Question on bed sores. Should I be concerned?

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Question on bed sores. Should I be concerned?

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So I just got a call from my mom's facility and they said she had a stage 2 bed sore on her butt that they are keeping clean and ordered medicine for it to heal. They just wanted me to know. When I asked why she had a sore they said because she favors her right side while laying in bed. My mom had a stroke 4 months ago and is now left side paralyzed. They get her up in her wheelchair everyday but she lies in bed 90% of the time.

My question is, should I be worried or are bed sores inevitable? Her facility does a good job of keeping her clean (that I am aware of).

Bed Sores Skilled Nursing Facility Stroke

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I do not know why this popped up again or if Slothlover2019 is still around but...
I am wondering how and why this got to a Stage 2 pressure sore and Slothlover is just being informed.
A Pressure sore can be a sign of neglect. Particularly one on the torso/butt.
Pressure sores are NOT inevitable.
A person should be moved/repositioned every 2 hours at the minimum.

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It popped up because someone responded to an old post. I so hope the OP has done something in the last 2 months.

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Bedsores comes from pressure points if the body. It's a break down of tissues on that part of the body where blood flow slowly.
Examples like a water hose you fold it and the flow of water decreases . Also if you continue to bend the same area over over it breaks open ..

Yes you should be concerned, if get infection will get inside body causes septic . Also the liquid from in get to other parts of skin can break down skin like rash .

Happy to hear Nursing is attending this. Possible if permitted a motion mattress .

Remember this happens because people/seniors can't move from that position. Nursing possible place pillows or soft item in the areas yet seniors need to move. Take care Brown Sugar

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Absolutely! Pressure sores can turn into nasty wounds that get infected. Then it will be really difficult to manage them. Get help as soon as possible.

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For darned sure! Bed sores are a sign of neglect. No patient should lie on one side for more than 2 hours. I keep a turn record for each of my patients and make sure that staff is completing the record during every shift. There's as lot that goes into caring for the paralyzed and demented, but it can be done. You just have to have the resolve to do it.

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Keeping a bed sore clean is not everything. It needs to be watched by someone who knows what to look for. Tissue starts to die and with this infection and with infection sepsis that can kill. You never want it to get to the infection state. That dead tissue has to be scrapped away.

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The reason they let you know is to cover their liability. The nursing home needs not only to keep it clean but to make sure she doesn't lay on it too long. Keeping a pillow on the right side so she does not roll over is your best bet to keep her off it. She should be turned every two hours so that bed sores do not develop.

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Slothlover2019: There is too much pressure on one area of your mother's tailbone. Perhaps she will require a gel cushion to alleviate the pressure.

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In 2014, my mother had a low level bed sore on her right hip because staff did not get to her for at least two hours one night, but my brother caught it early enough to report to management. The staff apologized and neglect never happened again since the Oregon NH was a great facility. Turned out one caregiver was out.

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In follow up to the daily lotion I said for preventative (once healed), the coconut oil with tea tree.... one caution.

Tea tree is too harsh, so the formula is 2-3 drops tea tree mixed well in 1 tablespoon of coconut oil.

Best of luck!

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Be concerned. Pressure wounds can get bad quickly. Can't help but wonder why you weren't notified until it was stage 2 - skin has broken open. Should have told you when the skin was red or irritated.

Turning her often and using bolsters or special triangle shaped pillows to keep her off the area should be used at all times for her. I would call her doctor and ask if she needs wound specialist to look at it.

They can be prevented and with so many NH patients laying in bed for long periods, when they don't catch the problem you get to the stage 2 and on up. Keeping area clean is a must, however just applying some meds will not fix it. She has to have time off that area. I would say it's time for someone in the family to go there and sit to see how often they are tending to her, moving her, getting her off that side.

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Yes be worried. Is a nurse trained in wound care attending to the injury? Are you examining the area? Is she being turned every two hours? Are there clean pillows used to prop her on her side? Often the cases aren't changed after they are urine stained. Hydration is even more important now, but swelling from fluid retention contributes to bed sore formation. To repeat, we know you want to prevent pain and sepsis.

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You should be worried, if they took proper precautions this would not happen. My mom and dad were both wheelchair bound towards the end. My mom with a stroke. I should say the only time my mom had bed sores was in rehab or the hospital. They are preventable.

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Concerned yes, but not alarmed. Is your Mom close enough to visit? If so, I would ask to see the sores myself. I would visit often to check progress of treatment My other big questions: when did they start using the medication, what is it, how often is it used, are the sores covered, if so how often is it changed?
I would encourage you to read about bed sores and treatment, as well. Knowledge is power. Bed sores are painful. I would inquire as to what is your Mom getting for pain. Best wishes to you and your Mom.

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Bed sores are bad news but almost inevitable in many circumstances, often like your mother. The facility prop her up to take pressure off but that is often not done in a long term facility. A skilled nursing facility or hospital is more likely to tend to a situation like that.

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As mentioned:
"Alternating air mattress overlay. About $75 Vive brand is great. This will help heal, and will keep them from coming back. It also helps with general circulation and good sleep."

Here is what it does:

Alternating pressure therapy uses pressure manipulation to promote blood circulation, thus blood nourishes the skin. The air cells in the mattress gradually inflate and deflate underneath the user at a fixed or adjustable cycle period. This gives time for blood circulation to repair the skin breakdown and help alleviate the soreness.

Link to ordering - google as there are many although Medi-Care / Medi-Cal / Hospice may pay for it. Ask facility case manager / nursing supervisor about it.

https://www.your-medical-store.com/store/c80/Your-Medical-Store-Alternating-Pressure-Relief-Mattresses-for-Hospital-Beds?gclid=Cj0KCQiAz9ieBhCIARIsACB0oGIyCZBswvJvlJhwFFBM1G_v-e8G27BJpYDaQJKu86UIVms1WBApBRsaAhsvEALw_wcB

Gena / Touch Matters

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Yes, alternating pressure mattresses can be a great help. Very Few nursing homes or long term care facilities, even the best, seem able to prevent bedsores completely. Inadequate staffing and poorly trained care givers are the main reasons.

The alternating pressure mattress may compensate for some lapses in care, but still requires regular oversight by family as well as caregivers to see that the mattress is properly placed and operational.

Bedsores are a cause for concern because they easily become infected by micro-organisms that are very difficult to treat. If not vigorously treated with antibiotics, widespread infections may even be a direct cause of death.

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My husband had a stroke 19 years ago. I have 3" latex mattress topper on his bed & 2" latex pad in his wheelchair. He's a big guy, 6'2" and 230 lbs. He's NEVER had a bed sore or even a hint of one. I feel the latex has helped tremendously. I also think the alternating air mattress could help except they are made of plastic and they trap moisture unless you have something else between them and the patient. Good luck. And yes, you should be very concerned. Bed sores are serious.

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Yes, be concerned. Not alarmed, but concerned!!! Get right on it. Are you or other family close enough to monitor? Maybe bring your iwn nurse in. Stage 2 is pretty far already and will get worse super fast without better care than what she already got. And without some radical care they will not really heal but continue at some level. The FIX and I mean absolute the fix (many say they can't truly be healed):

#1 ASAP: Alternating air mattress overlay. About $75 Vive brand is great. This will help heal, and will keep them from coming back. It also helps with general circulation and good sleep.

Also #1 ASAP: Honey!!! Manuka is best but any unrefined raw honey will do.

Clean the sores, put honey on, seal, change every 2-3 days (2 at first, then 3 days). This is about the only way to truly heal them. And they heal fast!!!

#2 Once they are healed, truly healed, coconut oil with tea tree oil will continue to protect her fragile skin in that area. This would be ongoing as a lotion applied after each daily cleaning.

Some important notes:

Wash can be saline or a drop of mild soap like baby soap, in warm water on a soft cloth (does not need to be rinsed off).

Apply honey without double dipping. You do not want to infect the honey. Also, apply just a small dot of honey. Very little. Also, apply honey PER sore. So like one gloved finger per sore. You do not want to spread honey from sore to sore. This will spread sores, connect them.

To seal, buy special bandages that are padded and completely cover the area. They are expensive but necessary. And you won't need that many. Maybe 6-10. SEAL the bandage. Do NOT put any of the sticky part of the bandage on the sore, but you do want to be sure the seal is flush to the skin. All the way around. Absolutely NO gaps. Otherwise contamination gets in and further infects. IMPORTANT: Buy skin prep. Little cleaning pads that clean the skin around the sore to make the bandage stick. Do Not get this prep on the sore.

If you truly want to fix the bed sores, this is fail-safe, regardless of how bedridden or skin fragility. It has stunned doctors, to tell you the truth. This method permanently cured my Mom's stage 4 bedsores. Her doctor said he had never seen skin so healed. God bless!!!!

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As I said my daughter is a wound care nurse. A few months back she had to go to court because a family was suing her NH for a Bed sore. She had to prove that the bed sore was the cause ofvthe Hospital, not the NH. Upon admittance to Rehab, my daughter had to examine the patient coming in. That patient already had a bed sore that the hospital should have taken care of. Maybe not even discharging until it cleared up. Because Rehab is not skilled nursing. People are there for therapy. Keep forgetting to ask my daughter what was the outcome but probably found out the family was suing the wrong facility.

Pressure sores can be any place. Heels of feet. Elbows where they sit on arms of wheelchairs. My Dad went to Rehab with pressure points on his heels. They blistered. I brought it to nurses attn abd they were bandaged. My daughter came to visit and looked at them. There were signs of dead tissue. She looked at Dads chart and saw he came in with pressure points. He should have been given an air mattress then to prevent them from blistering. The DON got an earful. Yes, bed sores are serious.

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The lawyers should know who to sue. A bedsore can start in one facility and detoriate in another if not treated properly.

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It’s good the staff called and told you. Definitely go look at it yourself and then make surprise visits snd inspect the progress. Stage two is the worst you ever want to get because it degrades quickly if not taken care of properly. It doesn’t take much of a movement to be sufficient. Changing the position of a pillow between or under her legs, moving her from one side to the other supported with pillows, Pillows in the chairs too. Good luck.

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Unfortunately, pressure stores are inevitable if a person is bed bound with very limited mobility. Can she shift around herself? Is yes, are there grab bars for her to use to help her to shift? There are special mattresses that can be used that consistently shifts a patient to prevent the sores but the facility may not have them. I'm sure they are using a wedge or pillows to prop her and turn her often. They did the right thing to alert you. Pressure sores occur due to prolonged pressure in a localized area. It's good they caught it and are treating it accordingly because they can be very painful. Good luck 🌻

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Grab bars may not be allowed in a NH.

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ABSOLUTELY! Left unattended, they can be deadly.

I was a son taking care of his mom. The only time she experienced a pressure ulcer was when she was in the nursing home after her hip surgery (so much for "rehab") and when she was in the hospital for observation a few years later (less than a week). Both times I made it known to staff it was unacceptable. In each case, it took a few weeks after she came home to clear it up.

My case was different, as my mom could walk (with walker). Every two hours daily, I made sure she moved to another chair. Each chair had a gel cushion plus a foam cushion, and a pillow for her back. Since she was incontinent, all three were covered with pads that I changed daily. At least three times a day, I made sure she had clean pull-ups. I used Calmoseptine each time on her behind to form a barrier. Her bed sheets were washed daily and clean pads put on. It was tough work, but I am proud she never got a pressure ulcer under my watch.

If your situation allows, make surprise visits to the nursing home as much as possible, and advocate on your mom's behalf. They are supposed to be trained for each patient's situation and have a daily care plan. You need to make sure that plan is being followed as much as possible. I wish you the best.

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good job

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Yes, you should be worried. Just pray that this bed sore does not get infected and eat away at her flesh all the way down to her bone. This clearly shows that the nursing facility did not do their job of repositioning her as often as they should. This shows also that she was laying in the same position for a very, very long time. This is a lawsuit waiting to happen.

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bed sores need to be watch before infected muscles happen. go up and see her more often.

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My father in law was in basically brain dead for 7 years in Thailand. Thailand does not allow ending breathing assistance. Nursing care there is poor, doctors are much more involved. Given that we had to hire 24/7 private nursing. In the 7 years in bed he did not get one bed sore because he was moved frequently. Not realistic here but staying in the same position too long is the cause as I know it so seems she needs both wound care and more frequent repositioning

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I agree. Bed sores are the result of pressure from remaining in the same position too long. You or I can change positions or even get up if we are uncomfortable, but it sounds like mom can't change her position in bed. Part of her care is (or should be) repositioning her several times a day when she is in bed. In addition, caregivers are supposed to be trained to look for red marks which are an indicator that a person needs to be repositioned more often. Rubbing the red area lightly with lotion helps to bring back the circulation, and frequent repositioning are key in bed sore prevention. If your mom can move herself and keeps going back to that position in bed causing the bed sore, then maybe an air mattress cover or special bed pad are indicated. I hope this helps and I will keep you both in my prayers. God bless.

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Sadly, most nursing homes have inadequate staffing, and those employees who exist are unable to get to each resident often enough or even at all in order to move someone in order help prevent bedsores. So, where is the funding going to come from to hire more help? What about better wages and benefits?

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Move out there, home preferably with private nursing care

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Not everyone has that ability or the money.

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I would worry about it. It can worsen in no time. Does Mom still use her own PCP or the facilities? Whatever Dr she uses, they need to have him order Woundcare for her. An aide should not be doing the bandaging the Nurse should be and looking for any changes in the sore. Like dead tissue. They have Woundcare Units in hospitals for a reason. My daughter is a woundcare nurse and managed a unit.

That wheelchair cushion is a RoHo. Can be expensive. Its made up of pockets of air. You pump it to the desired firmness.

https://www.amazon.com/s?k=roho+cushion&gclid=Cj0KCQiAlKmeBhCkARIsAHy7WVuW7CqXIfm3l4HeResM0OG3eLKPJh-rhps5e2gfhzukEDZxm-pK6rQaApHSEALw_wcB&hvadid=616991107898&hvdev=t&hvlocphy=9003829&hvnetw=g&hvqmt=e&hvrand=9674490236155050115&hvtargid=kwd-127752380&hydadcr=24663_13611861&tag=googhydr-20&ref=pd_sl_2nqf6lswq_e

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Hubby uses RoHo seat cushion for wheelchair. It’s the only thing he that allows him comfort.

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Pressure sores are not inevitable, but I wouldn't be worried. They've found it, they've told you about it, and they're treating it.

I can't imagine what "medicine" they're going to use. There are different types of cream to apply, and cushioned and/or medicated dressings if the skin is broken and regularly in contact with urine or faeces, which range from barrier creams to one called ProShield Plus - looks like axle grease combined with epoxy resin and works a treat, you could call it Super Goo - which our District Nurses give us to use if we kick up a big enough fuss; but to be truthful the only way to prevent or cure a pressure sore is to get the pressure off it. And that's not always popular with ladies who are trying to sleep and don't care to be propped in unnatural positions.

If you're feeling ghoulish you can easily find images of pressure sore staging online. Stage II is as bad as you want it to get but not so bad it can't be halted reasonably fast. If they really can't persuade your mother to vary her lying position without making her wretched, perhaps they'll consider a variable pressure air mattress for her? Is this on the same side as the stroke, or the broken hip, or both?

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Some people seem to more prone that others to get bed sores imho due to amount of 'padding' on the bones, mobility/movement, circulation & nutritian too.

Using equipment can reduce some risk - alternating air mattress, pressure relieving cushion for chair/wheelchair.

Does the facility have an OT? An OT can prescribe the right equipment.

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Beatty, could you tell me if the problem is too much 'padding' on the bones, or not enough? I don't know much about bedsores, other than that my BIL in late stages of cancer had an inflating/deflating mattress that actually rocked him from side to side. So is it worse for fattypuffs or thinifers?

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Pressure sores do happen but they are NOT inevitable.
They occur when repositioning is not done routinely or if a particular area of the body is not relieved of pressure. (Heels, back of the head, shoulders are but 3 areas that can get pressure sores and are difficult to relieve of pressure)
Pressures sores can happen fast and they can progress fast. I am wondering why they waited until it was stage 2 before you were notified.
And it occurred NOT because she favors one side of the body over the other it is because they do not reposition to lessen the pressure.
Keeping her clean while important is not a cause / effect of pressure sores. But keeping her clean CAN, if someone notices, prevent pressure sores simply because someone is looking at the skin BUT if they are not looking at the entire area when the change and clean her it is not going to be effective.

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