When a person ages, their skin becomes thinner. Thus, when some elderly people become bedridden, bedsores, also known as pressure sores or decubitus ulcers — can occur easily. These sores result from sustained pressure to a body area, which prevents normal blood flow. Without adequate circulation the impaired skin dies.
The severity of pressure sores can be observed in four distinct stages. Stage one is where the wound is an irritated red patch of skin that usually dissipates after a short period of time once the pressure is relieved. The irritation can become worse until finally reaching the fourth stage, which results in a large area of skin loss, possible damage to the muscle and even bone. Such sores can be a caregiver’s nightmare and cause unimaginable suffering for the afflicted person.
While taking care of my father, we battled this dilemma daily throughout the last couple of years of his life. The less mobile he became, the more attention I had to pay to his skin condition.
If your patient is wheelchair-bound, you might think your only concern will be bedsores on his or her bottom. But you also will need to pay close attention to the shoulder blades, the spine and the backs of their arms. If bedridden, you also need to watch their ears and the back and sides of their head — actually, any point where pressure occurs.
Prevention always is a caregiver’s best defense. Examining the skin while bathing should become a daily ritual. Once he or she has become incontinent, your constant vigil becomes even more critical. Moist skin enhances the risk of bedsores creating an infection.
If sores become open they are slow to heal. They must be tended every day. Your loved one’s doctor can design a plan for you to follow, but the first step of treating any bedsore is to relieve the pressure that caused it. If they cannot reposition themselves, someone will have to turn them throughout the entire day — possibly as often as every two hours. Be sure to watch out for things like wrinkled sheets, the plastic of incontinence pads or any materials that might restrict circulation.
Technology has brought forward some great devices to assist with patient care: air- or water-filled cushions, specialized mattresses, skin care salves and other helpful products. See if you can get some of these products prescribed by the attending physician as most insurance policies will cover the cost. One rule that should always be followed is to contact his or her doctor immediately if you notice a sore has broken open. This is when a wound becomes extremely vulnerable to infection.
When visiting loved ones in a nursing home or hospital, don’t hesitate to check their skin. If anything worries you, talk with a member of the nursing staff or the facility director. Tell them you’ll be back daily and will check on their condition.
During my father’s final days, it seemed no matter how often we turned him; we couldn’t prevent his skin from breaking down. It’s a tough and heartbreaking battle. Just show up every day ready to do the best you can.
For a decade Gary Joseph LeBlanc was the primary caregiver of his father, after his father was diagnosed with Alzheimer’s disease. He can be reached at firstname.lastname@example.org. His newly released book “Managing Alzheimer’s and Dementia Behaviors,” and his other books “While I Still Can” and an expanded edition of “Staying Afloat in a Sea of Forgetfullness,” can be found at www.commonsensecaregiving.com.