Rite Aid is dedicated to helping caregivers take care of their loved ones - and that often means providing answers to difficult questions. Many commonly asked questions may have already been answered by our pharmacists and other experts. You can search here for more skin care advice.
A: If you cannot eat a balanced diet, your skin may not be properly nourished. And pressure ulcers are more likely to form when skin is not healthy. Make sure your loved one eats a balanced diet. Protein and calories are very important. If your loved one is unable to eat a normal diet, talk to your healthcare provider about offering nutritional supplements.
A: Bedsores are now commonly referred to as pressure ulcers. The National Library of Medicine, in its Preventing Pressure Ulcers: A Patient’s Guide, describes a pressure ulcer as an injury usually caused by unrelieved pressure that damages the skin and underlying tissue. Unrelieved pressure on the skin squeezes tiny blood vessels, which supply the skin with nutrients and oxygen. When skin is starved of nutrients and oxygen for too long, the tissue dies and a pressure ulcer forms. Skin reddening that disappears after pressure is removed is normal and not a pressure ulcer.
Other factors cause pressure ulcers too. If a person slides down in the bed or chair, blood vessels can stretch or bend and cause pressure ulcers. Even slight rubbing or friction on the skin may cause minor pressure ulcers.
A: Pressure ulcers form where bone causes the greatest force on the skin and tissue and squeezes them against an outside surface. This may be where bony parts of the body press against other body parts, a mattress or a chair. Nerves normally tell the body when to move to relieve pressure on the skin but people in bed who are unable to move may get pressure ulcers after as little as 1-2 hours. Those people in chairs who cannot move can get pressure ulcers in even less time because the force on the skin is greater. Their position should be changed every hour.
In those who must stay in bed, most pressure ulcers form on the lower back below the waist, the hip bone and on the heels. In people in chairs or wheelchairs, the exact spot where pressure ulcers form depends on the sitting position. Pressure ulcers can also form on the knees, ankles, shoulder blades, back of the head and spine.
A: Caregivers should check loved one’s skin at least once a day paying special attention to any areas that remain reddened after they have changed the person’s position and pressure has been relieved. You want to discover—and correct—any problems before pressure ulcers form. Pay special attention to the areas mentioned above.
A: In addition to inspecting skin daily, skin should be cleaned as soon as it becomes soiled, using a soft cloth or sponge. The person should be bathed when needed, for comfort and/or cleanliness. Use warm (not hot) water and a mild soap. Use creams and oils to prevent dry skin. It is important to minimize moisture from urine or stool, perspiration or wound drainage. Your healthcare provider or pharmacist can suggest a cream or ointment to protect the skin. Also, pads or briefs that absorb urine and have a quick-drying surface to keep moisture away from the skin should be used.
A: You can talk to your loved one’s healthcare provider about perhaps choosing a mattress. A special mattress that contains foam, air, gel or water may help to prevent pressure ulcers.
You can use pillows or wedges to assist with proper positioning. Use them to keep knees and ankles from touching one another, for example. You also want to place pillows above and/or below a bony area to bridge it; placing a pillow under a bony prominence does not reduce pressure. For example, to relieve pressure on the heels, place a pillow no lower than the ankle so that the heels remain elevated beyond the end of the pillow.
The ideal position for lying in bed is slightly on the side, the body forming a 30-degree angle to the mattress. Use pillows behind the person’s torso to maintain this position. Remember to shift the person to the opposite side, repositioning the pillows behind the torso, every two hours.
Your loved one’s healthcare provider can advise if the head should be raised slightly or not. This will depend on your loved one’s health condition and restrictions.
A: You should avoid using donut-shaped cushions because they reduce blood flow and cause tissue to swell, which increases the risk of getting a pressure ulcer. Instead, foam, gel or air cushions should be used to relieve pressure. Your healthcare provider or pharmacist can advise you. Also, keep in mind that the ideal sitting position is completely upright, knees bent sharply and feet flat on the floor. This allows pressure to be distributed over the backs of the thighs rather than solely on bony areas.