Following is the staging system that is most widely used to differentiate the condition of pressure sores.  It is consistent with the National Pressure Ulcer Advisory Panel and with the International Association for Enterostomal Therapy; thus, we highly recommend it to evaluate a bedridden patient’s condition in regards to developed pressure sores:

Stage I
Nonblanchable erythema of intact skin; the heralding lesion of skin ulceration.

Note: Reactive hyperemia can normally be expected to be present for one half to three fourths as long as the pressure occluded blood flow to the area (Lewis and Grant, 1925).  This should not be confused with a Stage I pressure ulcer.

Stage II
Partial thickness skin loss involving epidermis and/or dermis.  The sore is superficial and presents clinically as an abrasion, blister, or shallow crater.

Stage III
Full thickness skin loss involving damage or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia.  The sore presents clinically as a deep crater with or without undermining of adjacent tissue.

Stage IV
Full thickness skin loss with extensive destruction, tissue necrosis or damage to muscle, bone, or supporting structures (for example, tendon or joint capsule).

Note: Undermining and sinus tracts may also be associated with Stage IV pressure ulcers.

It is crucial to know at what stage the bedsores are to be able to assess the patient’s condition, dangers he or she may face, and the best treatment for his or her specific case.

In most cases, life-threatening bedsores, the ones at Stages III and IV, can be prevented and stopped at the first two Stages with prompt and rigorous treatment and with the constant use of devices like the low air loss mattress. Nevertheless, there are two limitations within this staging system:

One, it may be difficult to identify Stage I pressure sores in patients with dark pigmentation skin.

Two, When there is an eschar (a layer of dead, burned tissue), it is not possible to identify the severe staging of the sore until the eschar peels away or the damaged tissue has been surgically removed.

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There are several factors that have been acknowledged as things that put a person more at risk of developing pressure sores.

As soon as a person is spotted as a high-risk individual, certain measures have to be taken to reduce or eliminate the risk of him or her developing bedsores.

It is imperative that the care provider, whether it is a nurse or a family member, is knowledgeable about these risk factors in order to be able to prevent the unnecessary and painful development of pressure sores.

The risk factors will vary according to the patient’s specific circumstances; nevertheless, this is a list of the 5 most common risk factors:

1.Being confined to a bed, chair, or wheelchair
Individuals who are confined to a bed, a chair, or a wheelchair, and who are not able to move by themselves, are at high risk of developing pressure sores extremely fast; in as little as a couple of hours, if the pressure is not relieved regularly.

2.Being unable to change positions without assistance
Persons who are in a coma, who are paralyzed, and who are recovering from a hip fracture or other injury that limits mobility, are extremely prone to bed sores.

These patients must be moved consistently at regular intervals, and this is very difficult on caregivers, reason why it is imperative to get a pressure mattress to help both the patient and the caretaker.

3.Losing bowel or bladder control
People who have to remain in bed for long periods of time or permanently and lose the capacity to control their bladder or bowels are in danger of getting bedsores because the continuous moisture on the skin due to urine, stool, or perspiration can irritate and weaken it.

4.Eating bad, having an imbalanced diet and/or dehydration
Pressure sores develop more easily when the body and skin of people who have lost most of their mobility are not adequately nurtured.

5.Losing mental awareness
A person who is losing mental awareness may not have enough sensory perception or capacity to take action to prevent the development of pressure sores.

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The majority of pressure sores can be prevented, and the ones that do develop, do not need to get serious or even life threatening.

The caregiver has to consider the patient’s special circumstances when creating a care plan to make sure the person does not develop pressure sores that were preventable in the first place.

Here we give you a list of the 10 precautions that care providers should, but commonly neglect to oversee to avoid pressure sores:

1.They should make an initial proper, thorough, and methodical assessment of the patient’s risk of developing pressure sores.

2.They must conduct accurate periodical assessments to measure the patient’s risk.

3.They have to bathe the patient well and thoroughly.

4.They should assess and treat the patient’s incontinence condition to make sure that excess moisture on the skin does not cause pressure sores.

5.They have to maintain the patient well hydrated and eating enough and right.

6.They must reposition and move the patient at regular intervals to make sure the pressure is relieved properly.

7.They have to use proper support and moving devices such as a low air loss mattress, to relieve pressure from critical areas.

8.They should take into account postural alignment, weight distribution, balance, stability, and pressure relief when helping the person sit on a chair or wheelchair.

9.They have to use the right lifting devices and techniques to make sure that shear and friction do not cause pressure sores.

10.They must get educated on the best ways to prevent bedsores and find documentation that supports those measures.

In essence, every patient is different, and each one will present different conditions or combination of conditions that should guide the creation of the best care plan for him or her.  The caregiver should be able to see this uniqueness in order to prevent the patient’s condition from getting worse out of neglect.

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On the past several years there have been numerous concerns over shortages of staff and lack of beds in hospitals nationwide.  As an alternative and an answer to the problem, many states, and in fact countries, have developed what is often referred to as “hospital at home” services that provide the same care to patients in a home environment instead of a hospital setting. With the availability of hospital equipment such as hospital beds, a pressure mattress overlay, and the ease of finding qualified at home professional practitioners it has become fairly easy to create a caring and medically sound environment for patients outside of the hospital. In order to determine the quality and validity of such services, studies have been initiated by several organizations to evaluate overall patient health, patient satisfaction and cost savings.  Here are some of the results that were recorded.

Patients who were recovering from stroke did better in a hospital environment than an at home setting, for the first three months.  The study showed a significant reduction in mortality rates, however, after six months for those patients provided with hospital at home care.

Overall, patients who were provided with a hospital at home setting for a variety of conditions were far more satisfied than those who remained in hospital.  Studies were all in agreement that most people prefer to be cared for outside of a hospital and are more comfortable and satisfied in a home style environment.

Other trials noted that fewer patients in a home care setting developed other complications such as bowel or urinary complications.

For patients who were suffering with dementia, those who were receiving hospital at home care were less likely to be prescribed antipsychotic drugs.

For patients suffering from cellulite, there appeared to be no differences between the hospitalized patients and those receiving hospital at home care.

Patients who were being treated for COPD in a hospital at home care were prescribed antibiotics more often than those who were being treated in hospital.

The studies showed no significant differences among patients in or out of hospital when looking at their ability to perform day to day functions or in their cognitive abilities.

From an economic viewpoint, most hospital at home care programs were less expensive than hospital care.

It should be understood that, even with such studies, one should not preclude that hospital care is not as beneficial as home care in every situation, as hospital admittance is often necessary for the overall health of the patient.  But where there is the possibility of a patient receiving adequate care in a home style setting, it can be more comfortable, satisfying, and cost effective.

It is also worth mentioning that the quality of services and personnel that provide the hospital at home care should be carefully selected and closely monitored, and that a primary care physician be in constant contact with patients and caregivers.  It is not enough to merely assume that a patient is always better cared for at home or in a home style environment, than in a hospital.

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If you care for a loved one who has mobility problems or who is perhaps, totally bedridden, then you know how important it is to have help with the ongoing tasks of every day care.  Many of the health concerns that pose a threat to your loved one can be alleviated with the use of innovative products such as a bariatric mattress, adjustable beds, and sheepskin bedding.   Equally valuable, however, is the support and aid of qualified and professional help.  A CNA or Certified Nursing Assistant can often be a lifesaver for the overburdened caregiver.  Finding such a valuable helper can be a challenge but here are a few pointers that may help.

Keep in mind that each state has their own requirements regarding licensing and certification.  The title of CNA may even vary from location to location.  The best way to be sure you are working with a qualified professional is to ask for proof of certification.  The words certified, qualified and licensed are often used interchangeably, so it is very prudent to know how your area handles this issue.

While the names may vary, the basic qualifications are the same.  This person is neither a Registered Nurse, or a Registered Nurse Practitioner, both of whom has taken more education and is more qualified than a CNA.

Although a nursing assistant does not have a say in the actual medical treatment of a patient, they can be a very valuable resource in some of the less medical aspects of care such as bathing, grooming, dressing etc.  A CNA will have also had training in the best methods for turning, lifting or moving bedridden patients to ensure good health and comfort.  Since this is often one of the most exhausting caregiver tasks, having some help here is well worth the investment.

Although not directly involved with the medical side of things, a CNA is adequately trained and knowledgeable enough to be a great liaison between caregivers and professionals.  They have received their training within a hospital setting and are familiar with equipment, terms and procedures, as well as medical terms and conditions that may be confusing to the average person.

A qualified nursing assistant can also help with such tasks changing dressings, monitoring vital signs, and recording any changes in condition.  In addition, they can also help with changing linens, observing the condition of equipment and keeping an eye on the overall well being of the patient.  Their training and experience makes them alert to little things that might otherwise go unnoticed.

The presence of a nursing assistant is a great aid as well to the registered nurse and physician in charge of a patient because they are free to concentrate on the most important aspects of your loved ones care.

If you are caring for a bedridden patient at home, a CNA can truly be an extra set of eyes, ears and hands to help relieve caregiver stress and increase patient comfort.

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If you are the caregiver for a person who is confined to a wheelchair or bed you already know how vulnerable they are to certain health risks.  By utilizing the many services and products available today such as air pressure mattresses most of these conditions can be alleviated or prevented altogether.  It is always wise to be aware of the health risks and alert to controlling them before they become life threatening.  Here are 6 common conditions that caregivers should take care to keep a watchful eye on.

Bedsores
One of the most significant risks to the bedridden patient is the development of bedsores.  These lesions can develop and progress very rapidly in the patient who remains in the same position for too long.  Constant pressure on certain areas of the body decreases the amount of blood flow to those spots and friction increases resulting in damage to the skin.  Eventually the flesh actually dies and the lesions can become quite deep, even to the point of infecting the surrounding bone and muscle. By using an alternating pressure mattress which turns the patient on a regular basis, theses sores can be prevented.

Pulmonary congestion
Patients who are confined to bed and are unable to turn themselves are susceptible to several other serious conditions as well, one of the most significant being pneumonia and pulmonary congestion.  If the patient cannot turn themselves and remain immobile, pulmonary secretions can build up and become a threat to the patient’s health.  With the automatic gentle turning provided by a pressure mattress system, the secretions are loosened and do not build up.

Spinal column pressure
The gentle turning of the patient with a pressure mattress also helps to reduce the occurrence of back pain that can be caused by constant pressure on the spinal column.   This greatly increases patient comfort and overall well being.

Sleep problems
If you’ve ever slept on a bad mattress you can fully understand the importance of comfort to a good night’s sleep.  If a patient is unable to move themselves, the body becomes extremely stiff and uncomfortable, resulting in disrupted sleep.  With the constant gentle turning provided by an air pressure mattress, the patient is able to have a solid nights rest which ultimately helps improve overall physical and emotional  health.

Loss of appetite
Lack of movement and stimulation can quickly lead to a loss of appetite which can in turn result in very poor nutrition.  Providing adequate stimulation can help to prevent the patient from losing interest in food.  Bedridden patients should be provided with a variety of activities such as music, movies, reading, puzzles, social interaction and conversation.  Food should be interesting and appealing even if the patient is unable to feed themselves.

Depression
If other conditions such as a lack of social activity, loss of appetite and lack of sleep are allowed to persist, the bedridden or wheel chair confined patient can also become unresponsive and depressed.  This can be avoided by ensuring that the patient receives proper care and attention to the personal needs, both physical and emotional.

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