Does anyone know how to cope with cellulitis?

[AestheticallyChallenged]

This should really be in the Elderly Parents board but I'm posting here for traffic. My elderly mother has cellulitis in both legs due to ulcerated varicose ulcers and discoid eczema. She's on antibiotics and the nurse at her GP is dressing her legs twice a week. She's supposed to keep the bandages on but she fiddles with them and takes them off so the legs can't heal. Then she tries to redress them with dirty bandages that have been on the floor. Her legs ooze and weep fluid constantly so the bandages become saturated quite quickly. She's supposed to rest and elevate her legs but she has severe restless legs syndrome so she fidgets and moves about constantly day and night with only snatches of sleep. She's got many other health conditions and cognitive decline. I arrived yesterday to find she'd removed her bandages and her legs looked very red and angry so I rang NHS 111 as the nurse told me to do and the lovely district nurses came out at 2am and redressed them. By 5.30 am my mother had removed them (I stayed overnight but only got 1 - 2 hours sleep). Fortunately we've got an appointment today with the nurse at the surgery who will redress the legs. However this pattern is just going to keep repeating itself. How can I get my mum's dressings changed before they become saturated? How can I get her to keep them on ( she says they are too tight)? I'm my mother's carer ( so with her at least 35 hours a week) but I can't be with her all the time. I'm needed at home and if I live with my mother she will not let me sleep so that's not sustainable. Besides which even if I'm with her I can't stop her removing the bandages. I should say that these are prescription bandages ( impregnated with zinc) so I don't think a lay person is supposed to administer them. Thank you if anyone replies. If I don't reply I'm probably struggling with my mother...

Honestly, in your situation I would be looking for a onesie that she can't undo. The weather is getting colder and keeping her legs warm will help the circulation. Is she getting adequate pain relief? Drinking enough? Keeping hydrated is very important. Restless legs can be due to anaemia so she needs her bloods checked. She should have her vitamin D level checked too.

I was also going to mention getting her iron checked for the restless legs. This sounds like such a tough situation, the onesie solution sounds like a possibility.

magnesium for restless legs, and see if she can be prescribed something for it. will be driving her absolutely crazy

Yes this. Ask about something for nerve pain too.

Thank you, yes the legs do drive her crazy. It's been an ongoing thing for years but she has exhausted all the treatment options. Dopamine agonists helped at first but caused augmentation over time ( made it worse it's a common problem with them). She tried low dose opioids but unfortunately ended up with opioid poisoning. She's had an iron transfusion back in Spring which may have helped a tiny bit. I notice keeping to a strict anti-inflammatory and low histamine diet seems to help but she loves high GI carbs and sugar. Maybe tweaking her diet again could help both the skin and restless legs. I'm convinced gut issues play a huge part. unfortunately all the good bacteria is going to be wiped by the antibiotics. Do maybe a probiotics and prebiotics? The thing is is so hard to get her to take supplements etc. I've got her hight strength Omega 3 fish oil and sea buckthorn tablets which should help if she takes them consistently.

Oh and magnesium too she takes it off and on and tried the spray and Epsom salt baths. But sometimes they made it worse. I think with magnesium you have to find one that suits. You need a supplement that's low histamine and works with you particular microbiome I suspect.

Can the dressing changes be more frequent? If the dressing is saturated it needs to be changed as wet dressings don’t do what they are design for and must be uncomfortable

This is what I would like. The nurse said to ring the surgery to get the dressings changed if they become saturated or try NHS 111 if they aren't open. It's difficult getting my mother to the surgery at short notice though as I don't drive and she lives in a neighbouring village. ( 2 bus journeys or my DH gives me a lift). But having more regular appointments so I can at least plan my care visits around them would help ( DH works from home but can only give a lift in his lunch break). I could get my mother to pay for Ubers ( she's happy to) but I'm in the process of being registered as an LPA and the OPG can be iffy about such things. They don't like you using the donor's funds for transport or to benefit yourself.

The lpa doesn't affect that. If uour mum needs a taxi then she pays for it. My FIL used to go to a day centre once a week. Patient transport wouldn't pick him up as the place where he lived had a difficult junction so we arranged a weekly taxi to take him. My husband used his poa to pay the bill from his dad's account. It's a reasonable expense for his dad. The OPG would never want to be involved in that sort of thing

I think op means the uber would be for her to get to her mother and then both of them to the surgery. This would be tricky.

Has she been assessed by the tissue viability sister/nurse specialist? Your mum won't be the only patient who tries pulling dressings off. It sounds like she needs more regular dressing changes or a change in dressing type to one that can cope with the excess liquid between dressings. I know they are zinc dressings, but have you asked if you could be shown how to do them? I don't mean daily, but only as a last resort. Have you asked for district nurses to come to the house instead?

I wonder if a full length tubigrip bandage, over the top of the compression dressing would help her to stop picking them off? Possibly going thigh length so she can't touch the lower leg dressings?

Theoretically as it's for care and not a social visit it should be possible but I would have to keep rigorous records and then I'm still wary. I get carers allowance of £89 per week and other than that nothing. I can't afford Ubers. Whilst waiting for my lpa I buy a lot of things for my mother out of my own pocket. She pays back most of it, but I have to keep careful records or it can look like deprivation of assets or fraud.

Sometimes I walk. I enjoy it but it takes about one hour 40 minutes ( quickest route). But it's not that safe at night and sometimes I have to get there at night. Bus takes 1 hour minimum each way but I think stops about 10 pm. It's infuriating I daren't take ubers in case I'm accused by the OPG of fraud.

She's just got water pills delivered from the chemist. These are to help the oedema. She's had a bad reaction to diuretics in the past so that means another sleepless night on a chair ( no spare bed at the moment). But worth a try.

Does she get attendance allowance. I suppose she must do if you get CA. The rules are unreasonably strict IMO. It is more than a full time job being a carer.

@5289843DM she has not seen a tissue viability nurse only the practice nurses. They put on the zinc dressings, then padding to soak up the fluid then a tubigrip over the top. I will ask if there is anything we can use in-between dressings at least to keep the wound clean. We actually missed our appointment today due to our Uber being cancelled at the last minute so the wounds haven't been dressed still but the surgery have asked the district nurses to take over from now on and .we are waiting to hear if they agree. I've left my mother for tonight as I'm desperate to get some sleep. I'm hoping she's OK but she usually rings if there is a problem.