Preventing Skin Breakdown & Bedsores in the Nursing Home

by Linda Granz, former nursing home social worker

Skin breakdown and bedsores are big problems in nursing home residents. However, they are preventable. Here are some things you can do to make sure your loved one does not develop them while living in a nursing home.

Before you choose a nursing home, check out its pressure sore quality scores. Scores significantly above the national average indicate they aren't doing a good job of prevention. Here's how you find out: Search for your nursing home on WhereToFindCare.com and click through to the Quality tab. See the details for Long Stay Patients and look for these measures:

• Low-risk residents who have pressure sores
• High-risk residents who have pressure sores that stay the same or got worse
  

Once in a nursing home, there's still more you can do. Bring Depends or a similar product if your loved one has loss of bladder or bowel control. A nursing home typically provides cloth diapers, however most times the resident wets through the diaper and clothing too. Making matters worse, nurse aides are generally busy with many other residents and it may be a while before they notice and tend to your loved one's accident. This will result in redness, and if it happens enough, skin breakdown. Opting for a plastic product will save clothing and better insure against skin breakdown.

Make sure your loved one's bed linen is changed at least daily. Some families monitor this by visiting daily themselves or working with other families to check each others residents.

Make sure bed-bound residents are turned every two hours. When up in a chair a gel cushion should be used to provide comfort. Those up in a wheelchair also need to readjust periodically to alleviate pressure points. There is also special footwear (it looks like lamb's wool) which can pad feet when in bed or up in the chair.

Keep the resident's feet elevated on wheelchair footrests to encourage proper circulation. Legs dangling over the bed or wheelchair can impede circulation.

If you do notice skin redness or a wound, notify someone right away. The nursing department will provide treatment and "stage" the wound. The nursing home's dietary department also generally gets involved because certain dietary interventions can promote healing of a wound.

Moving Family to a Nursing Home: What to Bring

by Linda Granz, former nursing home social worker

Here's a checklist of things to consider when moving a parent or loved one to a nursing home. As a nursing home social worker, I've seen these things overlooked many times yet they can make a loved one's stay more comfortable.

1. Clothing for at least 7 days. Generally, residents moving into a nursing home are encouraged to bring in at least a week's worth of clothing changes. If a resident will be participating in a rehab or walking program, they are also encouraged to bring extra sweatshirts, sweatpants or jogging suits. Also, the shoe of choice for these programs has been the gym shoe with Velcro closures. Two or three pairs of non-skid socks may also be indicated. Various sweaters or jackets are also a good idea, so your loved one is comfortable in varying weather and room temperatures.
   
2. Leave the jewelry and valuables at home, with relatives or in a safe deposit box.
3. Shampoo and soap if the resident is sensitive or has brand preferences.
   
4. Personal touches for the resident's room such as pictures, quilts/blankets, clocks, calendars and decorative items. Make sure items are labeled with the resident's name.
5. Glasses, hearing aids and dentures. Make sure these items as well as their containers are labeled with the resident's name.
6. Radios or small TVs. Check with the nursing home to find out what sizes are appropriate or if these items are already provided. If you do bring them, make sure they are labeled with the resident's name.
7. Extra furniture and clothing. While these items go a long way for the comfort of your loved one, space in a nursing home is limited. Consult with the nursing home before you bring these items.
8. Phone and cable services. Consider whether the resident would benefit from having their own services and ask the nursing home how they are arranged within their facility.
9. Emergency contacts on an easily accessible list. Try laminating or using an inexpensive frame. Place it somewhere easy to access, yet is not readily viewable to visitors -- like inside a wardrobe door or bedside table drawer.
   
10. Address book to keep in contact with friends and family.
11. Laundry basket or hamper. This will keep the resident's room tidy and will be helpful if family will be doing the laundry.
12. Bladder control products. Products like Depends are a must-have if your loved one has loss of bladder or bowel control. Nursing homes generally supply cloth products but these can be less effective and may require more clothing on hand in the event of leaks.
    

3 in 20 Short Stay Nursing Home Patients have Pressure Sores

Pressure Sores, also known as bed sores or decubitis ulcers, occurs when there is friction between the body and the surface the body contacts and cuts off circulation of that area, generally at a pressure point. Some patients are at higher risk than others- age, those with limited mobility, fragile or thin skin, diabetes, or obesity to name a few.

The national average as reported on the most recent release of Nursing Home Compare data shows that the percent of Short-Stay residents who have pressure sores is 15%. And 22% of all nursing homes who reported this measure had a rate of 20% or higher.

The measure is calculated based on information from the patient assessment done on day 5 and 14. The 15% is composed of patients who are in one of two situations: They acquired a pressure sore between assessments (None on Day 5 but at least a Stage 1 pressure sore on Day 14) or their pressure sore got worse or stayed the same between Day 5 and Day 14.

Picture Source: Medline

How can you assist the nursing home team in caring for your loved one?

1. Assist, whenever possible, in moving the patient from one position to the other. Be careful not to drag the skin across the sheet as this creates friction and shearing.
2. Socks and long sleeves: Elbows and heels should be covered to avoid rubbing on the bed.
3. Bed height should be 30 degrees or lower to avoid putting weight on tail or back bone. (Some beds even have a 30 degree alarm)
4. Help motivate the patient to participate in regular mobility exercises as prescribed.
5. If your loved one has a pressure sore, ask for the stage number each time you visit or call - monitoring will help keep you informed of the progress
6. Learn what steps are being taken to care for the wound sore.
7. Know the pressure sore rate for your nursing home and compare it to national average. Is it better or worse? Understand why - ask the staff.
8. Do you research? Some treatment plans are more successful than others.
9. Consult a wound care specialist
10. To learn more about pressure sore stages and contributing factors, review Health Orchid

Be sure to check out this and other nursing home quality measures on WhereToFindCare.com. Results of individual quality measures can be found on the quality tab of each facility's page on WhereToFindCare.com.

Would You Want to Know if Your Nursing Home Almost Killed Someone?

If you're searching for nursing homes for a loved one, would it interest you to know that one of your contenders nearly killed someone? We recently received a comment about a nursing home that apparently provided poor care:

"STAY AWAY from this nursing home!!! They almost killed our relative!! The CNA's took absoloutely [sic] no care of her, and literally left her in bed to die. They gave her medications for a different resident...." Read the full comment on this nursing home (follow the link and click the Survey Results Tab). *

This isn't the kind of feedback you'll ever receive by looking only at quality data, inspection reports or even by taking a tour. Consumer ratings of nursing homes are growing increasingly important because not all of the horror stories make it on the news. WhereToFindCare.com compiles consumer nursing home ratings to help you make a better decision. If you have an experience, please help others make an informed decision - rate your nursing home today. It only takes a minute and you'll help ensure our elderly are well cared for.


*WhereToFindCare.com makes no claims regarding the accuracy of this statement and is not affiliated with any of the parties involved. When choosing a nursing home, we advise you to take multiple factors into consideration including quality, satisfaction and ratings data. All of these may be found on WhereToFindCare.com. This case may be an isolated incident and if you've had a different experience with this nursing home we encourage you to rate your experience.

Beware of Goverment Nursing Home Ratings

Medicare just released a more simplified "star" system for nursing home ratings. At first glance, it seems like a great idea, but we have a word of caution: Do not choose a nursing home based solely on these ratings.

1. Get resident and family opinions as well as recommendations. Check online nursing home ratings given by consumers.
2. Ask lots of questions about the things that are important to you and the prospective resident.
3. Tour the nursing home while looking for specific things.

Get more tips on finding the best nursing home.

Once you've found the perfect nursing home, help the rest of us out by rating your experience. Your review will give us valuable information about the quality of care given by your nursing home.

Nursing Home Tours

An important step in selecting a nursing home is taking a tour of the facility. A tour is a great opportunity to see everything the home has to offer and determine if it meets your needs. To help prepare our users, WheretoFindCare.com has compiled a list of tips for conducting a tour:

1. Ask to see the latest inspection report. If any corrections needed to be made, ask if they have been made and what was done to correct them.
2. Interview patients, family, and staff. Ask how satisfied they are with the nursing home.
3. Inquire about languages. Communication with a patient is important. Ask what the primary spoken language is and if any other languages can be accommodated, for example sign language.
...To see the whole list, visit: What to look for in an onsite tour?

Share your experience with us. Do you have any tips or advice for conducting a nursing home tour?

Living at a Nursing Home

Are you or a loved one currently living at a nursing home? Be sure to do the following:

1. Know your rights: Nursing home residents have certain rights and protections under the law but they tend to vary state by state. Stay informed by obtaining a copy of your rights from the nursing home.
2. Stay informed: This is your community. Attend resident/family council meetings. Learn other members concerns and issues. Express your opinions.
...For the entire list, visit: Living at a Nursing Home.

As you know, selecting a nursing home can be a very difficult process. Sharing your experience, whether good or bad, can help others in your community make an informed decision. In addition, providers will gain insight into their strengths and weakness, allowing them to make improvements to their services.

Visitors, patients, and caregivers are encouraged to rate their providers by taking a short survey on WheretoFindCare.com The surveys generally take 2-3 minutes to complete. Be sure to include any comments you have about the facility.

In addition, WheretoFindCare.com offers the Care Stars program. The Care Stars program is a way to honor employees that have provided us with exceptional care. Tell your CareStar you appreciate them by nominating when completing a survey.

Rate your provider today, visit: Rate a Provider

Making Arrangements for a Nursing Home

An admission director will walk you through the nursing home admission process. To help prepare you, WheretoFindCare.com has compiled a list of items typically asked for during the admission process:

1. Payment information: Gather insurance information and the policy numbers.
2.. Medical History
...To view the entire list, visit: Making arrangements at a nursing home.


Share your experience. Have you recently gone through the admission process? If so, what tips can you share?

Moving into a Nursing Home

Moving into a nursing home can be difficult for both the patient and the family. How can you prepare?

WheretoFindCare.com has compiled a list of tips aimed at making the transition as smooth as possible:

1. Inform family and friends about the move. Give out the new address and phone number so communication can continue.
2. Be sure to visit your loved one frequently.
...To view the entire list, visit: Moving into a nursing home.


Share your experiences with us. Do you have any tips regarding moving into a nursing home?

How to Pick the Best Nursing Home

Choosing a nursing home is a very important decision. With over 16,000 basic and skilled nursing facilities (SNF) nationwide, choosing the right one can be overwhelming. Where should you start?

The key is to research your choices so you find a home that fits your needs and provides quality care. WheretoFindCare.com has compiled of list of factors you should consider in your decision making:

1. Location
2. Quality
...To see the whole list, visit: How to pick the Best Nursing Home.

Share your experience with us. Do you have any advice on what to consider when selecting a nursing home?