could breath and turned her as much as possible. Healthcare officials does not approve of the Clorox bathe, but it works 99% better than wet and dry dressings and they can’t stop the caregiver from using this method.
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Reply to secretstaar59
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Have her turned and repositioned every 2 hours. The reason she has a pressure ulcer is because she is lying on/putting pressure on the same spot for hours on end.

Meanwhile, the hospice should be able to provide some type of cream or dressing to treat the current ulcer.
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Reply to dragonflower
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Tamera, make sure GM is using a pressure pad that goes on mattress. Also, pump-up cushion for chair/wheel chair. This is the formula I have used when skin starts to look irritated. 3 equal parts of: hydrocortisone cream (1% or more), A&D ointment (or generic), and liquid anti-acid (like Maalox or generic). A nurse told me to use baby shampoo for the private areas bc it's gentle on the skin.
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Reply to dads1caregiver
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Seek out advice from the Hospice Nurse.
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Reply to Llamalover47
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My 92 year old mom has had several bedsores. Triad Hydrophilic wound dressing, Pansement hydrophile, made by Coloplast. Clean area, put paste on and bandage, in a few days bedsores gone.
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Reply to easoncynthia58
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Get a dolphin air bed, costs tons of $$ though, but the rehab/nursing home should be able to get it and I think insurance covers it. First try a massaging foot vibrating pillow, I did with my mother’s pressure sores on legs and feet and it worked, they went away. Don’t know if this will work on bottom but why not try? It stimulates circulation.
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Reply to Manson
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Get pressure mattress & apply A&D & Desitin cream to bottom. Change diaper when wet & if in bed, turn her every couple hours. When cleaning bottom, use soft cleansing cloth w gentle body wash cleanser & pat area gently. That should heal area. Hugs 🤗
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Reply to CaregiverL
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Make sure she has an air mattress or other form of pressure relieving mattress, and is turned every 2-3 hours. Keep her dry and clean using incontinece products if necessary. Massage the area to stimulate circulation. Sitting in a chair for long periods, especially in wet or soiled diapers can aggravate this condition. Make sure she is getting liquid nutrients such as ensure or boost to assist with wound healing . Consult her doctor to refer her to a wound care specialist.
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Reply to Lithuanian1
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I have been told that a mixture of Maalox and Desitin works wonders. The Desitin has zinc oxide for healing, and the Maalox neutralizes the acids from the urine. Haven’t had to try it yet but am prepared if needed
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Reply to Mev909
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My mom is 89 years old and has Parkinson's. She developed a bed sore and the nursing home staff was treating it and it would get better then it would get worse. Depending on the staff that was on the floor. Some really care and do their jobs correctly others really didn't seem to care much. My mom had to go to a psychiatric hospital for a 2 week stay due to hallucinations and we were not able to see her very much while there. Upon returning to the nursing home they said it wasn't any better, but they would take care of it. About a week later I happen to be there when the nurse came in to change the bandage and OMG!!! The skin around the sore was BLACK with red around it!!!! I was so angry. I got on the phone with the administrator and told her I had seen the sore they had told me was getting better. It has been an uphill battle since. I have not been able to see my mom during this lock down, but have been staying on top of them as much as I can. They had to put her on antibiotics, use a special cream to get the black skin part to detach and now are having to pack it till it heals. She is having to be laid down after each meal and turned every 2 hours from side to side. Be sure to stay on top of it because it can get bad very quickly. Hope she heals before it gets to that point. It is awful to watch them suffer.
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Reply to PDcaregiver
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Arwen31 Apr 28, 2020
I feel for you, I really do. I've been there, the very same script happened to my mom. I still remember the shock I felt after many many years.
This was actually one of the reason I decided to take her home from the hospital. It took 1 year and 2 months, but it eventually healed completely.
Sending you and your mom lots of strength.
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My husband (91) is under hospice at-home care and the hospice nurse showed me their method for treating these pressure wounds. It involves gently cleaning the wound with a saline solution, then covering the entire bottom area with a Mepilex Border Sacrum bandage shaped specifically for that area.

It's a type of hydrocolloid bandage that is applied to pressure ulcers/sores and draining wounds without any ointment or salve. It heals the sores from the inside out and can be worn for up to 7 days. This has absolutely worked each and every time my husband developed sores in that area.

Speaking of the fragile skin of elderly people, these bandage come in regular sizes to cover other wounds and work equally as well on those too. The idea of covering a wound without an antibiotic ointment to have it heal seemed counter to my thinking. But now that I have first hand knowledge and seen the excellent results, I am a believer. Hope this information is helpful to those dealing with this situation.
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Reply to CLOWE48
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If your grandmother is receiving hospice services, I would speak with the hospice nurse about wound care. The nurse is the point person for care. She can speak with the physician for wound care orders as well as ordering a pressure reducing mattress. Additionally, she can perform a skin check to identify other areas that are at risk for breakdown.
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Reply to Peanuts56
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My mom developed sores on her bottom due to sitting for long periods of time.She had to get up and walk around every hour or so and put ointment on her bottom.Sometimes with a breathable bandage if it ruptured.
Changing positions and getting up to walk if possible helps greatly.
A cushion in the recliner also.
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Reply to Concerned43
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Many many years ago, i had preciouselderly loved ones who suffered and died from so called bedsores. Now that I am 86, i realize that elderly skin becomes fragile and easily damaged. I believe that we need to clean ourselves ansd or to be cleaned very very gently with no vigorous wiping. We also need to use antibacterial and or disinfectant soap or wipes. Very gentle cleaning with a disinfectant of some kind plus daily changing of sheets and washing sheets in a clorox solution.; these practices will prevent so called bedsores. I do not know how to healthem once they have developed. Howevr, it would seem antibiotics might help.
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Reply to BobbieSena
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My mom developed some bed sores while recovering from a broken back. We changed her position frequently and used a piece of manuca honey patch placed over the sore after the sore was rinsed with salt water and gently patted dry. Gauze went over the honey. Her body temp melted the thin layer of honey and covered the wound. It worked best! Couple days tops. We also tried a saline wash, patted dry and put fresh aloe from a plant onto the sore. We left it open to air dry then covered with gauze after it dried. That worked very well, but the honey healed her quicker. Good luck- the sores are very painful, stay on top of them, they do heal!
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Reply to DadsGurl
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Met a lady who cared for her bedridden husband for six years, she was proud to state he never got a bed sore. She applied bag balm to his skin.
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Reply to Getkicksonrte66
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No pressure on the sore. Turn frequently so she doesn't develop one on another area. Wound care team can address dressing changes and types of medications and dressings to the area.

These are the things needed to heal wounds: good circulation, good nutrition, good hydration, good hygiene, and good oxygenation. If she does not have all these pieces in place, it may never heal. If she is on hospice. it may not heal but that is no reason not to treat it or make sure she is comfortable.
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Reply to Taarna
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Medicare covers visits by a Wound Care Nurse. Please have your Doctor call.
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Reply to Ricky6
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Everything others said here is spot on. Address this urgently, before it breaks, if you can.

My personal experience with my mom's bed sore which she developped in the hospital during her coma many years ago and unfortunately developped into 4th grade:

* no pressure on it and air ( no wet pad) are the things that helped the most
* turn her as often as you can, even if you have to hire someone for this (nurses in hospitals are so busy sometimes that don't have the time to do it often enough)
* hyaluronic acid also helped more than other things
* watch for other potential spots (elbows, heels)
* nutrition: proteins are vital, loss of weight your enemy. This is very important.

Definitely ask for help to the specialists.
All fingers crossed!
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Reply to Arwen31
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jacobsonbob Apr 28, 2020
Good to hear from you, Arwen31! I hope you are doing well and keeping healthy these days!
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Medihoney is an excellent barrier cream that works well.
You also have good advice above.

All the best and prayers
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Reply to BritishCarer
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There are different dressings for pressure wounds. You want to catch is stage one or two if possible. If bedridden, I know you should try to turn evey two hours to keep weight off the area. They make bed air pressure mattresses that are helpful for pressure sores and they can help prevent sores also. We have had success with that so far, preventing one. Any place where bone on bone takes place or where there is pressure like elbow, knee, ankle are also areas that can get a sore. You can use blankets to keep these areas from hitting each other if someone is quite thin.

Hospice usually provides the gel pads and pressure air mattress.

The hospice nurse is he best source to get on top of it asap.
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Reply to Silverspring
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Getting her weight off it, I'm afraid.

So that means:

looking at the surface her bottom rests on. Is she in a chair or a bed most of the time? What kind? How often is she able to get up and move around, and if she isn't able to stand, with assistance if required, how can you encourage her to change her position?

If it's a chair, a riser recliner is best because its angle can be easily altered. Ask an OT to visit and advise on pressure relief.

If it's a bed, a variable pressure air mattress on a profiling bed is ideal.

But even with every conceivable gadget under the sun, frequent changes of position are essential.

As the ulcer isn't yet breaking the skin (are you sure?) I expect the hospice nurses will advise a barrier cream, especially if your grandmother is incontinent or unable to use a commode or toilet.

The more aggressive you are (you the team, that is, everybody who is involved in looking after your grandmother) about stopping this ulcer in its tracks, the better your chances of keeping it under control.

Is it troubling your grandmother? I would almost hope so, if it weren't for the thought of the poor lady's pain, because that way she's more likely to co-operate with your efforts than if she doesn't get what all the fuss is about. But of course I hope much more that you're able to keep her comfortable.
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Reply to Countrymouse
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Go to the store and into the baby products section. There are several different paste (Can't remember names at this moment but there was one with a frog that worked really well on my Dad). Will protect it, keep it dry and if it hasn't broken the skin should go away within a week. Apply liberally with a glove. Depending on the size of the sore, buy gauze squares and paper tape to cover it. Change gauze and apply paste as needed probably AM and PM for sure.

You do have to address the pressure point so tuck a pillow under her bottom so that she is off that side. Change her position during the day. You may have to add more pillows (different sizes) for comfort. One on her back, between her legs, etc. Ask hospice for advise if you need guidance.

Hopes this helps.

Let me know if you have any questions. This is new territory.

GOD BLESS!
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Reply to SometimesStrong
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Tamara101 Apr 26, 2020
Thank you for your advice yes we do have her floating on pillows she has a special air mattress it circulates and transfers air she’s just lost a lot Weight.
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Does she have an alternating pressure mattress?

This definitely warrants an immediate call to the hospice nurse.
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Reply to BarbBrooklyn
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Call the hospice nurse and have them address this ASAP. Try to keep GM turned often. Bedsores can be very painful.
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Reply to 97yroldmom
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