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Pressure Sores, Recliner, and Refusal to get off butt
star26
Posted: Tuesday, October 8, 2019 3:23 PM
Joined: 2/6/2018
Posts: 8


Hi, I'm new to the forum and at my wit's end. My father, 90 yrs old with moderate Alz & vascular dementia, has two Stage 2 pressure sores on his butt because he is in his recliner 24/7. This has been going on for over a year but they've recently become worse and cause him considerable pain.  I have a hospital bed and a new electric recliner that lays flat allowing him to turn on his side, but he refuses to use the bed or try turning on his side. He also removes bandages and pads that he's supposed to sit on. He now cannot even lean back on the chair because of pain and he's sitting up on the edge of the chair and falling asleep like that. I'm afraid he'll fall forward on the floor. I think I've tried everything with the exception of an inflatable pad with a pump on the recliner. I don't know if it would fit on his recliner or that my Dad would not remove it like he removes everything else.  For the last year, a variety of medical professionals have told him the risks and that he needs to get off his butt etc. He laughs and ignores them. He obviously is not in his right mind to be able to make his own health decisions so I don't feel like I can let him make this decision, but it seems to be out of my hands. He's in control of his body.  Has anyone been in this situation? Do I just accept it? Thank you.
caregiving daughter
Posted: Tuesday, October 8, 2019 4:16 PM
Joined: 11/27/2012
Posts: 2084


I believe the pad would be referred to as decubitous care. It's critical to avoid bed sores. They are very serious. He could also get a special mattress but it doesn't sound like he ever lies flat. What if you removed his recliner and replaced it with a broda chair with the pad allowing pressure to be fluctuated. If he hates it, he could go then go to his special mattress. My guess is the risk of infection is great and therefore, you are facing a run to the ER pretty soon. Then he's in a hospital bed. The hospital social worker would likely tell you he cannot return home given the risk of this reoccurring. Who knows for sure but I'm guessing that's how the exchange would go.
JJAz
Posted: Tuesday, October 8, 2019 7:30 PM
Joined: 10/21/2016
Posts: 2447


Alternating air mattresses or chair pads are intended as a SUPPLEMENT to keeping pressure off of the pressure wound.  If he's not willing to stop the problem, these products won't help.  How do I know this?  The wound-specialist physician told this to my Dad (in very plain language).  My Dad didn't take it seriously either.

Blessings,

Jamie


abc123
Posted: Tuesday, October 8, 2019 9:02 PM
Joined: 6/12/2016
Posts: 525


I certainly hope you can get this situation under control very soon because an infected pressure sore is painful and dangerous. I wish you the best.
Victoria2020
Posted: Tuesday, October 8, 2019 10:25 PM
Joined: 9/21/2017
Posts: 924


caregiving daughter's look in the future is right on. Since he won't comply in the home and has bed sores he should be in a professional nursing situation. They can  tunnel into the body.


https://is.gd/U74gY2  article on dementia and sores


RobOT
Posted: Wednesday, October 9, 2019 10:58 AM
Joined: 3/12/2017
Posts: 31


Caregiving daughter is absolutely spot on.  One solution, not to sound uncaring, is to see if you can get him into a care facility where he will be monitored for positions and get decubitus treatment.  While removing the recliner may help, he probably needs to be completely off the sores.  These ulcers can go along for months as small openings, and then suddenly open up, spread, tunnel, and expose muscle and even bone.  The other thing is the possibility of a fall, which is possibly worse than the ulcers.  It might help to get a video of him falling asleep at the edge of the chair, and even his reaction to removing the recliner.  Sneaky, low down and dirty, yes, but if you could swing it, might save him untold misery.  Good luck!
star26
Posted: Wednesday, October 9, 2019 4:11 PM
Joined: 2/6/2018
Posts: 8


Thank you everyone for the information, ideas, and the article link. I feel like I'm getting a wake up call. I'm glad I'm seeing the big picture of his deficits and consequences before it got too ugly. I've got to figure out a better caregiving plan so he has more supervision, more skilled care, and hopefully people that are able to position him off the sores if he will allow it. His sometimes angry and nasty attitude makes everything so much harder. He actually is already having falls, about one per month, and he's slid out of the recliner onto the floor twice in the last 4 days because he can't consistently operate it safely. It takes my Dad and me 30 minutes and lots of effort and pain to get him back up again. Thanks for waking me up to the reality of the situation.
Victoria2020
Posted: Wednesday, October 9, 2019 5:26 PM
Joined: 9/21/2017
Posts: 924


With the recent falls, and the sores, he really needs to be seen ASAP - why not go to the ER and get outside help.

Your love and compassion is clear but bed sores are a major trigger for authorities.

 https://www.nursinghomelawcenter.org/woman-arrested-for-elder-abuse-including-neglect-of-mothers-seve.html

It is an extreme case but the take away is: you can't punt. As you say- you can't control his body- get him where they can move him easier.


star26
Posted: Wednesday, October 9, 2019 6:27 PM
Joined: 2/6/2018
Posts: 8


Thank you for your concern. I share it. A doctor saw him Monday night and his regular nurse practitioner saw him this morning. He has received regular medical care for these sores for a year, no less than 1 RN visit per month who reports to his primary care doctor and the primary care doctor sees him every 3rd month. That's why I'm so frustrated. The issue is that I can't get him off his butt and they won't heal. I bought a hospital bed, a new recliner, seat pads, and I pay a CNA to come in every day for 6 hours/day. I've also had physical therapists and occupational therapists here thinking that there was some trick we could learn for getting him in bed and comfortably on his side but it didn't work. We're going to try a wound care nurse and I'll keep searching for aides that have the ability to position him on his side comfortably or some other clever solution.  IF HE AGREES. It seems like whatever would be done in a nursing home could be done in his home?  The entire house has already been modified for him.
caregiving daughter
Posted: Wednesday, October 9, 2019 7:14 PM
Joined: 11/27/2012
Posts: 2084


The wound nurse is a good idea
TessC
Posted: Thursday, October 10, 2019 5:30 PM
Joined: 4/1/2014
Posts: 4877


Next time he is out of the chair, haul it out and replace with the other chair. My mother could not agree to do something but if I just did it-she got over it very quickly because her short term memory was so bad at that stage. Good luck
Victoria2020
Posted: Thursday, October 10, 2019 7:33 PM
Joined: 9/21/2017
Posts: 924


star26 wrote:
IF HE AGREES. It seems like whatever would be done in a nursing home could be done in his home?  The entire house has already been modified for him.

I thought about what you wrote, it reminded me of the distress another CG had when their PWD was tended to in a hospital. When you try to do something and Dad says NO or refuses or cries out it hurts- you stop? Most of us would. We love them .

 In a nursing home they know he HAS to be repositioned  for his own good and take the protests etc.The end result will hopefully be a good one- healed sores. Also, they have the staffing to manage the lifting etc.

His agreement can't matter- look where it got him- his brain can't process the message.

 


GemsWinner12
Posted: Thursday, October 10, 2019 7:34 PM
Joined: 7/17/2017
Posts: 373


Tess has the right idea; get rid of the recliner. Put it out on the curb and put a free alert on Craigslist in your area; it will be gone in a heartbeat, especially if you live in or near a metropolitan area.  They are usually heavy, so you don't want to have to pay someone to haul it away.
Dreamer Lost
Posted: Friday, October 11, 2019 9:55 AM
Joined: 3/7/2019
Posts: 262


star26,  I agree with JJAz in that the equipment can only help so much.  My dad was in a Skilled facility that was supposed to be turning my dad every quarter to half hour as he was bed bound and couldn't/wouldn't reposition himself (not that I think they did it consistently though).  With pillows wedged behind him, he still managed to roll them out of the way and back on his back.  He also tended to slide down in the hospital bed and had to be pulled up every half hour. He still developed bed sores with the air mattress, repositioning, etc. but kept to a minimum with the wound nurse care.
 
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