Sunday, October 25, 2009

Preventing Skin Breakdown & Bedsores in the Nursing Home

prevent bedsores in the nursing homeby Linda Granz, former nursing home social worker

Skin breakdown and bedsores are big problems in nursing home residents. However, they are preventable. Here are some things you can do to make sure your loved one does not develop them while living in a nursing home.

Before you choose a nursing home, check out its pressure sore quality scores. Scores significantly above the national average indicate they aren't doing a good job of prevention. Here's how you find out: Search for your nursing home on and click through to the Quality tab. See the details for Long Stay Patients and look for these measures:
  • Low-risk residents who have pressure sores
  • High-risk residents who have pressure sores that stay the same or got worse
Once in a nursing home, there's still more you can do. Bring Depends or a similar product if your loved one has loss of bladder or bowel control. A nursing home typically provides cloth diapers, however most times the resident wets through the diaper and clothing too. Making matters worse, nurse aides are generally busy with many other residents and it may be a while before they notice and tend to your loved one's accident. This will result in redness, and if it happens enough, skin breakdown. Opting for a plastic product will save clothing and better insure against skin breakdown.

Make sure your loved one's bed linen is changed at least daily. Some families monitor this by visiting daily themselves or working with other families to check each others residents.

Make sure bed-bound residents are turned every two hours. When up in a chair a gel cushion should be used to provide comfort. Those up in a wheelchair also need to readjust periodically to alleviate pressure points. There is also special footwear (it looks like lamb's wool) which can pad feet when in bed or up in the chair.

Keep the resident's feet elevated on wheelchair footrests to encourage proper circulation. Legs dangling over the bed or wheelchair can impede circulation.

If you do notice skin redness or a wound, notify someone right away. The nursing department will provide treatment and "stage" the wound. The nursing home's dietary department also generally gets involved because certain dietary interventions can promote healing of a wound.

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