Five Ways Family Members Can Help Nursing Home Relatives Manage Bed Sores

Bed sores happen often, even though professional medical care facilities have the training and the staff to help prevent them from occurring. While there may be a shortage of nurse’s aides and assistants to help rotate residents of long-term care facilities, family members can help by monitoring the patient, and inspecting bed sores for progress.

Even in the best care facilities, pressure injuries sill occurs, and it is important for family members to know how to inspect a loved one for the condition, and how to advocate on their behalf for improved care.

What Are Bed Sores?

Also, known as ‘pressure sores’ in the medical community, the body can develop open lesions that can bleed and become infected, both at home, and in a hospital or long-term care environment.

There are eight regions of the body that are most prone to developing bed sores, as they are exposed to material and pressure friction daily. The high-risk areas are:

• The elbow
• The hips and hip bone
• The bottom or back of the heel
• The buttocks area
• Ankle bones
• The upper back and shoulder area
• The back of the head (resting on a pillow)
• The back of the calves (lower leg)

When bed sores develop, they start as deep tissue bruises below the skin, and may appear to be dark purple or green in coloration. They form the same way that a blood blister would form, only the condition is larger, and the tissue injury is deeper and far more painful. Bed sores do not resolve themselves or go away with time, and they require treatment and then careful supervision and prevention to avoid recurrences or worsening conditions.

There are four stages or levels of pressure sores, and bed sores can progress through all stages, increasing in severity if left unresolved. Medical practitioners provide a stage for each part of the development and growth of the bedsore.

• Stage I is similar in appearance to a sun burn on the skin. This first sign of a development may appear hot to the touch, or cold. Family members may touch the skin area gently; if it does not turn white when pressure is applied, it may be a bed sore developing.
• Stage II involves the formulation of a blister and open sore.
• Stage III involves a hole, or a depression in the skin that appears crater-like. Inside the wound, you can see body fat and the damaged tissue, and possibly bone.
• Stage IV is the worst condition of a bed sore, when it has deepened to the level of exposing bone, muscle and/or nerves. The patient experiences excruciating pain, and the wound may require surgery to repair.

Why Are Patients in Nursing Homes Susceptible to Developing Bed Sores

One of the greatest challenges in any hospital environment, is providing long-term care for individuals who are not able to perform the normal activities of daily living. Convalescent patients may not be able to walk, roll over and change position or stand up, and in many care facilities, it is virtually impossible for medical staff to lift, and move patients that are sedentary several times per day, when they may have hundreds of patients to care for.

Partially immobilized patients can sometimes use the fall guards and hand rails on a hospital bed, to slide themselves into a different position, when they feel pain or discomfort. The problem with this method of repositioning is that the friction from the blankets and hospital bed sheets (which are generally abrasive, thick durable fabrics, can exacerbate bed sores. The sliding movement places increased pressure on the skin and lesions, which can cause them to break open and bleed, or form new bed sores over time.

Patients in nursing homes and hospice care can easily develop bed sores, and since the body requires movement and circulation to heal, the wounds can take a long time to heal. While hospitals are meant to be sanitized environments, the bacterial load in the average shared hospital room is high, which places patients with bed sores at an increased risk of developing other health conditions, including the contraction of pneumonia, the flu or other topical infections like yeast, or other infectious diseases.

Sadly, the patients most prone to the development of pressure wounds are older, and obese individuals. If a nurse cannot lift or roll a patient without the help of an assistant, the patient may not get the frequency of physical repositioning that they need to avoid developing bed sores.

Proven Methods of Resolving and Improving Bedsores

The most effective way to prevent and treat bedsores is to ensure that sedentary patients and family members are alternated in position, throughout the day. If it is safe to do so, relatives can help the resident by moving them, elevating their legs with pillows to prompt better circulation, and applying a gentle massage to feet, legs and arms to stimulate blood flow.

If the patient is coherent, they should be taught how to prevent sliding or rubbing within the sheets, and reminded that if they are in discomfort they can (and should be) asking for help from the nursing staff. Nursing staff should be inspecting for bed sores on a regular basis, but this is something that relatives and caregivers can do on each visit, to help prevent worsening skin conditions or infections.

Clean and moisturized skin is less likely to conduct friction against fabrics and bedding in a hospital. The patient can be assisted at each visit, by applying moisturizing lotion to keep skin pliable and healthy. Body powder should not be used in a convalescent bed, as prolonged use may present a higher risk of respiratory problems.

Family and friends have the right to ask questions of medical care staff, when it pertains to the treatment of a patient that is related to them. If the patient is unable to communicate or advocate for their care needs to physicians and nurses, relatives can advocate on their behalf, to help reduce discomfort and secondary health risks. Facility acquired bedsores may be symptomatic of a larger problem within the healthcare facility; relatives can opt to move the resident to a new care center, by visiting the Medicare Nursing Home Compare tool. It’s free to look up ratings, reviews and other information to help you find the best care for your loved one.

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