How to Manage Bedsores in Long-Term Care Patients? - Family Medicine

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Managing bedsores, also known as pressure ulcers or decubitus ulcers, in long-term care patients is a critical aspect of nursing care, especially for individuals who are bedridden for extended periods, such as your sister who has cerebellar ataxia. Bedsores develop when there is prolonged pressure on the skin, often over bony areas, which can lead to skin breakdown and, if untreated, can result in serious infections.


Understanding Bedsores
Bedsores typically occur in patients who are unable to change positions independently. The risk factors include immobility, inadequate nutrition, moisture, and friction. The most common sites for bedsores are the sacrum, heels, elbows, and hips.

Stages of Bedsores
Bedsores are classified into four stages:
1. Stage I: The skin is intact but shows signs of redness that does not blanch when pressed.

2. Stage II: The skin breaks down, forming a shallow open sore or blister.

3. Stage III: The sore extends into the tissue beneath the skin, forming a deep wound.

4. Stage IV: The wound is very deep, reaching muscle and bone, and can lead to severe infection.


Management Strategies
1. Regular Position Changes: It is crucial to reposition your sister at least every two hours to relieve pressure on vulnerable areas. Use pillows or foam wedges to help keep her off bony prominences.

2. Skin Care: Keep the skin clean and dry. Use mild soap and water to cleanse the skin, and ensure it is thoroughly dried afterward. Moisturizers can help maintain skin integrity, but avoid using products that can cause excess moisture.

3. Nutrition: Adequate nutrition is vital for skin health and healing. Ensure that your sister is receiving a balanced diet rich in protein, vitamins (especially Vitamin C), and minerals. If she has difficulty eating, consider consulting a dietitian for nutritional supplements.

4. Pressure-Relieving Devices: Utilize specialized mattresses or cushions designed to reduce pressure on the skin. These can significantly decrease the risk of developing bedsores.

5. Wound Care: For existing sores, proper wound care is essential. Clean the wound with saline or a prescribed solution, and apply appropriate dressings. If the sore is worsening, it may require more advanced treatments, such as hydrocolloid dressings or even surgical intervention in severe cases.

6. Monitoring: Regularly inspect the skin for any signs of pressure ulcers, especially in high-risk areas. Early detection is key to preventing progression.


Seeking Medical Help
Given that your sister has developed a sore that is worsening, it is advisable to seek medical attention. You can consult a family physician or a specialist in wound care or geriatrics. They can provide a comprehensive assessment and recommend appropriate treatments. If your sister's condition is complex due to her cerebellar ataxia, a neurologist may also be involved in her care.


Conclusion
Managing bedsores in long-term care patients requires a proactive approach that includes regular repositioning, diligent skin care, proper nutrition, and appropriate medical intervention when necessary. It is essential to address these issues promptly to prevent complications and improve your sister's quality of life. If you have any further questions or need assistance finding a healthcare provider, do not hesitate to reach out for help.