Nursing home pressure sore

[Cherrysherbet]

I’m hoping someone here may have some advice for me.
My mum has been bedridden for almost a year. She had a very long hospital stay, followed by a few months at home. She is now in a nursing home after another short stay in hospital.
I was concerned to learn today that she has developed an open pressure sore in less than two weeks in this home. They haven’t yet told me how bad it is ( or even mentioned that this had happened until I asked) but the nurse was putting a lot of dressings in her room while I was there.

I will talk to the manager tomorrow. How concerned should I be? What should I ask/say?
This whole time, she never had open skin, but now I’m worried that it will get infected and be so painful for her.

How serious is this?
Thank you

Hi, sorry to hear about this. Preventing bed sores is something there is now pretty extensive guidance on which the care home should be following. I would be pretty upset by this and want to know firstly how it happened and secondly what they are going to do differently to stop it from happening again. There may be some unique circumstances that have prevented them from doing everything they should be doing to prevent them (I.e unusual injury positioning), not able to be moved at all around on bed due to surgery etc. but I would ask to be talked through exactly what their routines are to prevent bed stores and why they think they happened in this case. I hope she recovers soon x

www.nice.org.uk/about/nice-communities/social-care/quick-guides/helping-to-prevent-pressure-ulcers

This is the NICE guidance the care home should be following

It’s very serious and can be a marker of poor quality care. She may of course have developed it before entering the home, but that should have been picked up on admissio. Pressure wounds are graded, so would find that out and a management plan. Is she on a pressure mattresss, being turned. I don’t know if the district nurses become involved with care homes, but the GP should be alerted. If it occurred inside the home, It’s very serious and would be asking how this has arisen as care of bed bound patients should be ‘bread and butter’ stuff, and it may be the sort of thing that CQC are interested in as a marker of care or running unsafe staffing levels. In meantime if possible to up her protein intake that can help with healing (shakes etc). Your poor mum

Thank you so much for your advice, and the link.

Mum has dementia, and is unable to reposition herself at all. She has no injury that would prevent putting her in different positions, and hasn’t had surgery.

I have a general feeling that she is not being very well cared for. This has confirmed my suspicions. I am very aware that my expectations and hopes for her may be higher than is realistic, but she is my Mum, and I want what’s best for her. I couldn’t manage her at home anymore. Now I feel so guilty for putting her in this situation.

I will ask the manager what their routine is tomorrow. I feel so upset that this has happened.

Apandemicyousay

Shes had a few times this last year where her skin became red, but it was managed effectively with barrier cream. It never broke out. She’s been in the home for almost two weeks, and it’s only today that they brought dressings to her room. It’s definitely a new open wound.
They do seem short staffed often. I don’t think Mum gets much attention from them. Luckily I live close, so I go twice each day.

I will mention the protein shakes, thank you. Her appetite isn’t great, and I wouldn’t be surprised if she is deficient in protein and certain vitamins.

It would be good to find out what grade of pressure damage it is
Is she on a special mattress?
Have they done a waterlow score?
Who is dressing the pressure sore?
Has she been referred to the district nurses?
Ask to see her turning chart if she is bedbound

If it has happened this quickly and she is in a care/nursing home, then you may need to raise as a safeguarding concern to social services

You're completely right to feel so upset and your expectations definitely aren't unreasonable - preventing bed sores should be one of the absolute basics for a care home, it's a basic health and safety routine like giving medication etc. If you're not happy with the answers you receive at the meeting please don't hesitate to make a formal complaint. Your mum is so lucky to have you looking out for her so well

This is very serious and a result of poor care.. my friend's mother developed a bedsore in a care home. She ended up in hospital and it was the worst grade. The care home insisted that they had sought medical help but there was no evidence of that when my friend reported the home to the local authority safeguarding team. The doctors were appalled at the neglect. There were also other issues around her nutrition.

My friend moved her mother to another care home. It took a lot of skilled nursing to heal with input from the Tissue Viability Team.

It's good that you are close by to keep an eye on her care. Check to see what medical input she had received. I hope she gets better soon. Her GP can prescribe the protein shakes.

Wowzel
Thank you. I will ask what grade it is tomorrow.
She’s on a pressure relieving mattress. It’s a nursing home, so they have trained nurses on duty doing dressings etc.. I would imagine. Not sure if district nurses get involved, but I will ask.

rasberryandlime
During the whole process…..hospitals, home care, now nursing home, I have learned to pick my battles carefully. My instinct is to go in all guns blazing, but I know it’s not the way to solve these problems. I now try to gather as much info as I can, so they realise quickly that I know what I’m talking about, and I know what care my mum is entitled to. Thank you for your lovely comment, but I’m feeling like the worst Daughter in the world tonight.

JuliaDomna
Thank you. My Auntie had a pressure sore years ago. It went right through to the bone. I’m so worried for my Mum. I thought the nurses would prevent this. I need to get involved tomorrow, and make it clear they need measures in place to prevent it from getting worse.

I will ask them to get hold of the gp for protein shakes.

It's good that the nursing home has qualified nurses so hopefully they will be able to nip it in the bud with good nursing care. The protein drinks will help with the healing, especially as your mother has reduced appetite. My father virtually lived on these because he could not face eating. There is also a yogurt/dessert type as well as the drinks.

My friend's mother's bedsore went through to the bone and the poor woman was prescribed morphine patches for the pain. She was in a care home without medically trained staff so they really needed the input from the GP, which they did not seek. Unfortunately she had been placed there by the Council. There were other medical issues which hadn't been addressed so it was very distressing for both her mother and my friend. Hence the reporting to the safeguarding team and the move to a nursing home with qualified nurses. They have been excellent and now her mother no longer needs pain relief.

Good luck and I hope your poor mum gets better soon.

JuliaDomna

I’m glad your friends mother is out of pain now, but sorry she had to go through that. Pressure sores really are the worst things, and I’ve been so worried about my Mum developing one.

Just wanted to update…. I phoned the manager this morning, and she didn’t know anything about a sore! She went to ask the trained nurse that was on duty, and she said there was no open skin at all!
I explained that a nurse came in with dressings to put in Mums wardrobe and when I questioned her about it, she said Mum had an open wound.
The Manager went to investigate and it turned out the dressings were for another resident and she had got mixed up!!
I’m so relieved that Mum hasn’t got a sore, and still a bit annoyed that a trained nurse got two patients confused and gave out wrong information (especially when she does drugs rounds).
She has been thoroughly checked over by the Manager and a nurse today, and they say her skin is absolutely fine. Phew!
Thank you for all your advice. I will take it all on board and I’ll be keeping a very close eye on Mum.