Pressure sores are also known as decubitus ulcers and occur in patients who have little or no mobility allowing them to change positions and relieve the pressure on the body.  Sores can develop over time and may be diagnosed in “grades” of progression.  Prevention is the best method of dealing with anything that compromises our health, but bedsores can be alleviated efficiently when they are addressed in early stages.

Muscles and fat pad the body, distributing pressure in a more even fashion.  Our natural fidgeting from one side of the body to another helps also.  In folks who have little or no “natural” padding, and who are paralyzed or bedridden, the pressure is more direct and wears away at the skin.  Skin can also become very strained when the bone moves one way and the fleshy portion moves in another.
As we age, skin becomes thinner and prone to breakage.  If there is prolonged pressure on an area, when the individual changes position, the skin may “slip” and a small tear results.

Nerve impairment makes for diminished sensation, and the individual may have difficulty assessing whether a given area is more sensitive than another.  Over time, skin breakdown occurs, unless someone is checking the skin at regular intervals.

Bedsores don’t just develop from the outside route, although that is the main contributor.  External pressure that is consistent will leave anyone with soreness, and even a mark.  But there is activity going on under the skin, too.  Circulation changes when pressure is applied, which hampers the ability of the body’s tissues to “bounce back” both literally and figuratively.
 
Simple Solutions
If your loved one is less than mobile, or must be in bed full time, you can monitor their skin integrity.  This will help in identifying possible areas of skin breakdown, as well as areas that have already become sensitive. 

Your loved one may have at-home nursing care, but if you are around for bath time, both you and the home health aide should check together.  If your loved one is in a rehab facility or nursing home, they will probably check for bedsores on admission.  This eliminates their liability, and more importantly, allows for aggressive treatment to reverse the progression of the bedsore.

Keeping skin clean and dry is a “common sense” option that may be difficult to do if your loved one has any degree of incontinence.  Sanitary pants that wick away moisture can help, as well as any prescribed medication that will control incontinence that is due to muscle spasms.  The physician has to evaluate the degree of incontinence before prescribing any medication.

Staying mobile can be impossible for someone who is confined to a wheelchair or bed, and that’s where a trip to the medical supply store may be in order.  Caregivers can research for products online that will offer physical support with less pressure exerted on a single area.  Wheelchairs have come a long way since their creation, and the options for seating are numerous.  Your loved one may have a “basic” wheelchair for transportation, but you can still look into possible additions that can be purchased over the counter.

Again, prevention is always easier than correction where health is concerned.  Proper nutrition which may include vitamin supplements is also helpful.  The body’s ability to repair itself requires adequate food and water.  Individuals who don’t receive proper nutrition can have problems with healing.  If your loved one has trouble getting the correct amounts of food into them, look into liquid vitamin supplementation, or ask the doctor for a prescription for supplements.   Enzyme supplements help the body absorb what it takes in, and may be useful also.

Position And Location
Bedsores can occur in a variety of points on the body, most often where bone and muscle create higher pressure “hot spots.”  The hips and spine are the two most mentioned areas, but the back of the head, knees, ankles and heels are other locations that are sensitive. 

Areas of sensitivity vary with the areas of the body that have pressure exerted on them, even when “resting.”  Padding the area can help, whether this is with “homemade” solutions like blankets or pillows, or with professionally made items.
Your loved one may need some guidance in positioning themselves correctly.  We all have habits of sitting and lying down, and they can be hard to break.  As their caregiver, you can utilize some psychology to assist them.  If you are incorporating a new item to help support them, remind them that it is to help them feel more comfortable.  Work with them to find the optimal position that relieves pressure on an area, but still allows them to relax in that position.  Some of us are used to “sitting sloppy,” or lying down with arms and legs akimbo.  Support behind the knees or ankles may take getting used to, but be comfortable in the long run.  The medical supply company, doctor and physical therapist can help in educating you on the ideal positions.

Individuals who are in wheelchairs often go to regular clinic appointments to evaluate the chair and pressure points.  Make sure your loved one attends regularly, if this is prescribed. 

Less “Pressure” For Caregivers
Bedsores can begin as areas of skin that are warmer or more discolored compared to the skin around it.  No panic is necessary when you see these, but action in the form of position changing and addressing any core issues (like incontinence) is required.

It’s true that bedsores can progress quickly and become ulcerated, where the skin is very damaged and may have to be surgically removed.  However, they need not get that way with attention and intervention.

 Subscribe to our weekly e-newsletter