Pressure sores (bedsores)
Medical and physical issues
My neighbour pointed out to me one day that there was a red mark at the back of my mother’s neck and another on her arm which might be pressure sores. I didn’t know what pressure sores were, but he told me about them and suggested that I take certain precautions and contact a doctor if they did not disappear in a few days. Fortunately, they did and I take more care now.
A red patch on the person’s skin, which does not disappear after several hours, could well be a pressure sore. A pressure sore (or bedsore as it is often called) is an area of skin that has been damaged as a result of pressure or friction. People with dementia risk developing pressure sores if they remain in bed or sit in a chair for long periods of time without moving. Sores can appear on any part of the body but tend to be on those parts which come into contact with the bed or chair. However, although it is possible to treat them, they can be particularly painful and unpleasant for the person with dementia. For this reason, it is important to try to prevent them from occurring.
How to deal with pressure sores
If you suspect that a red patch is a pressure sore, try to determine what might have caused it. For example, it might have been caused by a crease in the sheets or an article of clothing causing friction which you could rectify straight away. Removing the source of pressure or friction and protecting the sore area is usually sufficient to resolve the problem. Pressure relief cushions might help to protect the sore area or bony parts of the body. There are numerous different kinds and it is best to ask your doctor, which would be most suitable for the person you are caring for. If the sore has become infected, it is extremely important that you seek medical assistance, as it may be difficult for you to dress the wound on your own. If the sore is badly infected, the doctor might even recommend a short stay in hospital. However, it is extremely unlikely that you would be faced with this situation if you deal with sores as soon as they occur.
How to prevent pressure sores
Movement, activity and a healthy diet
Even if it is not possible for the person with dementia to leave the bed or chair, you could encourage them to change position every two hours. Pay particular attention to those areas which are in contact with the bed or chair, as well as parts of the body that are not very well cushioned by flesh. You should try to encourage the person to stand up and walk around a little about every two hours. If this is not possible, the person could perhaps just rock from side to side in the chair or make slow movements to music. Regular exercise improves the circulation and may help relieve a build up of pressure (please refer to chapter on recreation, activities and exercise for examples of simple exercises). People’s skin tends to become more fragile as they age. However, a healthy, balanced diet can help keep skin in good condition and therefore make it more resistant to sores.
Personal hygiene and incontinence
While you assist the person with dementia to wash and dress, you could check whether they have any red patches which look like pressure sores. Make sure that they are properly dry after washing and that their skin is gently patted rather than rubbed dry. Rubbing or massaging any part of the body where the skin is red could cause further damage. If the person suffers from incontinence, it is important to make sure that they do not sit around in wet clothes or lie in a damp bed. If urine stays in contact with the skin for any length of time, the skin is likely to become spongy and less resistant to sores. For this reason, if the person suffers from incontinence and is confined to a bed or chair it might be a good idea to consider the use of continence aids.
Avoiding sources of pressure and friction
Anything which hampers circulation or causes friction or pressure may lead to the development of pressure sores. Excessive heat and moisture can also cause them. The following precautions are therefore advisable:
- Avoid tight clothing and bedding that is too tightly tucked in, especially over the feet.
- Avoid the person becoming too hot and sweaty
- Avoid clothing which could cause friction (e.g. self-support tights, tight waistbands, etc.)
- Make sure the bottom sheet of the bed is not too creased
- Check that there are no objects in the person’s pockets which might cause friction.
Last Updated: Monday 10 August 2009