Importance of Changing Position

Contents Loading contents… Pressure ulcers, sometimes called “bed sores”, are areas of damaged tissue that develop whenpressure reduces the blood flow to a specific part of the body (most often tail bone, heels).Pressure sores are common in patients in hospice care. Decreased mobility, increased time spent inbed, and altered nutrition can all make a person […]

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Pressure ulcers, sometimes called "bed sores", are areas of damaged tissue that develop whenpressure reduces the blood flow to a specific part of the body (most often tail bone, heels).
Pressure sores are common in patients in hospice care. Decreased mobility, increased time spent inbed, and altered nutrition can all make a person more vulnerable to developing bed sores.

Pressure sores can develop quickly, often after only two or three hours of reduced blood supply.

They can become deep enough to penetrate muscle and bone and can heal very slowly or not at all.

  • The key to preventing them is to reduce the amount of friction and pressure between theperson's skin and the bed.

  • This means helping them move often as well as looking after their overall health.

  • Pressure sores can be prevented with techniques like frequent repositioning and having yourloved one lay on a special surface such as an egg-crate mattress.

  • Check them early and often for signs of developing pressure sores and treat them as soon asthey appear.

How to prevent pressure ulcers

Pressure sores are painful. As a caregiver, one of the most important things you can do to keep your loved one comfortable is to prevent one from developing pressure ulcers. This involves lifting and moving the person regularly. Make sure to ask for help with these tasks if you need it.

  • Turning your loved one who is bed-bound is the most important thing you can do to prevent pressure ulcers from occurring.

  • Frequent turning alternates areas of pressure on bony parts of the body such as the lower back,hips, elbows, and heels.

  • Plan on repositioning them every two hours, alternating between their right and left sides and their back. You don't need to disturb them or wake them frequently at night to maintain this schedule. However, if they do call for you late at night, take that opportunity to turn them.

  • Small changes in position are effective.

  • It’s easy to lose track of which side they should be turned to if they have been on their back for a while. Small changes in position are effective.

  • One way to keep track is to use a soft cotton wristband to mark the side that they should be turned to next.

Techniques to use:

Use pillows to help position your loved one. Pillows add comfort and can reduce pressure on bony
areas.
For example:

  • Place a pillow under their back to prop them on their side.

  • Place a pillow under their back to prop them on their side.

  • Use one under the ankles to “float” their heels off the bed.

  • If your loved one is spending most of the day in a recliner chair, repositioning is still important. Small adjustments in seating position are often effective enough at relieving pressure.

Egg crate mattress, chair pads, special mattresses

Hospice will provide these free of charge.

  • An egg crate surface helps distribute pressure more evenly, helping minimize the amount of pressure on one area.

  • Air mattress overlay: This type of surface is placed on top of a mattress and typically alternates air pressure in various columns.

  • Fluidized air mattresses: These special mattresses contain silicone-coated glass beads that
    become fluid when the air is pumped through them. A downside is the frame, which makes
    transferring a person to and from bed difficult. If the person wants to sit up in bed, they may
    need a foam wedge to help support their back. This mattress is best suited for palliative care patients who are fully bed-bound, have severe pressure ulcers, and are in a lot of pain.

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