Hi. Mum was moved to a different nursing home by the ICB about a month ago. Mum has end stage Alzheimer's and is bed-ridden. She's unable to communicate her needs.
Both of mum's legs have been contracted for about 18 months. The contractures developed during the months following hip replacement surgery in 2021, after which she was unable to comply with OT & Physio input due to her lack of cognition. Mum's distress at being hoisted resulted in her becoming bedbound.
The contractures mean that both of mum's legs are bent at the knee and are flopped across to her right hand side, with her left leg resting on top of her right - skin on skin. Mum always lies on her back with her hips/pelvis twisted to her right. She's repositioned 4 hourly, but carers are unable to change her position by much due to the contractures. In recent months, mum developed moisture lesions between her legs, which were successfully treated. Quite rightly, the care home requested another referral to OT with a view to seeking their advice on positioning/equipment to prevent skin breakdown. Unfortunately, OT declined to assist as mum had been diagnosed as EOL - that's a disgrace, but another story. Consequently, the care home used pillows, cushions and folded towels to alleviate pressure. They also used extra pillows under mum's upper arms (shoulder to elbow) to provide further pressure relief. Mum was, and still is, laying on an Airflow mattress.
Since being in her new care home, I've noticed that there are no extra pillows placed anywhere around mum and her contracted legs are once again stuck together, skin on skin. I raised the issue with the nurse, bringing her attention to the moisture lesions which had previously occurred. The nurse responded by stating that mum's skin is checked regularly and that the skin between her legs looks healthy. I asked if a pillow could be placed between mum's legs to help prevent moisture lesions (or worse) developing again and she said that she might have a cushion somewhere! I was rather dismayed by her response.
I'm not a nurse, but I do understand the concept of preventative measures to avoid the development of pressure ulcers, of which mum is at high risk. I will contact the ICB, as the contract for mum's care is between them and the care home.
I wonder if anyone reading my post has experience of dealing with contractures, frailty and pressure ulcers, and how the situation was dealt with by caregivers and healthcare professionals?
Both of mum's legs have been contracted for about 18 months. The contractures developed during the months following hip replacement surgery in 2021, after which she was unable to comply with OT & Physio input due to her lack of cognition. Mum's distress at being hoisted resulted in her becoming bedbound.
The contractures mean that both of mum's legs are bent at the knee and are flopped across to her right hand side, with her left leg resting on top of her right - skin on skin. Mum always lies on her back with her hips/pelvis twisted to her right. She's repositioned 4 hourly, but carers are unable to change her position by much due to the contractures. In recent months, mum developed moisture lesions between her legs, which were successfully treated. Quite rightly, the care home requested another referral to OT with a view to seeking their advice on positioning/equipment to prevent skin breakdown. Unfortunately, OT declined to assist as mum had been diagnosed as EOL - that's a disgrace, but another story. Consequently, the care home used pillows, cushions and folded towels to alleviate pressure. They also used extra pillows under mum's upper arms (shoulder to elbow) to provide further pressure relief. Mum was, and still is, laying on an Airflow mattress.
Since being in her new care home, I've noticed that there are no extra pillows placed anywhere around mum and her contracted legs are once again stuck together, skin on skin. I raised the issue with the nurse, bringing her attention to the moisture lesions which had previously occurred. The nurse responded by stating that mum's skin is checked regularly and that the skin between her legs looks healthy. I asked if a pillow could be placed between mum's legs to help prevent moisture lesions (or worse) developing again and she said that she might have a cushion somewhere! I was rather dismayed by her response.
I'm not a nurse, but I do understand the concept of preventative measures to avoid the development of pressure ulcers, of which mum is at high risk. I will contact the ICB, as the contract for mum's care is between them and the care home.
I wonder if anyone reading my post has experience of dealing with contractures, frailty and pressure ulcers, and how the situation was dealt with by caregivers and healthcare professionals?
