The 40-70 rule emerged as a guide to help families talk to their senior loved ones about how they will be taken care of as they age and become more dependent, and about what both parties feel, think, and expect of their lives during this stage.

It is meant to be a way to improve the communication gap that may exist between adult children and their senior parents.  The condition of aging commonly shocks family caregivers profoundly, because of the many difficult situations that come up during this phase of life.

Sometimes it can be very hard to talk to your dad about him crashing the car against a pole, or to ask your mom if she is taking all her medications as the doctor prescribed, or to find the way to tell your parents that they need more help at home.  This is challenging even for families where communication is open and trusting, and in many cases what happens is that people decide to not say anything at all, leaving many situations unresolved.

Adult children have to learn to talk to their senior parents sooner than later, before a serious crisis is just around the corner or has already taken place, and this is what the 40-70 rule is all about.  It helps families with senior loved ones deal with sensitive topics and difficult conversations right on time.

Basically, the rule is that if you are 40 and your parents are 70, you have to start talking about certain senior matters.  This rule is based on the fact that 1/3 of adults in the United States have problems talking to their parents because of the prolongation of the parent-son role.  Yes, many parents continue to have a very controlling relationship with their children, even after they become adults, making certain conversations quite difficult.

Do not wait until your aging parent is partially or totally bedridden, cannot understand you, or requires the help of a bariatric mattress to prevent bed sores; because sadly, this happens too often, and you end up regretting not having had the opportunity to discuss their wishes and expectations with them.

Get more information about the 40-70 rule; read this booklet, and get the help you and your senior loved one need.

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Living with pressure sores is never an enjoyable experience. If you are at risk of developing them, or you are taking care of someone who might be at risk, get informed about pressure sores to avoid developing these unpleasant injuries.
This guide will tell you the best ways to prevent and care for pressure sores.

What are pressure sores and what causes them?

Pressure sores are also described as bed sores, pressure ulcers or decubitus ulcers. They are formed when constant pressure on part of the skin causes the blood vessels feeding that part to shut down. At first, this causes a red or dark patch on the skin. As further pressure is applied, the skin continues to deteriorate, breaking down to form blisters and dead skin, and then going on to affect underlying tissues, bones and joints.

Pressure sores can appear on any part of the body, but will usually develop on parts most susceptible to pressure when sitting or lying down, e.g., the lower back, buttocks, shoulders, hips, heels, knees and ankles.

In general, people who are bed-bound or in wheelchairs are particularly susceptible to developing bed pressure sores. Other factors that increase the likelihood of developing these sores include old age, immobility, incontinence, malnutrition and dehydration, diseases that slow healing, mental disorders that result in a lack of awareness about the body’s condition and the taking of certain medications such as sedatives.

How will I know if I have a pressure sore?
There are four stages of severity in the development of a pressure sore.
-  Initially, you may find it appears as a red area of skin (or a darker area of skin than normal on darker skins). It is a mark that doesn’t disappear after a few hours and may also feel tender. Sometimes, the initial appearance of a pressure sore may appear like a bruise – purple in color and painful to touch.
- The second stage may include a partial loss of skin that may appear as a blister, shallow crater or abrasion.
- The third stage of severity involves a full skin loss which extends to the underlying skin tissue.
- The last stage involves a total skin loss and the sore extends to the underlying tissue, muscle and bone.

How do I treat existing sores?
Properly caring for your existing pressure sore is the best way to promote healing and prevent it from becoming more severe. You might be caring for your pressure sores yourself or have a caregiver who cares for them, but it is always best to be informed about the process. Here are four main steps that need to be followed:

1. Pressure relief
Continuing to place pressure on an existing pressure sore will aggravate the sore and prevent it from healing. Instead, it is essential to relieve the area from any form of pressure. If possible invest in a pressure-reliving mattress or pressure relieving aids such as cushions to help you.

2. Cleaning
Pressure sores will heal well if they are kept clean and it will also ensure the prevention of infection. This means they should be free of dead tissue, have excess fluid drained away from the sore and should also be clear of any other debris. A healthcare professional should show you how to clean or rinse the sore and also how to wipe away any loose material. The right equipment and methods should be used too. If too much force is used, it can aggravate the sore or if not enough force is used, the wound may not be cleansed properly.

3. Removing dead tissue
Dead tissue which is present in the pressure sore can lead to infection and prevent the sore from healing. Your healthcare professional will usually carry out the process of removing the dead tissue. Since it may be painful, a pain-reliever may be taken beforehand. Procedures that may be used can range from simply rinsing the sore to applying enzyme medications to dissolve the dead tissue. In rare cases, surgery to remove deeply embedded dead tissue may be required.

4. Dressings
It is important to choose the right dressings to care for your pressure sores. Speak to your healthcare professional about the different types available. You will require different types depending on the type that will best aid healing, how often the dressing needs to be changed and whether or not the sore is infected.  Dressings are normally required to keep the sore moist and the surrounding skin dry.

What else should I know?
When cleaning your sores, it is a good time to check for signs that it is healing well. Ideally, you should see signs of a sore healing within 2 to 4 weeks. This includes seeing a decrease in the size and depth of a sore and a decrease in drainage.
Also, you should look out for any signs that the sore has become infected as the infection can spread to the underlying tissues, bones and even to the rest of the body. Signs of infection include having think green or yellow drainage, a foul odor, redness, warmth or tenderness surrounding the sore and swelling. Watch out for signs of fever, chills, weakness, confusion, difficulty concentrating and rapid heart beat that can indicate the infection might have spread throughout the body. If you are concerned and experience any of these symptoms, contact your healthcare provider immediately.

To manage the pain that pressure sores cause, changing your body position is often a factor that helps. In addition, some patients may choose toe an over-the-counter pain reliever or ask their doctor for a prescription.

How can I avoid developing pressure sores?

There are many ways to prevent pressure sores from occurring. Try to incorporate the following tips into your daily routine:

-    Examine yourself very carefully ever day for any signs of sores developing. Recognizing you have a sore developing at an early stage will help you take care of it and prevent it from becoming more severe.
-    Eat a nutritious and balanced diet, with extra protein to help keep your skin tissue healthy. A good diet will ensure your body has what it needs to heal itself well and cope with infection.
-    Use barrier creams or protective creams to protect areas that are susceptible to becoming moist.
-    Protect vulnerable areas of your body from pressure, fiction and moisture. If you are in a wheelchair or undertaking bed rest, it is essential that you change your body position every two hours (or it is recommended that those sitting down change positions every hour). Your caregiver or physician can give you guidance on which positions are best to use.
-    Keep you skin clean, dry and well-moisturized. Moisturize your skin thoroughly after washing as skin can be weakened when it dries out. Avoid using talcum powder which depletes the skin’s natural oils.
-    Make sure any existing sores are cleaned, dressed and bandaged properly.
-    Drink at least 2 liters of fluid a day.
-    Make sure there are no wrinkles or crumbs on your bed sheets or chair.
-    Go to great lengths to avoid rubbing areas of your skin that could get sore. This includes avoiding dragging your heels or elbows when moving around in bed.
-    Invest in pressure-relieving aids such as pillows, sheepskins and foam pads. The best investment patients can make to prevent pressures sores is buying a good pressure mattress. These mattresses are designed to relieve any pressure that is exerted on a patient when lying down. Some designs even help reposition the patient’s weight every few minutes, meaning there is no need to continually reposition them. Pressure-relieving mattresses are one of the best tools used to prevent the development of pressure sores.

If you liked this article, tell all your friends about it. They’ll thank you for it. If you have a blog or website, you can link to it or even post it to your own site (don’t forget to mention www.volkner.com as the original source).