If you are caring for a loved one who is bed or chair-limited for most of their waking hours, this post is for you. You may be lucky enough to not have dealt with a bedsore (pressure ulcer) yet, or maybe you have. The most frustrating thing about bedsores is that their very presence is simply an accompaniment to another debilitating disease which has severely limited mobility or circulation in the first place. It’s like the double whammy you and your loved one never asked for.
Seemingly innocuous to start, bedsores can quickly spiral out of control, becoming deeper, more macerated, and infected. Proper aid and assistance from an attentive doctor, wound care specialist, and home health nurse is a must for tending to a stage 2+ bedsore. Is it possible to prevent pressure ulcers from forming in the first place, even if your loved one spends all day in bed? Absolutely. These strategies can help:
Get the right kind of mattress
If your loved one is “bed-ridden,” chances are they have a hospital bed in the home that mechanically raises up and down in which they can sleep, watch TV, eat, etc. If they are still sleeping on a regular bed and sitting up with pillows and other props, this tip is even more important.
Your average mattress is made of materials like foam, cotton batting, puffed-up polyester, and springs. Lying or sitting on the average mattress over time lets the bony points of the body add more and more pressure to internal tissues, causing breakdown and skin irritation. This is what leads to a bedsore.
Simple upgrades to your bed with memory foam toppers, gel padding, or an alternating pressure pad can completely transform blood circulation and weight distribution. A recent 2017 study looking at bedridden spinal cord surgical patients found that a whopping 82% of them developed sacral ulcers (on their bottom) when just a preventative wound dressing was used while only 36% did who were given a gel mattress to lie on. Depending on your health insurance and medical provider, an order can be written for a specialty mattress by your doctor and fulfilled by a medical equipment company; or you can look at a local bed/bedding store and online.
Use barrier cream
Did you know the start of a pressure ulcer can simply look like a reddish or dark discoloration on the skin? Recognizing the signs of the beginning of a bedsore and taking action right away can make a huge difference for the future of your loved one’s health. Barrier creams include a family of gels, creams, and ointments which can be applied to early pre-bedsore areas, healed bedsores, and closed stage 1 bedsores to treat and prevent further breakdown.
You can ask both a doctor or home health nurse about barrier creams they recommend or look online to see what other people have found successful – some popular choices include Corona Cream, EPC (Extra Protective Cream), and MediHoney. The goal is to provide a barrier between contaminants and moisture which can lead to skin irritation and breakdown – this is especially important for bed-limited folks who are incontinent.
While an alternating pressure pad or other specialty mattress can do some of the work of repositioning and disbursing your loved one’s weight while they spend time in bed, manual repositioning is just as important. With a couple thin to medium-width pills tucked up under your loved ones back and bottom, you can make sure their weight is shifted from side to side at least every 2 hours. This helps keep blood circulating and relieves pressure of bonier points of the body.
To some caregivers’ surprise, the heels can be a somewhat hidden place that bedsores develop, simply from feet lying and rubbing on the bed all day. Medical professionals encourage caregivers to “float the heels” of the people they care for by propping a pillow or rolled up blanket under the ankles to keep the heels from actually touching the bed. Johns Hopkins Medicine also shares that patients and caregivers should avoid using “donut” pillows to prevent pressure ulcers as they actually force more pressure from bones onto internal tissues, especially around the tailbone area.
Modify your loved one’s diet
Caregivers know what a challenge eating and diet can be when it comes to preparing food for your loved one and helping them eat. The disease or condition which impairs your loved one’s mobility may also impair their ability to eat or swallow, or cause them to take medicine that suppresses their appetite. When it comes to preventing bedsores, however, diet can be an important ingredient.
In addition to protein, vitamin C, zinc, calcium, and potassium aid the body in vascular circulation, strengthening skin, and tissue repair. Whole foods like broccoli, beets, citrus fruits, lean chicken, quinoa, nuts, and milk can help deliver some of these critical tissue-building vitamins and minerals. Supplements like Juven powder may alternatively aid the body with tissue repair as well.
Will doing all of these things 100% secure that your loved one never experiences a pressure ulcer ever? No, but they can make a huge difference and help you catch and seek treatment for a pressure ulcer far before it becomes health-threatening. Caregivers know knowledge is power when it comes to caring for someone – we hope this bedsore knowledge saves you and your loved one headaches (and pain) in the future.
Joe Fleming, Vive Health