Bedsore Question for You Medical People - Warning - not for the faint of heart

[Julles]

Reading the recent threads about hospital and nursing home abuse, and about medical personnel who just don't care very much, I'm wondering....

When I worked in the funeral home, when we picked up people from nursing homes, often there were bedsores, and I mean really bad bedsores.  About the size of your hand, icky around the sides, and the centers all the way down to the tissue and muscle.

I always assumed that this is just what happens when people are bedridden and can't move, and have to lie in one position for long periods.  I know the aids are supposed to move them periodically, to prevent bedsores.  But they just form, anyway, in some cases.

Well, now I'm wondering if that is correct.  Are there ways to totally prevent bedsores, even if the patient is pretty much comatose and has to lie in one position, putting pressure on one point, all the time? 

We saw these so commonly that I just can't imagine that all those workers in all those nursing homes were neglecting their duties.

But maybe they were.

Anyone got an answer?

[Joyce]

I'm afraid the answer is yes, they were neglecting their duties.     :'(

[Indiana Karen]

The medical personnel have learned a lot about bedsores.  I can remember years ago, it being so common.  My mother-in-law was in a nursing home (she died four years ago).  They had a lot of different procedures in place to prevent them.  She was incontinent, after lunch every day she was undressed and put into bed for a nap under a sheet, this was so that her skin could breath.  She also had a mattress that was inflatable and on a timer.  The only time she got one was when she broke her hip and was in the hospital.  When she came back to the nursing home they called us and said that she was getting a bedsore.  I remember a group of therapists would come to her room several times a day to clean and treat it, she drank something too, to help the healing, and it healed quickly.   

[cricket67]

I took care of this young man for 16 years that was in a wheelchair....when he was in bed we as workers had to turn him every 2 hours to make sure he did not get bedsores...and when he was in his wheelcahir we as workers had to help him recline that wheelchair every hour again to make sure the skin does not break down....when giving him a bath we had to be careful to not rub hard and break the skin.....again to make sure of no break down....cause a break down can cause a bedsore.....and i can say he has never had one...

[pegs pond]

Retired RN here, bedsores are the bane of nursing!  They ARE preventable under most circumstances.  Patients need beds with special mattress or high density foam, something to equally distribute pressure, to be turned every two hours (this is where nursing homes and hospitals fail) Frequent bathing, washing after changing diaper, frequent diaper changes, just generally GOOD care!  BUT with that said there are other factors that come into it and the main one is nutrition.  If a person is not eating enough protein the skin will break down MUCH easier, ditto with dehydration.  So with a patient that say has cancer, is not eating or drinking much it is VERY hard to prevent them.  The high tech air and fluid beds help a lot but are cost prohibitive for most.  Once a bed sore starts on a geriatric or terminal patient they are nearly impossible to heal (therefore the bane of nursing).  Therefore the main goal is PREVENTION!  I had a hospice cancer patient that her's ate all the way to the spine and you could see the bones she had it when we got her and no matter what we and her family did it just got bigger.  Family faithfully turned her every two hours, we had special mattress brought in, RN care to change bandages and treat it daily...nothing helped.
More info than ya needed?  LOL
Peg

[Bullfrog]

A friend of mine at work has a daughter that became a quadriplegic after an accident. He and his wife are very diligent about turning her regularly and she does not have any bedsores. Another friend at work commented just yesterday that he has some points in heaven for the love and care that he and his wife have devoted to this girl. She is their life, they don't go anywhere anymore, their whole life is devoted to taking care of their daughter, he sure has my respect.

[Esther]

Boy, I don't know if I could do that Bullfrog. But again, a lot of us do what we have to, in life, not by choice.

I wonder how anybody who goes in a hospital or nursing home, ever comes out alive. I'm not saying they are dangerous places, just saying that after watching my dad in facilities for 3 months, I am amazed the caregivers ever get the treatments and meds straight for anybody. They have so many patients and when you figure they change shifts three times a day, I don't know how they keep it straight who gets what and when.

My dad had to potty one night at the rehab hospital and evidently the alarm on his bed hadn't been set. He had been told he wasn't to get out of bed without help but he was kind of confused for a while after he was run over by a truck, pretty much full length. At the hospital he had been sedated for 5-6 days too and I am convinced that left him goofy. Well he tries to get out of bed instead of ringing for help and ends up falling. They had to run him in the middle of the night back to the hospital for xrays etc. My stepmother had a fit and was saying some pretty harsh stuff about the staff. I felt sorry for them because I saw how understaffed they were and most of them were very caring and efficient. There seemed to be at least one on every shift who was extremely dedicated and managed to keep him safe and well cared for. So between the hospitals, Naomi and I he lived to still be plugging along at 87 now. He wasn't ever able to drive again because we think there was brain damage somehow but she drives well and they get along just fine.

Well back to the bedsore thing. I know when my mom was taking care of her mother, she had several of those sheepskin pads that she used for Grandma. She was cinvinced they helped to keep the bedsores from forming.

And my dad, came real close to having them but when it was discovered, they started right away a successful regimen of treatment to prevent them. They did a good job. 

[Vickie]

My paraplegic daughter had a bedsore that took one year to heal. Even though she had good care she still got one. Now she is doing better and has no new ones.

[Bullfrog]

Speaking generally here and not throwing a blanket over the masses but....

I endured two years of classes to become a paramedic. A lot of the people that were in the three different class levels of Basic, Intermediate and then finally Paramedic weren't the sharpest kinife in the drawer. How they actually passed the state test really puzzles me. That being said, there is a really vast difference between a question in black ink printed on white paper that only has three possible answers and real life emergencies.

This test on paper really pales in comparison when you are faced with the real test, someone actually dying in the back of your truck and you are all alone as a rookie medic. It is 40 minutes to the nearest care and the variables come into play. Sure, they have a closed head injury and you have been taught how to treat that to a degree. But the skull is an enclosed vault and the swelling tissue has nowhere to go but down the spinal canal. the brainstem or medulla oblongata is where all of the primitive functions of life reside, respirations, heartbeat and blood pressure control central. As this tissue get crammed down the spinal canal, the vital signs go into a downward spiral. They taught this in class but there is nothing that you can do about it in the back of an ambulance, you can't drill a hole in their skull to relieve the prssure like they can in the O.R.

That is one paramedic's example but the point that I'm trying to make is that life and insult to life due to injury has many variables that come into play. A medic or nurse may be able to pass the test on paper but when it gets real, things change rapidly and a lot of other things come into play. Some soon realize that these are actual lives that they are playing with and bail out quickly. Others don't want to waste the years of training and just hang, being really sorry nurses or medics and many people pay with their lives for this, they skate by without being sued and loosing their license.

Most of them realize that they can't cut it and become nursing home nurses where the pressure isn't so great and people are on death's door anyway. If that hurts anyone's feelings, I'm sorry but that is my take on it from 18 years experience in the emergency services. The nurses that couldn't make the grade in a hospital are the ones who give the last care to our loved ones and that sucks but that is real life. The complacency sets in and the patients, our parents and grandparents  who fought in our wars and nursed us as babies lie in their own feces and urine while they complain about their job and chat. Life isn't always pretty, especially in a third rate nursing home. There are excellent ones, don't get me wrong and some caregivers really do care, but I have seen the neglect for many years.

[Sunbeam56]

Bedsores are preventable.
Most of the time. Some patients have other complications - medications that stress the liver as an example, that do not allow doctors to prescribe the antibiotics, which also stress the liver... but bedsores should never be allowed to kill a patient.
Unfortunately, just like any other wound, they can become infected, the infection can become septicemia, and the patient will die.

Patients that die from bedsores are not just the poor ones, that can't afford complete care. Christopher Reeves (Superman) died from a decubitus ulcer (bedsore) that became infected.  :'(
But, the people on medicare/medicaid/welfare are more likely to be confined in a nursing home that is understaffed. So if the family can't, by their efforts, supplement the care that is being provided, the patient will not be turned regularly, not be cleaned regularly, not be given medication as scheduled, and so on... and they die.

[PondJoy]

I had no idea about Christopher Reeve and the cause of death....interesting.  Here is some information you migh find interesting also.

According to Dana Reeve, speaking on national television, neither a pressure sore nor infection directly precipitated Reeve's coma and subsequent death. Despite what was reported at the time, Reeve's body almost certainly did not go into septic shock (a type of blood poisoning that can lead to organ failure and death). The most probable cause of death, Dana Reeve said, was a reaction to a drug Reeve was given to help treat a suspected infection. He had been given the drug on previous occasions, successfully. Reeve had a history of drug sensitivity. Shortly after getting an injection of the drug, Reeve's body went into shock (anaphylactic) resulting in coma and eventually, the shutting down of his organ systems. He never emerged from the coma and died less than 18 hours later.

Dana Reeve was very clear about the quality of care her husband received. She praised the medical staff and noted that their actions in the final hours were appropriate and unequivocal.

There may be lessons to be learned from the high profile life and death of Christopher Reeve. By all accounts Reeve's final days were totally normal; he was on the road making a speech, he was busy being a moviemaker, an advocate and a dad, basically doing the things he wanted to do. He never paid heed to the actuarial life-limits placed on his type of paralysis by statisticians (11.4 years).

Certainly, Reeve's medical staff urged him to heed the fundamental protocol for dealing with any level of pressure sore, that is, to get out of the wheelchair and let the wounds heal up. But Reeve chose to live his life fully and well and as much as possible on his own terms. He was not, as his wife explained, a man who was easily persuaded to slow down.

The primary lesson, of course, is to be especially aggressive with wounds. It may not be possible to prevent the occurrence of a pressure sore. With appropriate seating and sleeping equipment and attention to basic care, though, most people who are paralyzed can enjoy health and skin integrity for years to come.

While it may not have been a factor in Reeve's death, septicemia is a real possibility if a pressure sore gets out of control. This degree of infection is generally controllable, however.

[Sean]

In the hospital I work at they use what is called a RIK mattress or a Fluid Overlay mattress that are either silicone tubes or fluid filled tubes and are often used for paraplegics, quads, patients in a coma and frail patients like the elderly. The problem is they are extremely expensive, several thousand dollars per mattress, more than the hospital bed alone so when the physician deems it necessary we rent them from KCI, the manufacturer.

Here is a link to the overlay I spoke of from KCI...   http://www.kci1.com/466.asp

To prevent bed sores patients need to be turned at least once every 2 - 3 hours, however depending on the patients anatomy it may need to be more frequent as bony prominences will loose circulation faster than a fatty area. A frail light patient may need to be turned less often than an obese patient due to the pressure exerted on the extremities and skin.

Foam and other cushioning pads or pillows will extend the need to turn a patient as frequent.

Cheers,
Sean

[Bullfrog]

Sean, this reminded me of one of my patients. She was very thin and frail but ambualtory. I made a routine pickup to return her to the nursing home and she had early alzheimers and she was actually quite charming. As I wheeled down the hall on the stretcher she saw a woman with kids and said to me "Oh look! Babies! I just love babies." Then she lowered her voice and told me "I made a few babies myself when I was younger" and she winked at me. We laughed and I got kind of attached to her on the ride to a nearby town where her nursing home was.

I went there frequently to pick up or drop off patients and would stop by the day room to visit her. She would make me sit right next to her and hold her hand. She always made a show of me and told the other old ladies "Look what I've got" She would hold my hand up and pat it with the other hand. We would laugh and talk for a few minutes before I had to leave and go back in service.

One day my now X wife and I were going through Silsbee and I told her she just had to meet this woman. She agreed and we went to the nursing home and there she was in the day room. I introduced my wife and she just clouded up, the smile was gone. She said...

"I wait for you and wait for you, and now you've went and took up with another woman." She was very upset, she actually thought I was her boyfriend. My wife felt horrible and I felt very uneasy myself. What was intended as a nice visit went totally wrong. When we left my wife felt bad and said "My God, why did you do that? I feel terrible, you should have just went on letting her think that you were her boyfriend."

I actually didn't know that she felt that way. 

[Julles]

Well, Bullfrog, I can understand you and your ex feeling bad - that's only human.  But the little old lady was slipping into dementia, so there really is no way to know what sort of reasoning or lack thereof was going on inside her head.

So sad to see that happen; no way to live, that's for sure.

Did you go back to visit her again, at other times? 

I used to volunteer in a state run hopsital (poor mental patients) and also the state run nursing home (poor old people).    Not going to comment on the horrid conditions, but the people were, well, they were a learning experience.  Everything from charming and endearing to quirky and funny to wacky to just plain pitiful. 

It was good experience for me; with everyone, especially young people, could get a glimpse of what it's like to live with poor health, or a feable body, or a mind that no longer works as it should.   

[FrankJScott]

Please try Google before asking about Best Product Site d22e164

[FrankJScott]

For the people inquiring about collect your car, vehicle price valuation, to sell my car, we buy any car price check, sell your clunker, we scrap cars, we buy your, vehicle scrappage near me, sell car collection, selling my car what documents do i need,  I highly recommend this related site for scrap my car site or scrap lorries, value any car, car valuation for sale, know the value of my car, know the price of your car, find out market value of my car, we buy your car parts, we value your car, scrap my car what to do, best way to scrap my car, and don't forget this this guy on scrap my car blog on top of car value online, cash for cars scrap metal, free online car valuation no email, online valuation of my car, check car value, finding the right car, buy my car valuation, buying cars for parts, we buy any car no log book, scrap best price, as well as this awesome scrap my car link which is also great. Also, have a look at this full report on scrap my car site on top of sell unused car, scrap car no log book, best car scrap yard near me, scrap cars for sale near me, buy my car, vehicle valuation services near me, cash for any car, calculate car price online, remove any car, value my car free, as well as this next page for scrap my car info with get best price for my car, scrap car collection near me, cars for scrap cash, scrap my car for cash near me, haul away cars for cash near me, car take, sell clunker car, pay for scrap cars, scrap your car today, on your car,  for good measure. Check more @ Awesome Therapeutic Rehab Blog a263ec5

[FrankJScott]

In response to the lady asking about georgia malpractice lawyers, lawyer macon, fort smith cancer diagnosis lawyer, i-16 georgia accident, commercial truck accidents attorney, product liability lawsuit funding warner robins, accident lawyer macon ga, can i request video surveillance from a store, lawyers truck, accidente de camion abogado valdosta,  I highly suggest this top rated accident lawyer info or can truck drivers take antidepressants, product liability attorney georgia, 18 wheeler accident attorney atlanta, casos ganados por negligencia médica, i16 wreck, georgia state driving laws, injury law firms near me, macon lawyers, mcarthur law firm macon ga, personal injury law firm macon, on top of this more bonuses about accident attorney info not to mention what is an attractive nuisance, personal injury lawyer atlanta georgia, medical malpractice lawyers macon ga, big truck accident attorney, negligence security attorney, macon lawyers, truck accident attorney in atlanta, manufacturer's defect, macon car accident, car accident attorney in augusta, on top of this awesome wrongful death attorney advice which is also great. Also, have a look at this helpful site on accident lawyer tips and don't forget atlanta 18 wheeler accident lawyer, surgical malpractice examples, personal injury law firm macon ga, what law does the video above demonstrate?, surgical error compensation, wrongful death lawyer georgia, truck accident lawyer in atlanta, macon car accident attorney, is lane splitting legal in georgia, product liability attorney atlanta, alongside all this over at this website for liability lawyer blog with car accident lawyer macon ga, injury attorney georgia, law firms in macon ga, 40-6-16 georgia fine, big rig accident attorney near me, nursing home abuse law firm augusta, what is surgical negligence, personal injury lawyer atlanta georgia, types of product defects, law office georgia,  for good measure. Check more @ Updated Clothing Store Simulator Blog c8e002d

[FrankJScott]

In reply to the lady talking about agen bet slot, bandar judi slot online terpercaya, slot yang lagi gacor hari ini, cuan slot login, slot online login, bonus spin slot, slot mob, daftar nama judi slot online, link yang gacor, login game slot,  I highly recommend this top rated WIN1000X site or slot bonus free, dunia slot online, raja play slot, judi slot game, mpo slot dana, judi slot yang gacor, may slot, kingdom slot online, link judi, slot hari ini yg gacor, as well as this excellent WIN1000X forum as well as slot apa yang gacor, cuan slot online, golden bet slot, nama slot online, slot online jackpot, nama nama slot online, game slot lagi gacor, game slot link, slot streaming, raja play slot, alongside all this for beginners for WIN1000X tips which is also great. Also, have a look at this best WIN1000X tips alongside all link tergacor di dunia, slot bet casino, www slot online, agen slot, judi depo, nama judi slot, link alternatif slot online, nama nama link slot gacor, link judi, slot gacor apa saja, as well as this going here on WIN1000X tips with dunia slot gacor, dunia slot online, link slot lagi gacor, situs agen judi slot, link judi slot online terbaru, slot online login, judi slot gacor online, link jackpot online, slot apa yang lagi gacor, nama nama game slot,  for good measure. Check more @ Updated IN1000X Login Guide a35ec8e

[FrankJScott]

In response to the lady talking about login slot, hoki login, 1b slot, rtp hoki slot, permainan sweet bonanza, casino 1000, satu slots, slot online princess, link rtp, mega cuan 88 slot,  I highly recommend this updated blog post on WIN1000X site or link slot online, mega slot88 login, play game slot, pragmatik bonanza, slot online77, gacor slot rtp, slot lengkap dengan rtp, slot gacor pp, koi slot 88 login, aplikasi slot online, and don't forget this top WIN1000X forum on top of sepakbolacc wap, tentang slot online, url slot, gacor online, koi cuan slot, pragmaticplay slot, situs rtp, slotgames online, slot 2008, bonanza sweet, alongside all this great site on WIN1000X info which is also great. Also, have a look at this her latest blog for WIN1000X details and don't forget logo rtp slot, slot 13, situs web slot, link alternatif, play game slot, gacor 7, ib88 link, slot online mahjong, link alternatif login, slot game 88, and don't forget this learn more about WIN1000X tips with slot adalah permainan, logo slot88, slot 11, slot online rtp, 88 situs, slot88 link, gacor online, link 88 slot, slot 10, olympus 88 login,  for good measure. Check more @ Excellent CUANSLOT Site 86_10fb

[FrankJScott]

To the guy asking about slot play, idn slot rtp, idn slot, website slot demo, slot slots, apa rtp slot, gacor play, rtp microgaming slots, demo slot rtp, to pada slot,  I highly suggest this made my day about Devil666 tips or game slot rtp, demo pragmatic play, depo games, pg casino, website rtp slot, id judi, slot home, apa rtp slot, slot slots, rtp slot dana, as well as this continue reading for Devil666 Slot forum not to mention rtp pragmatic play slot, app slot online, main game judi, situs deposit dana, demo casino live, deposit slot online, pragmatic play gacor, judi slot online, poker slot game, microgaming rtp, not to mention this get the facts about Devil666 tips which is also great. Also, have a look at this conversational tone on Devil666 details not to mention game play slot, gacor slot rtp, rtp slot logo, rtp live gacor, sini slot link alternatif, demo slot pp, pragmatic play demo gacor, slot gameplay, pragmatic play android, link judi, and don't forget this breaking news about Devil666 Slot info with link pg slot, slot demo link, bng slot, deposit slot online, slot rtp live, game online yang, situs deposit dana, rtp idnslot, judi slot yang gacor, slot deposit dana 2023,  for good measure. Check more @ Top Rated Cabinet Website a35ec8e