Many families we represent tell us that no one at a nursing home told them their mom or dad was suffering from a bed sore until it was terrible. The reason they keep quiet about these terrible wounds is that they don’t happen by accident.
Medical professionals refer to bed sores as “pressure injuries”, because they are caused by unrelieved pressure. Prevention of these injuries is done by basic nursing. For all our modern medicines and machines, the best way to simply prevent a pressure injury is simply relieve pressure. This doesn’t mean moving a person from bed to a chair. This is done by simply shifting a person in bed every two hours at a minimum, or in a wheelchair every hour.
Another basic nursing tool that prevents wounds from forming is simply keeping a person clean and dry of feces and urine. Many nursing home residents suffer incontinence – that is they can’t control when they go to the bathroom. As a result, they require adult diapers. In understaffed facilities, families report that their loved ones are frequently soaked in urine or they smell of feces.
Families complain they can’t get people to assist with changing, no one responds to the call bell light, staff shut off the call light telling the family they’ll return and don’t, or staff simply tell them to wait for shift change.
This issue is particularly troubling to me personally, because being kept clean is a basic dignity issue and one no person would stand for if they were cognitively intact. That said, this issue is also important form a medical perspective, because feces and urine will burn the skin. If a person is wet too long it will damage the skin. So, when a person is not kept clean and dry pressure injuries become far more likely.
Another basic nursing solution to preventing pressure injuries is to be sure there is adequate nutrition – mostly protein. This just means making sure residents are getting enough good food to eat. Without the right nutrition, the skin becomes more susceptible to wounds, and existing wounds will not heal. Many families report that their love done is suffering weight loss, or when they visit they find an uneaten tray of cold food sitting on the table. This basic nursing is an important tool to preventing pressure injuries.
All told, the overwhelming majority of pressure injuries are not accidents and are wholly avoidable. If someone you love is suffering from bed sores, call for a care conference and demand to know how they’re going to meet your loved ones basic needs.