My mom has started developing bedsores. Any ideas?

Lindaz, what do the hospice nurses say about this? They are the professionals, and I'm sure they deal with this all the time.

They are they ones (after we pointed out the worsening nature of the bedsores) who supplied patches to cover them and the special ointment. But I wonder if this is because of her age and the length of time that she has been bed-bound.

Based on what you describe, I don't know what else there could be to do for her. I think all you can do is keep doing what you are. It is so difficult to watch a loved one decline, but it sounds like you are doing all the right things. Sending thoughts for mercy and comfort to you & your mother.

Thank you sandwich42plus. I've read on-line that putting honey on them might help them to heal...Has anyone tried this?

Dont ever put anything on a pressure wound (bedsore) that is not specifically prescribed by a doctor or nurse. Bed sores happen when the body stays in a certain position for long periods of time. Blood pools in those areas (particularly with the elderly who have poorer circulation) eventually causing tissue breakdown. There are several things that can be done. The first, if possible, help her change position every hour or two throughout the day. If she is not incontinent, or is kept quite clean throughout the day, sometimes a sheepskin pad helps. The last possibility is a hospital bed with a special mattress. Hopefully, you have some kind of visiting nurse coming, if not, request one through her PCP. A nurse practitioner sent from her PCP office, is your best friend. if you get a good one, they can advocate for you to get the necessary medical equipment to keep your loved one comfortable.

I know they use sheepskin heel cups in the nursing homes. They also have sheepskin pads that can be used under their hips. Don't know what else to tell you, sounds as if you are doing all you can do. Their skin just gets like paper. I know you can get air mattresses that inflate and deflate underneath them to help the circulation.

terrasil wound max, silverdine...

mrsvena, thank you for your answer. She is in a hospital bed with the special air mattress. She is completely incontinent and has a catheter in. We do keep her clean and dry and are working with her doctor (who is amazing and comes to the home at least once a week, more if needed). It is just so hard to watch her decline and not be at least, able to help with the sores, as they must be painful to her.

I've not heard of the sheepskin heel caps and they sound like something we should try. I will ask the nurse about them when she comes tomorrow. We do have a podiatrist who comes about every 3 months to care for her feet and he gave us booties to put her feet in, but she then started rubbing her heels against the mattress (to get them off, I guess) and made the matter worse, but they were not made of sheepskin and may have been uncomfortable for her. Hugs to all!

I was just doing a google search and found that there are several different options for the heel protectors. There are also convoluted (eggcrate) foam ones that are slightly less expensive. Ask the nurse which she recommends. Obviously they would be for someone who doesn't get out of bed on their own, and I say this for someone else who might be reading. I would think they might cause tripping or a balance issue.

I use Johnson & Johnson Tough Pads hydrocolloid bandages for the sores. I forgot to say that earlier. I buy them at Walmart or Target, 4 to a box, they are not cheap but effective. You can probably find them elsewhere, too.

Lindaz,
I will pray for you & your mom. Was wondering, can you add a little more boost to your mom's smoothies- Ensure or Instant Breakfast drink- bc that has protein & added vitamins..
Also your air mattress may be sufficient, but I added a memory foam pad & it greatly helped my dad's bedsores. (Bought at Target) For bedsore band aids, we used "hydrocolloid" band aids- can be purchased at CVS (they make them) in large squares or small. The large ones can be cut to size of the sore. We put a little triple antibiotic ointment , cover with small piece of gauze then placed hydrocolloid on top & seal. The hydrocolloid bandaid can keep moisture out and promote healing, even in a diaper. Try elevating moms heels, maybe place soft blanket under her calves, to get her heels off the bed & prevent her from rubbing them.
Blessings to you!! I will pray for you & your mom- that The Lord will give you continued strength & His wisdom & for Him to provide comfort & His peace for you mom.

Ok having worked in the medical field for 30 plus years..sheep skin is great but depending on where the sores are ,she should be turned and repositioned every 2 hours if not more often.Lotion the areas not having sores.There is a bandage that can be used on the sores to prevent spreading,depending on what the insurance will cover..they are not cheap but effective.Do not and I cannot stress this enough,use any remedies that involve herbs or over the counter ointments.I had a patient once that the family decided to use some kind of herbs..well the patient wound up loosing her foot...not good..so contact the medical professionals..I also had a patient once that had such a bad butt sore that I had to reposition her every 15 minutes..so follow the professionals advice to the letter.Good luck

How is her appetite? What is her protein intake? If the body does not get enough nutrition, the skin will break down no matter what you do. It is very difficult to get proper nutrition in the end stages of life, especially with Alz patients. Even if nutrition is taken (i.e. tube feeding b/c the patient no longer can eat) during the very end stages of life, the body can no longer process or utilize it. Then, the body, because of lacking nutrients, will use non-critical organs (the skin) to nourish the vital organs (heart, brain, etc) and the sores occur quickly.
I would consider a Hospice referral for care and advice on what they think of her treatment options. It sounds like it might time.

Linda, I wonder if you were expecting to hear more about Manuka honey? I got some for my mother on the off chance that it wouldn't hurt and it might help, but not in anything like your mother's extreme situation. All I can tell you based on our experience, I'm afraid, is that it tastes delicious and is lovely for sore throats (mine); but one does hear the most exciting claims for its healing powers and it is of interest.

I would recommend you ask your mother's nursing team about it and see if they are prepared to do the research and give it a go. There's not much to lose and anything that helps is worth finding out about. But I concur absolutely about not applying anything at all without explicit medical and/or nursing approval. Your poor mother, I'm so sorry.

mom died on tuesday..mom had a bed sore..get of milk of magnesia put on cotton ball and over with banadge..beleive ir it works

My mom was bedridden for over 13 years. She was completely vegetative state, and couldn't even move a finger or head, etc.... The only times she had a bedsore was when she went to the hospital. A month later, she came home with a bedsore that was digging down. It kept widening and also going down inside. We used DuoDerm on it. We cut it to size - enough to cover her hole. Keep it on about 3 days, change it.

Prevention is what we did best. When mom became bedridden, the gov't caregivers told us horror stories of how bedsores can go deep down to the bone. That you can see the bone. After that, we did our best to prevent it. We used the electrical air mattress, lifter and waterproof padding. We did turn her on her sides at intervals. Night times, because we both had to sleep, mom spent the whole night in one position. Still no bedsores from this.

We changed her pampers 3 times a day (soiled or not), changed her hospital gown daily. I would pour a capful of a microbial waterless soap into mom's water when cleaning her - using baby wipes and this water to wipe her down. After drying her skin, I would automatically use moisturizing or hydrating body lotion on her back and buttocks. If I see signs of rashes, I either use Creamy Desitin, A&D Ointment or Calmoseptine. It just depends on a case by case basis. It's the rashes that can become pimple-like and then pops. That open sore then can become a real bedsore. With mom, the home care nurses had recommended using DuoDerm.

When dad got his first bedsore, I used DuoDerm. That healed. The 2nd bedsore was the first one I've ever seen in which the blood literally flowed down from it. It kept widening. Fortunately, the new home care nurse saw it. She used to specialize in open wounds. She cleaned his wound up, gently stuffed his wound with gauze. She said that it was very important to keep the bedsore clean and dry. She also said that he needs to take in more Vitamin C and protein (nutrient drink) to help his body heal.

FYI, I've learned from experience that if you ask the same question to the different home care nurses, you will get different advice. It really depends on their medical knowledge plus past experiences with it. So, you may want to ask the different nurses who drops by.

get her an alternate pressure mattress or a gel over lay these are designed for this purpose my mom has been bed -ridden for 4 years and since we got these she has not had a single bed sore .We started with the gel over lay then had to go to the alternate pressure mattress Mom also has a hospital bed so that we can elevate her head and stumps--- in most peoples case it would be their feet .also you can go to a foam and fabric store and get sponge wedges .when you turn your mom on her side you can wedge this between her and the bed and she wont be able to go completely on her back I got a few before we had the mattress and when i sat mom in her recliner i would put one under her knees to prevent breakdown & pressure ulcers (bed sores).i know how frustrating it is-- when mom started getting them it was like a wild fire I would get rid of one and another would pop up --If you can get your doctor to write an order of medical necessity for your mom for the mattress or overlay her insurance should cover it Medicaid paid for moms

Hickybottom, my condolences on your mother. {{Hugs}} .. I've never heard about using milk of magnesia. Nor honey for that matter.

Medi Honey I think you can get at Walmart but I know you can ask for it at Drug Stores

I forgot to mention. We were told with mom, that we didn't have to turn her fully to her side. As long as she's slightly slanted/tilted on her side (pillows behind her to hold her in place), that it was okay to do this. When she's slightly on her side, we still put a flat soft pillow between her legs so that her knees don't get a sore spot. As for her feet, we helped lessen the pressure when she's on her back. We put a pillow right under her knees. I bought one of those triangle pillows for her feet but it was too bulky (mom was so small). So, your mom doesn't have to be fully turned to the right or left. She can be slightly turned to her sides so that she doesn't land face down.

I put a memory foam topper on the mattress that came with the hospital bed. This seemed to work well for us, my mom did not have bedsores, guess we were just extremely lucky. You are doing all the right things and the level of care you are giving your mom speaks volume how much you love her. I will pray for peace and comfort for you and your mom.

My doctor told me that there is some type of skin bearer cream that would work and also zinc oxide or Desitin

Lindaz it sounds a though your mother is comming to the end of her very long life. Be assurred you are doing all the right things for her. At the end of life the skin becomes very thin and the circulation slows so the tissue gets very little nutrition. You have a catheter so she is not getting wet. Again at the end of life diarrhea can become a problem. Some loved ones will get sores on all sorts of strange place like their ears. The only addition at this point relief which is why the hospice team may suggest liquid morphine. I know the very idea frightens many caregivers but remember it is so her comfort. Sheepskin can be very effective as long as it is real sheepskin. A whole pad can be put under her heels, between her knees and anywhere it wont get soiled. The downside is that it can not be washed. Blessings

All good answers, this may help also.
Pressure ulcers
are a common problem in palliative care patients. Decreased mobility, increased time spent in bed, and altered nutrition make these patients prime targets for skin breakdown.
Pressure ulcers are painful. As a caregiver, one of the most important things you can do to keep your patient comfortable is to prevent one from developing.
Relieve the Pressure
Turning a patient who is bed bound is the most important thing you can do to prevent pressure ulcers from occurring. Frequent turning alternates areas of pressure on bony areas, such as the lower back, hips, elbows, and heels.
You should plan on turning your loved one every two hours, alternating between the right and left sides and laying him flat on his back. Every two hours is ideal but there is no need to set an alarm clock to wake you up every couple of hours at night. If you and your patient are sleeping comfortably, leave well enough alone. If he does wake you up in the middle of the night, however, take that opportunity to turn him.
It's easy to lose track of which side he should be turned to if he's been on his back for awhile. One family I met had a simple solution for this. They used a soft cotton wrist band to mark the side that their grandmother should be turned to next. The grandmother liked the idea as well because the wrist band was pink -– her favorite color!
When you’re positioning him in bed, pillows are your best friend. Use one under the back to prop him on his side; place one between the knees when he's on his side; use one under the ankles to “float” his heels off the bed. Pillows add comfort and can reduce pressure on bony areas.
See “How to Position a Patient in Bed” for tips on proper turning and positioning.
If your loved one is spending most of the day in a recliner chair, repositioning him is still important. Small adjustments in seating position are often effective enough at relieving pressure. Keeping a folded draw sheet underneath him while he's sitting will make this task easier. When it’s time to reposition him, simply hold the draw sheet (preferably with the help of another able bodied person) and slightly shift his weight. You can also try changing the degree of recline to redistribute body weight.
Special Devices That Can Help You
In addition to turning and repositioning frequently, using a special surface to reduce or relieve pressure can help a great deal. The simplest of these is an egg crate mattress. Many hospice and home health agencies provide these free of charge but they are relatively inexpensive at your local department store. If your loved one is spending a lot of time up in a chair, egg crate chair pads are also available. An egg crate surface helps distribute pressure more evenly, helping minimize the amount of pressure on one area.
A step up from the egg crate mattress is an air mattress overlay. This type of surface is placed on top of a mattress and typically alternates air pressure in various columns. When using an egg crate mattress or an air mattress overlay, it’s still important to maintain the turning schedule. These devices don’t replace frequent repositioning.
The big guns of pressure relieving devices are the fluidized air mattresses. These special mattresses contain silicone-coated glass beads that become fluid when air is pumped through them. These mattresses do a wonderful job of relieving pressure but they have their downside. The frame of the mattress makes transferring to and from bed difficult. And if the person wants to sit up in bed, a foam wedge would probably need to be used to help support their back. This mattress is really best suited for palliative care patients who are fully bed bound, have severe pressure ulcers, and are in a lot of pain.
Reduce Friction and Shear
Friction is the rubbing of skin on an external surface, usually bed sheets. Friction to the most commonly affected areas can be reduced with protective devices. Heel and elbow cradles are typically made of egg-crate material and Velcro on. Skin protecting dressings, such as films (Tegaderm) and thin hydrocolloid bandages (Duoderm) can protect the skin from repeated friction but won’t help reduce pressure.
The most important thing you can do to prevent injury from friction is to make sure you don’t create any yourself when you’re repositioning your loved one. Use a draw sheet to help you lift your loved one off the bed when you lift and reposition.
See “How to Properly Lift a Patient” for more tips on safe lifting, including the use of draw sheets.
Shear is created when the deeper fatty tissues and blood vessels are damaged by a combination of friction and gravity. The best way to avoid this type of injury is to avoid a semi-Fowler and upright position in bed. Semi-Fowler position is where the head is raised less than 30 degrees and upright positions more than 30 degrees. Now, you obviously can’t avoid these positions all of the time. Many patients need to be semi-Fowler to help ease shortness of breath or prevent gastric reflux and all patients need to be in an upright position to eat safely.
To minimize the risk of shear injury in a semi-Fowler or upright position, take precautions to prevent your loved one from sliding down in bed. You can do this by raising the foot of the bed and propping the knees up with pillows.
Shear injury can happen in chairs too. To keep your patient from sliding in his chair, use footstools or ottomans to prop his feet and pillows or special devices to keep his hips at a 90-degree angle.

By Angela Morrow, RN

My husband has the same problem. I bought an electric air mattress that inflates and deflates so it is moving him for me. Her insurance, since she is in hospice, will cover this cost. She would probably tolerate that well since it isn't like really putting them on one side and then another. As far as what to put on the sores, the statements made here are correct. Being on hospice, ask her nurses what to put on them. I was putting the colloid patches on, because that is what was being done before, then found that they had improved enough to not need them and the patches, it turns out, was actually keeping them open and active. I now just put a zinc oxide ointment on them and leave them unbandaged. I hope these suggestions help.

Hi, I am sorry to hear of the difficulties. I can share with what we have done.
1. We had medicare cover for a air loss mattress. You can take your mom to the wound care center (I know she is in hospice care and so the point is to make her comfortable, but it is your call. You can take her off hospice to do the wound care visit and then put her back on hospice, we did that all the time for mom so that medicare would pay for services. They wont pay for a wound care visit while on hospice so the bill would go to you if you took mom to wound care while on hospice). Wound care wrote a script of necessity for air loss bed mattress to help lessen bed sores as well as a Roho Cushion with the cut out at the butt area that actually massages the areas for comfort

2. we rotate her every two hours and proper her with pillows

3. we massage her and exercise her (I.E. leg lifts arm lifts, etc.) we had a physical therapist come in and demonstrate. See if hospice can bring in PT to help with this. They may also be able to write a script for air loss mattress for her without you having to go to wound care center.

4. Nutrition. We did protein powders and put them in everything that was water content. So smoothies, yougurts, apple sauce, soups, etc.

5. You can prop pillows on both sides and put pillows between legs and pillow, soft round pillow (I purchased one from walmart while we waited for roho cushion) and elevated her legs with pillows.
By the way, does she have a hospital bed? We had medicare years back order one for her. It is old now they wont allow us to get another one, but it helps in elevation of her torso and her legs.

Lastly, for the sores there was zinc oxide cream we used or barrier ointment with the patches from the local store. Prior to sores, we did 'baby bottom' cream which was cocoa butter and that did wonders!

I hope this helps and God's speed!

For mom's heels, space boots we call them...hospice can order the booties to put on her feet to prevent and alleviate the pressure sores on her heels.

A Low Air Loss Mattress helps much better than the alternating pressure ones. It's much more costly but they do a great job.

My mother developed a bedsore on her bottom because she insisted on sitting in a chair for hours at a time. With the addition of a hospital bed, an air mattress and zinc oxide, it didn't spread and healed quickly. I turned her as much as possible, but she kept slumping down, returning to a position which I guess she felt most comfortable.I kept her dry and applied the ointment several times a day. She really loved the air mattress, said it made her feel much better. Finally she started to ask for the bed, which slowly replaced her favorite chair. Be confident that you are doing your best to keep her comfortable. Blessings to you and your family.

I have used dermawound (developed by a doctor and not expensive), and terasil wound care. Also, if her nutrition is poor, buy Pro-Stat. It is an amino acid complex that hospitals give to patients to help them heal from surgery and burns. It heals from the inside out. That has helped as well. You can also try TheraHoney Wound Dressing. It contains medical grade manuka honey. Good luck.