Does anyone have a practical solution when needing to manually reposition someone in bed every couple hours thru the night on a regular basis to prevent bedsores? Any thoughts on how to lessen the impact to your own sleep?
My 88-year-old dad has an adjustable TempurPedic, but we have been told that we still need to reposition him every so often during the night (turning left or right, adding pillows for support, and so on.) to prevent a constant pressure to one area of skin. I've also purchased a ROHO cushion for his recliner and wheelchair. (My dad's doctor said even with the ROHO, Dad needs to shift his position now and then while sitting and to get up from the chair more often.)
The ROHO and the repositioning at night seem to be helping and a large, purple discolored area on his buttocks--that we are told is the last stage before a bedsore could develop--has thankfully turned from purple to pink--and in some spots to a normal skin tone--over a period of maybe six weeks.
Unfortunately the sleep interruption every few hours has been a bit of an adjustment for me and I'm also not getting as much sleep overall. Sometimes Dad wakes up when I go to turn him and then he wants something and it might be half an hour or more before I'm back in my own bed. Other times I just can't get back to sleep for some reason once I'm up, especially after the 3 a.m. turn.
Things are busy during the day and I can't always catch a nap to make up for it. My mom is 87 and needs her sleep. We do have a caregiving agency, but we already use them about 20 hours a week for our daytime needs. It would be a big expense to have them come every night as well.
The only thing I can think of is maybe a therapeutic air mattress like is used in a hospital or rehab setting. My understanding is that if you have this type of air mattress then there is no need to reposition at all, since the mattress inflates/deflates on a set schedule to prevent a constant pressure to any one area of skin. But it may be too difficult for someone with my dad's level of mobility to get out of this type of bed in the morning by himself without being lifted; I'm not all that strong in my arms and may not be able to help get him up.
Wondering if there are better solutions out there... your thoughts and suggestions greatly appreciated.
so its very important that you do care for the carer.
- As mentioned, the ROHO cushion on Dad's recliner/wheelchair we got improved his skin condition somewhat. But in the weeks that followed we saw no additional improvement--it seemed to level off.
- I continued repositioning overnight, but it eventually caught up with me and I no longer felt with it during the day. Sometimes I had trouble remembering this and that as I went about my daily tasks. This concerned me, both for my own health and because I need to stay on top of things for my parents.
- I eventually purchased a ROHO overlay for Dad's mattress (big, static air pockets). This appeared to help relieve pressure overnight. When Dad would get up in the morning, I noticed the area tended to look better than the night before. When I tried lying on the overlay myself, I hated getting back up--it was kinda like lying on air!
- I then asked Dad's dermatologist to look at the area on his buttocks. She told us that we needed to handle this pressure situation more aggressively to avoid it turning into a bedsore. She recommended turning overnight, but I explained that with the ROHO overlay in place it wasn't even physically possible for me to reposition Dad in bed. (I had tried this when we first got the ROHO overlay, but no luck.) She then suggested focusing on a better solution during the day and said if we got that part resolved, maybe repositioning at night wouldn't be necessary.
- I then started researching online the alternating-air cushions for wheelchairs/recliners There weren't all that many advertised online and none on Amazon. The prices were pretty ugly. I was also concerned because some of the customer reviews were negative in terms of reliability, ability to reach the sellers for resolution of a problem, etc. Eventually I chose a product from the Ease Cushion website. It had the most consistent, positive customer reviews I had found and extensive technical details about their product. They had me talk with their engineer about Dad's particular needs first and he recommended for Dad the Ease Cushion Stage 1 Overlay with Answer Pump. I chose the waterproof version. (The Stage 1 Overlay is actually one of their lower-priced models. Some of the alternating-air cushions on various websites run as high as two or three thousand dollars--or more.) Their engineer had me go to another of their websites to view its product details; he felt we'd be happier with their Answer Pump because it's portable and doesn't have to be plugged into a wall socket while in use.) Dad uses it about 12 hours a day and it sits on top of a regular foam cushion. The battery stays charged for about a week. It's nice because we can take it to doctor visits, restaurants, etc. and not have to worry anymore that Dad is sitting too long in one place.
- After a week or so of using the Ease Cushion Stage 1 Overlay, we started noticing improvement in Dad's skin tone. Occasionally I'd see flesh colored skin where there was previously red, even after he'd been sitting for long periods of time like an hour or so. This continued to improve so that there was eventually only a very small area of purple surrounded by flesh-colored skin.
- Yesterday we saw Dad's dermatologist again for a different skin issue. While he was being seen, I asked her to look at Dad's buttocks. She said the skin is back to normal now--no remaining pressure issue. Hurray!
I am so grateful we eventually found something that worked to resolve this skin issue--and works good enough during the day that I don't need to reposition overnight anymore. I've seen photos of what pressure sores look like and how bad they can get and have had friends tell me about the horrors of their loved one's pressure sore, and I sure didn't want that to happen to my dad.
It is called an Apex Neo-Turn 5300 and Medicare is covering it because mom developed a couple of pressure ulcers because of after now becoming bed bound from two broken hips (couldn't walk after the last one) and then broke her arm a few weeks ago (forgot she couldn't walk!) and even though she's always had great circulation and avoided breakdown before, I had her so doped up on Lortab for the pain and was busier than a one-armed paper hanger, I totally forgot to check her heels and they got bad. They are healing up as soon as I got the pressure off them, which I did as soon as it was brought to my attention (but at that moment I wanted to just die! I couldn't believe I had let that happen!).
But those ulcers were a blessing in disguise because my mom doesn't like to lay any way except on her back and anytime I tried to turn her on her side, she cried until I relented. She's good. ;-)
So getting this bed was the best thing so far that we've gotten to improve both of our qualities of life...she stays on her back and the bed gently turns her from side to side but the cells under her head are static so she doesn't feel sea-sick or anything like that. And there are cells on either side at the edge that stay inflated so that she doesn't roll into the rails on the bed. When we need to do something that does require manually positioning her in bed, there is a button I push and it makes the bed flat and static (but still inflated) while we do what we gotta do. I can adjust the time cycle for different increments, I think it is every 4 mins, 8 mins, 15 mins, and 60 mins.
The mattress costs something like $5000 but with a Dr.'s order that includes the proper diagnosis (one of which is bedsores and I don't know if there are any other qualifying dx such as immobility) Medicare covers 80% and the supplement gets the rest. They rent it for 13 months and if we are still using it then, it becomes ours and Medicare doesn't have to pay anymore. Kind of like medical-rent-to-own.
Look into it and see if you can get one or something similar to help your situation! Especially since your dad's circulation isn't optimum, judging from what you said about the healing time of the darkened area he developed...he's going to be very susceptible to pressure ulcers and if he gets one, it will require even more diligence to heal (or improve as they say) than you might be able to muster.
I think you could talk with his Dr. and figure out how to get it Medicare approved, considering your situation. In any case, I suggest you give it a try! You can't go on indefinitely doing this as you are...and I know that from personal experience.
The caring support and practical wisdom from folks on this site is awesome. Take care and very best wishes to each of you and your families.
In the 10 years of caring for mom, we turned her every 4 hours in the daytime. At nights, we took turns -one night she will sleep on her left side, the next night her right, then left, then right. We don't put her on her back at nights because she chokes on her phlegm and she can die if we both slept too deeply to hear her choking and suction it up. So, nights - she slept on her sides.
From the beginning, we had the air mattress. It inflates and then deflates. Mom's latest air mattress had very hard a bubbles that it left round red dark marks on her body. So, we used a pin to puncture a hole on the mattress so that some air comes out as it inflates and the bubble is not so hard...even with the inflation on the lowest level possible.
Also very important to avoid bedsores - I ordered one of those triangle pillows for the foot. It will cradle the feet and ankle so that she doesn't have pressure sores on her bony feet.
When she's on her back, to help relieve pressure on her legs, we would put a pillow right beneath her knees. On her sides, a pillow between her legs. As for her arms, she sweats when her arms touches her body. So we use those mini pillows (for babies) to put between her upper arm and the body, or a slightly longer pillow to put between her hand resting on her stomach.
Pressure sores also come from not moving much. So father had made it a point to mover her legs and arms - exercises. Get the blood moving. Hope this helps.
The air mattress is covered by Medicare. For us it was 80% coverage. We pay the 20%. Doctor has to prescribe it and you need to find a Home care supplier who accepts Medicare. In the end, I just bought the air mattresses instead of the hassle of taking mom to the clinic to get a prescription. Here - it cost about $200.00.
So, it's a combination of things that helps to prevent pressure sores.
Do you have a husband that could take a turn--in the turning?lol
I would go for the bed/mattress/whatever is automatic--to eliminate you physically having to get up-- that will assist in relieving the pressure. You may need someone to come in 2 over nights a week--midnight to 5 am-- at least you could sleep from 10pm to 5 am. I did that after awhile when my Mother was waking every 2 hours--or just yelling all night. It is not good for the caregiver. Please be proactive about this. I'm sure someone else will have a better idea, but this was my experience:) Take Care, xo