Anyone who is confined to bed for a long time is liable to develop bedsores, especially if movement is restricted or if sensation is impaired. The sores occur on those parts of the body that bear the weight of the body or rub constantly against the bedclothes. The most common sites are the elbows, knees, shoulder blades, spine and buttocks.
A bedsore begins as a patch of tender, reddened, inflamed skin. Later, it can become purple. Then it breaks down and an ulcer or sore develops. If any skin redness or inflammation occurs, consult the physician right away. The ulcers generally take a long time to heal and are quite uncomfortable and harmful to the patient's health.
Bedsores can be prevented. Someone confined to bed can still get a kind of exercise unless he or she is paralyzed or otherwise immobile. Every hour or so, a period of wriggling the toes, rotating the ankles, flexing the arms and legs, tightening and relaxing muscles, and stretching the whole body will both stimulate circulation and prevent joint contracture, or stiffening.
If a stroke patient cannot move or is very weak, gently bend and straighten the joints manually at least once a day. Also, change his or her position as often as you can at least every two to three hours, but more often if possible so that the pressure of the body on any particular area is relieved. This is most easily done, especially if the sick person is a great deal heavier than you, by using a draw sheet or by rolling the person from side to side. Otherwise, lift the person into a new position (enlisting someone else's help if necessary).
Dragging the person may damage the skin and increase the chances of bedsores. Use a bed or foot cradle (frames that raise the covers) to keep the weight of the bed clothes off the sick person's legs and feet.
If the person is lying permanently on his or her side, support the upper arms and thighs with soft pillows to keep the elbows and knees apart, and put a pillow between the ankles to keep them from rubbing against each other. The person will still have to be turned frequently to prevent bedsores.
Make sure that the sheets are always clean, dry, crumb free, and pulled as tight as possible to prevent wrinkling. If the stroke or disabled person is likely to be bed ridden for a long time, you may want to get a fluffy sheepskin (preferably a synthetic, washable one) for the person to lie on, to help cushion the whole body. Sheep skin bootees can be bought also, to protect the heels and ankles.
Also, wash the patient frequently and keep the skin on places that are vulnerable to bedsores particularly clean and dry. If you notice any reddening, keep pressure off that area and let the physician know that a bedsore is beginning to form.
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