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Mom has a red spot the size of a nickel or quarter on her buttock that the hospice nurse says looks like the beginning of pressure spot. She recommended repositioning her every 2 hours, butt cream, etc. She's been pretty much bed bound for the past year. She has stopped eating and drinking, mostly due to Achalasia complications and copious amounts of phlegm that cause her to choke. The doctor will no longer do the botox injections, which helped Mom get food and water down, because he says her overall health would make the outpatient procedure too risky. She has lost a lot of weight from this. She is on a transderm scop patch to dry up her secretions. If we take it off within an hour or two she starts choking and gagging on the phlegm. It is so difficult. I haven't been good about moving her around. She can move herself a bit and will grab her bed rails and move onto her back or her side, even after we turn her. Aside from the nurse's instructions is there anything else I can do to keep this red spot from getting worse? Mom has never had one in the 10 years I've been caring for her so I have no experience with this. How common is this at this stage? I work full time and have a caregiver come when I'm at work. The hospice nurse showed the daytime caregiver how to protect Mom's skin. The nurse told me mom is comfortable and needs to be turned every 2 hours or so to try to prevent the pressure sores and don't worry about turning during the night. My mom also hasn't been urinating much, probably because she's not drinking but a few ounces a day. I was just thinking that maybe the patch and lack of fluid intake are contributing and will ask hospice about it. When she drinks water or her shakes, and they manage to get past her esophagus and actually into her stomach, she sometimes gets severe stomach pain and throws up. I'm just sitting here watching her sleep, feeling awful because of this red spot and her not eating or drinking or peeing. I feel so dang guilty for not taking better care. Aside from the nurse's instructions does anyone have any advice on how to keep this from getting worse? Peace and blessings to you all.

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A lot of people on the forum have used alternating pressure mattress pads and say they are a god send.
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Calmoseptine is what I use on my Mom when she comes back from the hospital with a beginning bed sore. It is a thick pink paste and I buy mine on Amazon. I also purchased an alternating pressure pad.
If you search bed sore, you can see what people are doing. My Mom doesn't really like to be on her side, so I am so blessed that she has not developed a bed sore in nearly 2 years of being bedridden.
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Oh, gosh, Dees, my heart breaks for you...just breaks. I’m not sure what’s worse, having to watch them suffer day after day or finding them one day and seeing they’ve gone Home during the night. Either one is such a helpless feeling. Bedsores are an ever-present issue with my hubby as well. He doesn’t move all day, except when I roll him to change him. He’s a big guy and I am only strong enough to do that once a day. All you can do is the best you can. Mom is getting hospice and medical care. You speak with her caregivers often and it sounds like they’re good ones. Blessings to you for being you....sending many hugs.
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Definitely ask for an alternating pressure pad, with upturned edges to prevent falling out of bed. Turning also helps, laying her on her side, if she's not a roll out risk.

My father was in a very similar situation. Aides and nurses also put pillows under his knees and ankles to keep them elevated. Keeping the ankles from rubbing against the mattress could help prevent pressure sores on the backs of the ankles.

Is she losing a lot of weight?

You should not feel guilty at all; it's definitely not your fault that these complications have developed. Being bedbound, not able to swallow much food, having thick secretions are complicated issues.

What you can do to compensate for her discomfort is be with her, hold her hand, play music for her, and talk to her.
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Thanks everyone. I'll request the special mattress and try the other recommendations. I appreciate your responses so much!
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I've read that pressure sores are more common and harder to heal in the last few months of life, the body just doesn't heal as well any more 😟Repositioning doesn't have to mean completely rolling her side to side, even small adjustments periodically will shift her weight. I was amazed at how long it took for a quarter sized red spot to fade on my mom (weeks!), it proved to me that much of the damage was below skin deep.
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Make sure she's sitting on a very soft surface like a nice bed pillow, also powder helps, sometimes skin can drag across diapers and tear even, skin gets very thin as we get older. Hope this helps.
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Thank you, everyone. I appreciated all of your suggestions. My beloved Mom passed yesterday. Blessings to you all and your loved ones.
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Also along with the above advice ask the hospice nurse to order a sheet of Duoderm. It works to cover the area and prevent any sweat or urine on that spot & is easily applied. If they don’t provide it, i’ve Seen it in Medical supplies stores. We used it on small reddened areas in home care. The most important intervention is to reposition every two hours.
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Oh, Dees! I'm so terribly sorry for your loss!

((((((hugs)))))))))
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