Bedsores or ulcers are injuries to the patients' skin from prolonged pressure on a particular area. It is caused most often on skin where bony areas are more prominent. Tail bone or coccyx, heels, shoulders, ankles, ears, knees, and elbows are frequently bedsore-prone. Patients with limited mobility or inability to change position are quick to develop them, including the elderly with fragile or thin and dry skin. Dehydration, dryness, urinary and bowel incontinence also may make skin prone to sores. Friction and being dragged across a bed or chair can make skin fragile and prone to breaks.
Once a bed sore has formed, infection of the skin, bone and joints can occur. Prevention is the key to maintaining proper skin integrity.
As care givers, we have a responsibility to our clients to assess skin integrity often, therefore preventing bedsores. Steps we can take to keep our clients' skin healthy include; repositioning regularly and placing them in proper position every hour. When clients are bed-ridden, or during the night, reposition every two hours. A thirty degree tilt in bed is the optimum position. Placing a transfer pad under the client can help to reposition and reduce friction and shearing. Using gel or egg crate sitting pads for chairs and wheelchairs, as well as egg crate mattresses, help to increase circulation to the skin. Do not position the body on any bony areas. Use pillows and cushions to keep the body straight. Incorporate as much passive and active exercise for the bed-ridden or limited mobility patient. Exercises increase the flow to all muscles. Keeping our clients well nourished and hydrated helps keep skin plump and healthy. Inspect your clients' skin for redness or dry areas on a daily basis. Massage with non-perfumed creams several times a day. Incontinence and bedsores co-exist. The acidity in urine decomposes the skin and results in skin breakdown. Diapers or incontinent pads must be checked hourly and changed quickly.
Bedsores are extremely painful and hard to heal once discovered. Preventing pressure sores is critical as it is easier to prevent them than to treat them. As care-givers to the elderly, we must take the time daily to examine, care for, and be proactive in the prevention of bedsores.
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