Bedsores. The Truth.

We recently ran a story on the ‘gram (thumbnail pics to the right of post >>>) about bedsores (also known as pressure sores or decubitus ulcers). Fear not, there are no grizzly images in this post. The continuation of the bedsore story, we outline here…

Not a topic many may think needs discussion. Wrong. When I first heard about them I thought this was something older people “Just Get”. Sound familiar? Didn’t people used to say that about dementia itself back in the 80’s? -Yes. Were they wrong? MASSIVELY. So let’s look at this. Are bedsores “normal”? Absolutely not. Should they be tolerated (& by tolerated I mean ‘ignored’)? -No.

If you know someone who has one or are concerned someone may be getting one, this post will walk you through what you can do about it. It happened to my Mother and I was none the wiser. I wish I’d known then, what I know now. If I had of known, it could have saved Mum from months of suffering. Here in part is some of our story…

My Mother was admitted to a care home and within a week or so of being there, we were told that she had a bed sore. This bed sore progressed to become a Grade 4. Grade 4 is the worst kind.

When Mum was transferred to the said care home, she did not have any sores. She was in a wheelchair but she was not on bedrest. It is said that anyone who is in a wheelchair for long periods of time Or anyone who may be in bed for long periods of time, should be checked regularly for marks on the skin, which can potentially lead to the development of a bedsore.

Image: Harvard Health

Pain:

What I also wasn’t aware of was that my Mother was in a lot of pain and for a very long time, sadly, unbeknownst to me, Mum went without pain-relief. Pressure sores are extremely painful and if you know someone who has one, please persevere and insist that pain relief Is being given (with Grade 4 sores this should be every 4 hours). The person may be unable to tell you that they are in pain (often the case with dementia) though of course they can still feel pain. Signs that a loved one is in pain can be: that they are quieter than normal, facial wincing, shaking, trembling, loss of appetite and so on. Further signs, outlined here.

My Mother also went without a medical bed and without proper positioning. I often found her laid Directly on the sore which must have been absolute agony for her. Having moved Mum from the home in question and having discussed this at length with a medic, I am told that no one should ever be laid directly on the sore as it will not heal if they are. 

Unfortunately, poor care does still happen, even today in first world countries and that includes the UK. To ensure your loved one is not at risk, you can raise a safeguard with your local authority and inform CQC (the Care Quality Commission) which I discuss later in this post. I was not aware as a relative that I could raise my own safeguard until much later but it is quite simple to do. A safeguard protects a vulnerable adult who may be in the care system and for whatever reason is not being cared for properly.

The Care Quality Commission “monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find, including performance ratings to help people choose care.” -CQC Website.

For *safeguarding, more info below.

Bedsore Causes:

Bedsores are caused by pressure against the skin that limits blood flow to the skin. Other factors related to limited mobility can make the skin vulnerable to damage and contribute to the development of pressure sores.  -Google

Mayo Clinic:

Warning Signs of Pressure Ulcers Are:

• Unusual changes in skin colour or texture
• Swelling
• Pus-like draining
• An area of skin that feels cooler or warmer to the touch than other areas
• Tender areas

Pressure sores can develop very quickly and be so serious that they are life-threatening. However, having spoken personally to a Continuing Healthcare team expert from the NHS just this week, I am told, under good authority, that no one should develop a bed sore.

Good care then is paramount.

Image: Decubitus Ulcer Victims

Preventing Bedsores:

• Good Diet
• Correct bed (medical bed)
• Correct Bedding (friction proof)
• Correct positioning (regular but not overly regular; rotating/turning), by a care/medical professional
• Airflow mattress or cushion for wheelchair/chair
• Moisture and heat control
• Inspect the skin daily
• Good hygiene

*Safeguarding Tips:

If you do know someone with a bedsore and feel that their needs are not being met, then it is imperative to raise a safeguard for the adult’s well-being and safety. This can be done by searching for your local authority’s (county council’s) safeguard number, phoning and reporting what you know. It’s a chat over the phone. It could save someone’s life.

Above are a few tips that were shared on our IG. (Please note due to IG layout there is an overlap in text). 

Alternatively: Google your local authority –example: Essex County Council – followed by: Raise a Safeguard -and you should find info from there, phone numbers/info.

Every county in the UK is different, unfortunately, we cannot list all of the contact details here. For London, this will split into boroughs.

Medical Bed and Airflow Mattress:

A ‘medical bed’ as referred to in colloquial terms or ‘Profiling Bed’ like this one should be available to your loved one and if it isn’t you can inquire about this with the home & social services to ensure they have one:

Image: Alpine HC Group

A profiling bed, like the one above, will have railings to prevent a person from falling out, the ability to raise the person (while keeping them in the same position) i.e. up or down and the ability to change the position of the person without manoeuvring them manually or with a hoist. Eg, to a sitting position, they can be raised or laid flat using the bed controls. See video below. This can be done with a person either on their side or on their back. Most people with bed sores to the back areas (back, buttocks, sacrum) are ‘on rest’ on their side at all times, turned from left to right frequently and in this way, needn’t be moved onto their back or dragged up a regular bed to be upright enough to eat or drink.

These beds can be used in conjunction with a pressure airflow mattress. A pressure airflow mattress is essential for anyone who has had, currently has or is at risk of (a) bedsore(s). See videos/images below.

Profiling Bed:

Profiling Mattress:

An airflow mattress will have an electrical pump (see image below) attached to keep it inflated at all times:

Image: Health & Care

Airflow cushions for wheelchairs or chairs are also available:

Image: Viola

Ensure the Following:

While I wasn’t aware at the time that my Mother’s bedsore saga began, that she ought to have been in a medical bed, I also assumed that she was being given antibiotics and pain relief. I highlight “assumed” here. Sadly not all of this was the case it transpired later. My Mum is now in a Bupa Nursing Home and is being cared for correctly but I would urge anyone who knows someone who has a bed sore, to ensure that they have the following and the important aspects of the list I have highlighted in bold text below:

• Pain Relief
• Antibiotics (if required having discussed with a doctor) 
• Correct positioning – Not just When they are turned but How they are laid. No one should Ever be laid directly on the sore. 
• Correct positioning (rotating/turning) – usually this is every 2,3 or 4 hours.
• Good Diet – Protein is essential in healing pressure sores
• Correct bed (medical bed)
• Correct Bedding (friction proof)
• Airflow mattress or cushion for wheelchair/chair
• Moisture and heat control
• Inspect the skin daily
• Good hygiene

I would also urge anyone to ask about the different types of dressing for a sore. Different ones and different treatments are available depending on the individual’s needs.

They may require a Nursing Home rather than a Care Home so that 24-hour nurses are on hand for medical practice. This may include but not be limited to: catheters, dressing changes, administering of a particular medication.

—

Important Notice: 

While all discussed in the above post is from personal experience with my Mum’s health, I am not a doctor. The Dementia Cafe advises that with Any medical or social issue, you seek professional advice on all of the above from a medical and social professional, your local authority (county council) be it; social services, safeguarding department via your county council Or if you are concerned about the facility your loved one is in, then contact: the Care Quality Commission (CQC).

If you cannot make headway with any improvements to your loved one’s care and you feel that it is imperative eg. life threatening, you are entitled to contact the safeguarding team (as previously mentioned), you are within your rights to report any Human Rights infringements to the police or a legal representative and you do have the entitlement to ask Members of Parliament or the Secretary of State for Health and Social Care for assistance if you feel you need it because you are not being listened to. Ordinarily I would say that this, hopefully, is not necessary, however, my own personal experience regarding my Mother’s case did result in all of the aforementioned happening. I write this post in the hope that this should never happen to anyone ever again and raise awareness regarding these issues, for the welfare and benefit of all of those in the same situation as my Mother or those in any way, in a parallel situation.