WHERE IS THE CARE ARTICLE – PRESSURE CARE – OUR ADVICE

Pressure Care Information from Us

We have learnt many things through our experiences. Here is as many as we can think of to inform and assist you. If anyone knows any more, let us know!

 

• ASK ASK AND ASK AGAIN. Ask for information. What is happening with your elderly loved one’s
pressure care. What the situation is. What does the nursing care plan say. Make sure the care
establishment is adhering to the care plan. Next of Kin has a right to know. If you are not told,
take that as being something is wrong! You have a right to know.
• Heels with pressure sores can be rested on a pressure relieving, heat reacting cushion to help heel
and if person is immobile and sits in chair.
• There are a variety of dressings available, check you know what is being used and why.
• Tissue Viability Nurses are expert in pressure care and management. They are in hospitals and
community care.
• If your loved one wishes you to be present at dressing changes they have that right.
• Your loved one should have pain control offered before dressing changes take place.
• Observe that equipment used is sanitised during dressing changes
• Make sure there is no infection in wounds, this can be missed, anti-biotics will be needed if so.
If there is a bad smell, probably this is an infected wound.
• There are different interventions in care of wounds, ask about them and investigate yourself.
• To help heel wounds on heels. Elevate legs (seek professional advice to do it the correct way) with
low pillow or blanket under calves.
• Make sure your person is being turned/moved position if they are on a special mattress or not. You
will still need turning even if you are on a special mattress to heal wounds. There should be a
turning sheet to log times of moves noted in the care plan, in homes, hospitals, hospices etc – have
a look at it, ask so that you understand what you are reading.
• You loved one can take supplements to help heal (check with Doctor) for example, Zinc.
• Get assistance with nutrition, by a dietician if need be and have supplements if needed.
• Do not be palmed off with news that you loved one doesn’t like them, there are different ones!
• Make sure pressure is off healing wounds at all times!
• Make sure air alternating mattresses are 1) switched on and working 2) fully inflating 3) is the
correct type for your loved one
• You have a right for your loved one to be on an air alternating mattress if they have pressures
sores or are at high risk of developing them within hours of admission to hospital.
• A pressure risk assessment must be carried out within hours of admission to any care establishment
to determine risk, ask if it has been done.
• Watch the ears of your loved one, if they are not turned they can get sores here too!
• Do not assume your mum’s body is intact, find out. It is very difficult if you are not bathing etc
or doing her personal care to really know.
• If your loved one cannot shift themselves, ask about pressure care.
• If your loved complains of a sore bottom, check it, with their permission of course.
• If at any time carers to not have time to assist district nurses when they request so, take this as
a red flag.
• Be aware district nurses keep their own records of visits.
• Be aware that district nurses do not always communicate between themselves or with residential care
homes. And residential care homes with them.
• Do not assume that pressure care risk assessments are carried out correctly, ask and check. Do not
assume they are reviewed regularly as they should be, because needs change, ask and check.
• There is an accident incident book in every care home, check it if in any doubt about anything that
may have happened to your loved one.
• Never assume the doctor knows what is happening in a care home or a GP.
• Never assume that they give you the correct advice, always check. We were told that tissue
viability was for burns only, incorrect. This delayed our mum getting the correct treatment in a
timely way.
• If need be get your own private tissue viability advice.
• There is various equipment and clothing that can help with someone who has pressure wounds: look
online or ask. For example: protective booties, bed cradles, side opening underwear, nighties that
open at the back, clothing that can be velcroed on, pressure relieving cushions, wedges, heel
protectors etc.
• Do not have your loved one propped up in bed to sleep too high with too many pillows, this puts
pressure on the bones of the body.
• Never allow anyone to have your loved in wheelchair without foot plates! This will help to reduce
the flow of blood to the feet.
• Be aware that positioning is crucial in bed and chair, be aware of pressure areas as much as you can.
• Make sure your loved one is sitting upright and not slumped in the wheelchair or chair if possible.
• If riser recliner armchair used with foot rest that elevates, make sure pressure is not put on the
heels from it.
• Tilting in space wheelchairs exist! They are for healing up and preventing pressure sores. You can
move position of the person easily tilting slightly back and forth at different angles.
• There are chairs with pressure relieving equipment embedded in them.
• If you are a carer who moves or turns your loved one, get free help how to manual handle and turn
and move correctly – it is out there.
• Refer to http://www.nhs.uk/Conditions/Pressure-ulcers/Pages/Treatment.aspx
• Pressure Care Risk Assessment. Will also consider ways of avoiding putting any vulnerable areas of
skin under pressure.
• Ask for training and advice about pressure care, i.e. correct positioning, how best to support feet,
special equipment and how to use it.
• Debridement. This is the removal of dead tissue from the ulcer to help stimulate the healing
process. A local anaesthetic will be used. There are different forms of debridement, including
maggot therapy, ultrasound, laser, surgery, specially designed dressings and pastes.