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My grandmother is 93 years old and is on hospice she has developed a pressure ulcer it hasn’t opened up yet. The bed sore is located on her right bottom.

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Getting her weight off it, I'm afraid.

So that means:

looking at the surface her bottom rests on. Is she in a chair or a bed most of the time? What kind? How often is she able to get up and move around, and if she isn't able to stand, with assistance if required, how can you encourage her to change her position?

If it's a chair, a riser recliner is best because its angle can be easily altered. Ask an OT to visit and advise on pressure relief.

If it's a bed, a variable pressure air mattress on a profiling bed is ideal.

But even with every conceivable gadget under the sun, frequent changes of position are essential.

As the ulcer isn't yet breaking the skin (are you sure?) I expect the hospice nurses will advise a barrier cream, especially if your grandmother is incontinent or unable to use a commode or toilet.

The more aggressive you are (you the team, that is, everybody who is involved in looking after your grandmother) about stopping this ulcer in its tracks, the better your chances of keeping it under control.

Is it troubling your grandmother? I would almost hope so, if it weren't for the thought of the poor lady's pain, because that way she's more likely to co-operate with your efforts than if she doesn't get what all the fuss is about. But of course I hope much more that you're able to keep her comfortable.
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Call the hospice nurse and have them address this ASAP. Try to keep GM turned often. Bedsores can be very painful.
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Everything others said here is spot on. Address this urgently, before it breaks, if you can.

My personal experience with my mom's bed sore which she developped in the hospital during her coma many years ago and unfortunately developped into 4th grade:

* no pressure on it and air ( no wet pad) are the things that helped the most
* turn her as often as you can, even if you have to hire someone for this (nurses in hospitals are so busy sometimes that don't have the time to do it often enough)
* hyaluronic acid also helped more than other things
* watch for other potential spots (elbows, heels)
* nutrition: proteins are vital, loss of weight your enemy. This is very important.

Definitely ask for help to the specialists.
All fingers crossed!
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jacobsonbob Apr 2020
Good to hear from you, Arwen31! I hope you are doing well and keeping healthy these days!
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Does she have an alternating pressure mattress?

This definitely warrants an immediate call to the hospice nurse.
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No pressure on the sore. Turn frequently so she doesn't develop one on another area. Wound care team can address dressing changes and types of medications and dressings to the area.

These are the things needed to heal wounds: good circulation, good nutrition, good hydration, good hygiene, and good oxygenation. If she does not have all these pieces in place, it may never heal. If she is on hospice. it may not heal but that is no reason not to treat it or make sure she is comfortable.
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My mom developed some bed sores while recovering from a broken back. We changed her position frequently and used a piece of manuca honey patch placed over the sore after the sore was rinsed with salt water and gently patted dry. Gauze went over the honey. Her body temp melted the thin layer of honey and covered the wound. It worked best! Couple days tops. We also tried a saline wash, patted dry and put fresh aloe from a plant onto the sore. We left it open to air dry then covered with gauze after it dried. That worked very well, but the honey healed her quicker. Good luck- the sores are very painful, stay on top of them, they do heal!
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Many many years ago, i had preciouselderly loved ones who suffered and died from so called bedsores. Now that I am 86, i realize that elderly skin becomes fragile and easily damaged. I believe that we need to clean ourselves ansd or to be cleaned very very gently with no vigorous wiping. We also need to use antibacterial and or disinfectant soap or wipes. Very gentle cleaning with a disinfectant of some kind plus daily changing of sheets and washing sheets in a clorox solution.; these practices will prevent so called bedsores. I do not know how to healthem once they have developed. Howevr, it would seem antibiotics might help.
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My husband (91) is under hospice at-home care and the hospice nurse showed me their method for treating these pressure wounds. It involves gently cleaning the wound with a saline solution, then covering the entire bottom area with a Mepilex Border Sacrum bandage shaped specifically for that area.

It's a type of hydrocolloid bandage that is applied to pressure ulcers/sores and draining wounds without any ointment or salve. It heals the sores from the inside out and can be worn for up to 7 days. This has absolutely worked each and every time my husband developed sores in that area.

Speaking of the fragile skin of elderly people, these bandage come in regular sizes to cover other wounds and work equally as well on those too. The idea of covering a wound without an antibiotic ointment to have it heal seemed counter to my thinking. But now that I have first hand knowledge and seen the excellent results, I am a believer. Hope this information is helpful to those dealing with this situation.
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My mom is 89 years old and has Parkinson's. She developed a bed sore and the nursing home staff was treating it and it would get better then it would get worse. Depending on the staff that was on the floor. Some really care and do their jobs correctly others really didn't seem to care much. My mom had to go to a psychiatric hospital for a 2 week stay due to hallucinations and we were not able to see her very much while there. Upon returning to the nursing home they said it wasn't any better, but they would take care of it. About a week later I happen to be there when the nurse came in to change the bandage and OMG!!! The skin around the sore was BLACK with red around it!!!! I was so angry. I got on the phone with the administrator and told her I had seen the sore they had told me was getting better. It has been an uphill battle since. I have not been able to see my mom during this lock down, but have been staying on top of them as much as I can. They had to put her on antibiotics, use a special cream to get the black skin part to detach and now are having to pack it till it heals. She is having to be laid down after each meal and turned every 2 hours from side to side. Be sure to stay on top of it because it can get bad very quickly. Hope she heals before it gets to that point. It is awful to watch them suffer.
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Arwen31 Apr 2020
I feel for you, I really do. I've been there, the very same script happened to my mom. I still remember the shock I felt after many many years.
This was actually one of the reason I decided to take her home from the hospital. It took 1 year and 2 months, but it eventually healed completely.
Sending you and your mom lots of strength.
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Go to the store and into the baby products section. There are several different paste (Can't remember names at this moment but there was one with a frog that worked really well on my Dad). Will protect it, keep it dry and if it hasn't broken the skin should go away within a week. Apply liberally with a glove. Depending on the size of the sore, buy gauze squares and paper tape to cover it. Change gauze and apply paste as needed probably AM and PM for sure.

You do have to address the pressure point so tuck a pillow under her bottom so that she is off that side. Change her position during the day. You may have to add more pillows (different sizes) for comfort. One on her back, between her legs, etc. Ask hospice for advise if you need guidance.

Hopes this helps.

Let me know if you have any questions. This is new territory.

GOD BLESS!
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Tamara101 Apr 2020
Thank you for your advice yes we do have her floating on pillows she has a special air mattress it circulates and transfers air she’s just lost a lot Weight.
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