Skincare for bedbound patient at home

[Notverygrownup]

Mum had a fall and a hip replacement but because of her severe dementia she would not co-operate with the physios and so has lost the ability to walk. She has also lost the ability to swallow, but we are confident that we can give her soft foods and that she would want to be home with her husband if at all possible. She knows (and loves) him.

She will be returning home with a hospital bed and hoist, and four care visits a day, morning, noon, afternoon and evening. However she will be in bed for 12 hours a night with no care visit planned/available to turn her. And I have had no advice or support from the hospital to know how to manage this.

She could pay for a private night time visit from carers. Or I have found matresses online which cost £1000+ with an air pump so that they vary the shape of the matress. She could afford one and I am pretty sure that it will be essential - but would she still need turning regularly. Am I mad to have said that we could manage her? (I have been concentrating on finding out about her new physical needs, organising the care package, learning about her new medications and eating regime - skin care has only just come to the top of the list)

Posting at a mad time of day, so may bump for traffic later. Any advice much appreciated.

[Digestive28]

I would ask for an occupational health assessment - the GP or hospital should be able to refer and they will be able to advise about mattresses. There is all sorts of devices which can do the turning for you etc but worth getting advice. If no luck that way then maybe worth trying age concern contact helplines as can put you in touch with local support agencies. Good luck
In relation to skincare, no idea!

[Digestive28]

There Is also some NICE guidelines about pressure ulcers which maybe worth looking at, it outlines the current evidence base treatment etc on the NHS so maybe worth looking at and seeing current advice

[Toddlerteaplease]

An OT should be able to help with the mattress. If she's list the ability to swallow, I would not want to feed her anything until she's had a salt assessment. She could aspirate on food and fluids.

[Domino45]

The OT would be able to advise/ assess whether she meets the criteria for a hospital bed or a pressure relief mattress. I would have thought this would have been considered as part of discharge planning by the hospital. If she returns home without the equipment and her skin starts to deteriorate a referral to the district nurses can be made and they can assess in the community. I have come across a toto bed before which turns the mattress automatically but district nurses assessed for this.

[Notverygrownup]

Thanks. Yes, she has had the SALT assessments - just mentioned that for context.

Will go back to the OTs re turning and skincare. Thank you

[cheesywotnots]

If they have ordered a hospital bed they may have ordered a pressure mattress too, just ask the o.t, she will also need a pressure cushion if she is going to be sitting in a chair or maybe a riser chair if she is immobile, again the o,t, can organise this. If she is incontinent this will affect her skin and comfort so ask for an assessment and an overnight visit from either the carers or the district nurse team. I would ask to speak to the discharge planner and get a copy of her needs assessment and careplan. It should details what her needs are, what equipment t is being delivered, where the hospital bed and hoist will be placed, what training the carers have, what her swallowing plan is and has she been referred to the community ity speech therapist, dietician, district nurses and continence service.

[Bebe03]

The hospital will order one for her, if not the district nurses who I imagine are already involved will get on for you. They are standard equipment so won’t need an specialists health professional to assess. Do you pay for care? Have you had an assessment to see if you can get funding in the community? The discharge nurses may have done one whilst in hospital, maybe worth checking?

[Notwhoyouthink35]

Cavlon cream is used to pressure sores. There are night time carers that come in through the night in most areas, I’m pretty sure she would be entitled to a over night visit.

There are lots of people like this living at home, with the proper care package you will manage fine.