One day, I was in school training to be a caregiver and our teacher asked us to take an object out of our pencil case and put it under one of our bum cheeks. To say we were all confused was an understatement and you can imagine all the laughing going on in the room. But the laughing stopped by the end of the lesson because that was the day we learned about bed sores.
Long story short, the items we were sitting on was her way of explaining how sitting in one spot for too long can inflict a lot of pain and discomfort. And did it ever! I can only imagine the pain someone goes through if they are left in one spot for too long.
Fast forward to today…
Thankfully, my nursing home is really good at preventing bed sores. We’ve had a couple sneak in over the years, but we typically get to them before they turn into anything too serious. Our repositioning policy doesn’t give them a chance to develop past stage 2. It’s important to reposition your patient at least every 2 hours to get them off the area to restore circulation. For even more protection, use a hospital bed at home equipped with an alternating pressure mattress. It will help to relieve even more pressure.
We’ve had a few residents come from other facilities and they had bad bed sores that needed to be tended to. One time I helped a nurse clean and pack a stage 4 bed sore and it was an unique experience. Not something most people can stomach. It got me curious, so I researched more about them and decided to share what I found so you can treat bed sores at home if the situation presents itself.
What is a bed sore?
Injuries caused to skin and underlying tissue due to prolonged pressure on the skin are called bed sores. They can also be identified by other names, such as pressure ulcer, pressure sores, and decubitus ulcers.
Pressure sores generally occur when a person is restricted to a wheelchair or bed for a long duration of time due to prolonged illness. This problem is commonly visible among the elderly, but this can also be developed in people under a comma or restricted to movement due to various health issues or disabilities.
What causes bed sores?
If a person is confined to bed or stays in one position for a long duration it will reduce blood circulation to various parts of the skin, resulting in severe sores or blisters. If left too long without treatment, a pressure sore can work its way to the bone.
Pressure ulcers can occur even faster if soiled clothes or undergarments are left without changing for a long period of time as urine will break down the skin.
Where do bed sores occur?
The parts of body mostly affected by bed sores are bony prominences like:
- lower back
- shoulder blades
Symptoms of Bed Sores:
The symptoms of bed sores are:
- Itchiness in the area of body which are under continuous pressure.
- Skin that has turned red and does not turn white when pressure is put on it.
- Warm and tender sensation in the areas affected by bed sores.
- Skin is still intact.
- Swelling and formation of pus in the skin.
- Breaks in the skin.
- Foul smelling.
- Sore has travelled through skin and fat tissues.
- Sores and blisters normally occur in final stages (i.e. third and fourth stages).
- Muscle and joint pain.
- Sore has travelled through the muscle and to the bone.
Once these symptoms are noticed, the bed sore can be treated to give relief from pain.
Stages of Bed Sores:
There are mainly four stages of bed sores. During theses four stages of bed sores the person can experience minor discomfort to severe pain. However, in the worst stages of bed sores, elderly patient feels little or no pain due to the incredible amounts of tissue damage. In the initial stage the bed sore appears in red color and when it come to final stage it will turn to purple.
These sores tend to break open if it is left neglected so, it is important to treat these sores as early as possible. Infection can be caused and spread to different muscle parts in the body if these sores break open. Need to take utmost care to prevent inflammation and infection. The patient can go through a lot of pain due to inflammation and infection. Due to the itching tendency it is important to make sure that they do not itch and make scratches as it can lead to worsening and spreading of the infection.
In stage 1 the bed sores typically appear in red-colored patches. Skin that are turned to red and does not turn white when pressure is put on it. For people with dark skin, the bed sore affected area will be in different color when compared to other part of the skin. Skin format will also differ considerably (skin tends to be firmer and softer) from other part of the skin. You may feel slight warmness when the affected area of the skin is touched. Skin is not infected in stage 1 and you will not find tears or breaks in the patient’s skin however it can be very painful to elderly people.
The affected skin will appear more destructive. Resulting in open sore, cuts or blister, and the skin around the wound will be discolored. Sore becomes very painful in second stage. This happens when sore digs deeper.
The affected skin appearance will be crater-like appearance. This is because the sores have developed through the second layer of skin into the fat tissue.
This is the final stage of development of the sore. It is the most serious and acute type of bed sores. The skin and tissues are in acute damage causing large wound. Infection will also occur in this stage. In this stage the sores have further developed to affect the muscles, bones joints and ligaments.
Bed Sore Treatment:
Bedsores can be easily treated when identified in its early stages. It’s essential to start treatment during these beginning stages or the outcome of the bed sore will become much worse. It’s critical to prevent the bed sores from progressing to stage 4.
Turning and repositioning the patient frequently will allow the blood to flow evenly to all the parts of the skin and underlying tissue. Doing so will help avoid applying direct pressure on the affected area. It will also release the pressure and stress on the skin, that will infuriate the existing sore and reduce the chances of getting new sores.
- It is recommended to reposition yourself if you have strength in your upper body. A device like trapeze bar can be used for self-repositioning. It is recommended to change the position every 2 hours of a patient confined to a bed.
- Individuals using a wheelchair are recommended to reposition every 15 to 30 minutes. If it is difficult for the person to move, then the help of a caretaker is needed.
Make sure that the skin is kept clean and dry at all times. The severity of sores influences the type of cleaning to be done. It is more prone to infection and inflammation if the bed sores are not cleaned properly. To make saline water. Mix two spoons of salt in a bowl of water and boil it. Cool the water to use it to clean bedsores.
- Stage 1 – If the patient is suffering from stage 1 of sores, cleaning with a mild soap will suffice.
- Stage 2 – In stage 2 bedsores, the cleaning is done by washing the area with salt and water. This will remove the extra fluid and loose material. Need to do stage 2 cleaning very gently because the cleaning process is very painful for the patient. Once the cleaning is done, it is covered with a special type of gauze bandage. We should always allow the affected area to dry thoroughly once it is washed before dressing it with gauze or bandage.
- Stage 3 and 4 – these bed sores requires special attention. The cleaning can be done by someone who is a specialist like doctor or nurse. Please don’t attempt at home.
Dressing the sores is important to keep it covered. Sometimes gauze is used to keep the area moist and must be changed every day. Advances in medicine has developed newer kinds of dressing such as hydrocolloid dressings. Hydrocolloid dressings can stay on the affected area for 3 to 7 days. It is a bandage made of gel that molds the bed sore to promote healing. At my nursing home we use a hydrocolloid dressing called Tegaderm by 3M.
- Remove dead tissues appearing on the sores. Infection can be caused due to dead tissues. Dead tissues are something that appears like a scab in the sore and interfere with the healing. Dead tissues can be removed from the sores in different ways. One of the method is by rinsing the bed sores every time when the bandage is changed. However, with the development of medicine, there are special dressing invented that will help your body dissolve dead tissues on its own. But the dressing must be left for several days.
- Another way of removing the dead tissues is by putting the wet gauze on the bed sores and waiting for it to dry. Once it is dried the dead tissues will stick to the gauze and when the gauze is pulled off the dead tissues will be removed. There are instances when bed sores are acute, the dead sores must be removed surgically by the doctor. Due to the pain involved in removing the dead gauze it is suggested to take pain medicine thirty minutes or sixty minutes before the dressing is changed.
- A soft padding such as foam cushion, special forms of bedding, on the patient wheel chair and bed can provide pressure relief to prevent bed sores. Use of sheepskin can help in alleviating pressure on the bedsore affected area.
- Quite often elderly patients are malnourished. It’s necessary to give good nourishment for people with bed sores. Patient should have ample amount of water with a well balanced healthy diet with a good intake of calories, protein, and nutrition such as vitamin “A”, “B”, “C”,” D”,” E”, Iron and Zinc which is essential for healing sores. As per expert’s advice it is important to take food that are rich fiber.
Home Remedies for Treating Bed Sores
They can also be treated naturally by wide variety of home remedies. Home remedy treatment are very safe and does not have any side effects. Due to its safe nature it is preferred by large percentage of people across the globe. This makes you avoid expensive treatment and medication by favoring safe home remedy treatment.
The gel of the famous medical plant Aloe Vera plant is an excellent remedy for bed sores. It plays a diverse role in curing the bed sores. On applying the gel of this plant in the sore affected areas everyday, it will have diverse effect on the sore affected area. It will heal the sore, keep the skin soft and smooth, cools the affected area by providing relief from pain.
Turmeric has anti-inflammatory, antiseptic, and antioxidant properties. Due its unique quality it quickens the healing procedure of bed sores. It helps your body to resist with infection and deal with symptoms.
First you need to clean the affected area with salt water. Sprinkle ample amount of
turmeric powder on the affected area. Make sure that the wound is covered properly by turmeric. Then cover the area with clean bandage. Do this thrice a day to accelerate the healing procedure.
It is recommended to drink warm milk with turmeric powder added to it twice a day.
Coconut oil is known for its richness in medium fatty acid. Constant pressure on the skin will always cause damage, by applying coconut oil in the skin it will prevent the damage caused due to constant pressure. Additionally, when applying the coconut oil, it will massage the body and help in increasing the blood circulation. While massaging with the coconut, make sure pressure is not applied on the bedsores. Other types of oil recommended are olive oil, mustard oil or any other massage oil.
- Smudge some warm coconut oil on the body parts (such as your legs, limb, back) where much pressure is used while sitting on wheelchair or lying on bed.
- Gently massage and allow the oil to penetrate deep into the skin.
- By applying three to four times a day it will both heal the sores and prevent new
sores from coming into your body.
Honey has got a very rich antiseptic properties, that can soothe the skin where there are mild bedsores. By using honey, it has various effect on the bed sores. It will reduce itching, give great relief from pains and also promotes the procedure of healing. Honey’s nature is known to reduce the risk of infection due sores.
To prepare a thick mixture of honey and sugar, equal amount of honey and sugar is used. Apply the prepared mixture on the bed sore affected area and cover it with a clean bandage. Doing it once in a day will suffice.
An easy way to do it is by spreading honey over a large banana leaf and lying on it for few hours a day. Repeat it daily.
Petroleum Jelly is the most effective way in treating bed sores. It has nature of keeping the skin moist and nice. Cover the bed sores wounds with sterile bandage by applying adequate amount of petroleum jelly.
The bed sores healing procedures is a very slow process. The bed sores wounds will slowly get smaller. Over a course time less fluids will drain out from bedsores. The process involves new tissues that starts growing at the bottom of the sore. The new tissue will appear in light red or pink in color with a lumpy and shiny look. It can take two to four weeks of treatment before you can witness the signs of healing.