Pressure sore prevention

Good news luckygirl!!
Hope you didn't mind the comment, sometimes it takes somebody outside the immediate issue to see more clearly.
Bottom line, you need to see what is available for both of you out there and tap into it!
(We're fine - there are those much worse off than us. )

Best wishes to all you carers. I hope you have family support. It must be so demanding. Sending you hugs.....

That's good news, luckygirl.
Very quick response: always nice to know when someone gets such good care. Hope it goes ok.

Thanks so much for all the ideas - and photos, and links.
I have organised or a DN to come out and give us some advice - she/he is coming on Monday, so a very quick response.

MawB - so sorry that your OH is so besieged with health problems.

In the hospital when they face these problems with sores they change the mattress to an inflated one.

You need correct advice as these sores can become nasty.

Sounds like you are dealing with a lot bless you

Luckygirl yes the ring will do more harm than good. As others have said you need to get the DN round as soon as possible - your DH needs an air mattress

Air Overlay

He won't need to change position, have pillows, sheepskins here and there, the mattress moves and disperses the pressure.

In view of his AF maybe he should have a profiling bed (hospital style) then he can be more upright comfortably, with his feet slightly raised

bed

There are many different types and not all come with the cot sides, in case that's something he would object to at home.

All provided and maintained by the NHS.

If it is available (and recommended) I am only too happy to accept gratefully whatever is offered.
Paw is a poorlier person than many people have realised and this could have been a bit of a turning point. Being bed bound could lead to chest infections as he is immunosuppressed and possibly finish off his lungs (pulmonary fibrosis plus asthma) being chairbound would have meant a wheelchair and the oedema which results from his kidney problems (hepato renal syndrome) would be worse, he has AF, UC, and an incurable liver disease (PSC) and 8 weeks in hospital really knocked any stuffing he had out of him!!
Whether 6 weeks of "Re-enablement" will do more than return him to his baseline of earlier this year, who knows, but I am grabbing all help or therapy on offer!
If I am not being intrusive, I think you sound as if you could benefit from more external support too.

All interesting info - it sounds as though Paw is getting the full works!

My aim here is prevention as he is so very thin and I was quite shocked that he could get such a bad ulcer from his truss after only wearing it for one day.

My grandma - who weighted in at about 5.5 stone at the end of her life - died from her infected pressure sores, so it somewhat concentrates the mind!

Maw that sounds good. You do not want to feel that your home has been invaded by strangers. Hopefully over the next 6 weeks Paw will regain some muscle power and he will be marginally more self reliant.

The district nurses here have a dedicated team who can come and advise on pressure relief. Not everything works for every body, you sort of have to suck it and see, but your first point of call is definitely the district nurse.

Charleygirl we have opted for twice a day, late morning/lunchtime and bedtime (7 ish) More than that would have been too intrusive IMO as it is, life is pretty busy in the mornings but we could have had up to 4 visits a day for the 6 week period.
Paw is happy to stay in PJs for the morning either in his armchair in the bedroom or sitting up in bed. I can empty catheter leg bags, detaching the night bag and assorted other bits.

https://www.gransnet.com/uploads/talk/201709/medium-346611-image.jpg https://www.gransnet.com/uploads/talk/201709/medium-400128-image.jpg

Paw has also been given 2 seat cushions like this one for his armchair downstairs and for the one in the bedroom.
Not things of beauty but the Re-enablement Team threatened me with dire consequences if he didn't use them.
I just put them on to of the existing seats so easy enough to remove if I want to.
I realise how lucky we have been with the post-hospital community support system. Regular Physio and OT visits, 6 weeks of Carers if we want and someone at the end of a phone when I have needed them .
Hope this helps.

Maw how often to the carers come in to attend to Paw, is it x2 daily, to get him up, washed, dressed, catheter care and then the reverse at bedtime?

Paw has been given a tube of ProShield.

I think the most up to date info I have (from just a month or two ago) was that drapolene (sp?) is now used.

I am well aware that this is not practical but moving the bedridden patient from side to side two hourly is one way. If a person is placed on his/her side, a pillow should be placed length wise between the legs. Try it yourself in bed and you will get an idea of the best angle for the pillow.

Pillows put in the wrong place eg length wise under a leg if the patient is lying on his back could cause a DVT so please be careful.

DN told me to stop using sudocrem as it is too drying , she gave us a big tub of another cream , can't remember the name, but DN is the right place for help and advice

Thanks for the ideas - he sits up during the night because if he lies down, and particularly if he lies on his side, he goes into AF.

The idea of a pillow under his knees so that his feet can be flat - might try that tonight.

He has already had a nasty ulcer caused by his truss and it was a bit of a wake-up call - it has taken a few weeks to heal.

Best to get professional advice ASAP and just a warning, I have been told Sudocrem is no longer recommended as a barrier Cream (why? No idea) so do check with a DN

This may be a bit off the wall, but would it be worth considering a body pillow under one side of his body so that he is more likely to sleep on his side?

Also after a spell being bed-bound last year, the DN recommended Sudocrem for a suspect BS, as per an earlier post.

Please do, luckygirl. Pressure sores are so hard to heal, once they've broken the skin. They start a while before they show as sores, so best to plan ahead, as it were.

Yes he was a GP - but so much of what he knew seems to have been eaten up by the PD. We are registered with a different surgery from his previous practice; but I might simply look up DNs and see if I can contact one directly. I had a feeling that the rubber ring and sheepskin might be old hat!

He is up and about all day, so this is good, but so thin that he gets sore overnight.

Isn't your DH a doctor, Luckygirl? Or am I confusing you with somebody else.
I would hope the DNs etc at his surgery (former surgery? ) would be offering advice, assessment and some action.
Good luck, 7 st is very thin indeed and if he were in hospital all the "pressure sore" alert bells would be ringing!

Just for now. The district nurse put a pillow under my husband's knees which had the effect of placing the feet flat on the bed instead of the heels. It was only an immediate solution but it did help.

Ours is called a REPOSE inflatable mattress overlay, for information.