How to stop bruise on elderly persons leg ( poor circulation etc ) becoming ulcer ?Any practice nurses around ?

[gingeroots]

My mum ,90+ ,CHF and AF takes 300mg aspirin daily in preference to warfarin ,thin skin ,varicouse veins ,odema etc has one leg bandaged with several layers/light compression .
Other not .
She has obviously banged unbandaged leg and now has dark red bruises .
Previously similar episodes sees bruise becoming blood blister becoming ulcer .

When I ask HP for advice they say "keep an eye on it " ,but this approach has not in past prevented deterioation .

Mum keeps her legs up ( hip height ) a lot /as much as she can . Oh and I cream daily .

Any advice ?

I think you're doing everything you can - elevation improves the circulation and creaming keeps the skin supple so it's less likely to break down. If the creaming can be increased to at least twice daily if possible that may help.

At the first nanosecond of broken skin get it dressed, and if she can get straight into compression so much the better. Can she wear support hosiery on her unbandaged leg?

Thanks Sidge that's really helpful .
Will be more vigilant about creaming .
She has tubigrip on the unbandaged leg but when I arrived ( she lives alone ) it was pushed down exposing a lot of her leg ,as actually were the bandages on her other leg .
I suspect she'd dislodged them herself but that's another story .

I've dressed the knock with aquacel ,soft band ( ? ) ,slinky ,and tubifast .
So both legs the same now .

A lot of my patients with bandaged legs are fiddlers

You probably won't need Aquacel on the skin if it's intact (save it for when it's broken) but if you have any NA dressings, or even soft pads like Mesorb or Surgipad you could put those under the Soffban and Slinky to protect it a little. It sounds like you're on top of it so keep an eye, as you are doing, and if the skin breaks get in fast with the nurses!

Gingeroots As you say your mother lives alone is she able to get up and walk about - get out and walk about ? Are you the only one of the family caring for her?

Sidge - thanks again ,it's a comfort to know it's not just my mum who thinks she needs to push the dressings down and tuck the top layer inside the bottom layer .
They probably itch/are hot .
I suppose in an ideal world the secondary dressings would come off each night and more creaming could be done ? But that wouldn't be feasible for anyone .

I'm not sure how she'd tolerate support hosiery - where could I look to see what's available ?

Claire - mum moves around in her very small home ,she can go out with escort and wheeled walker /wheelchair if distance involved .

She has very limited eyesight ,very independent ( but not always sensible/realistic in what she attempts ) .
She's not someone you can work with ,it all has to be on her terms and she'd rather decieve than just tell you something straight out .
The day prior to finding her legs in a mess I hadn't visited ( very unusual ) and I suspect she'd been silly and crashing around ( she's very fierce and clumsy in all her movements ,has surprising strength ) .

I understand how fiercly she guards her independence but I do find her a trial - she'd retain more independence if she could ever admit that she doesn't always know best and work with me ,not against me .

Sigh ,bet I'll be just the same