What is Home Care Assistance

What is home care assistance

Home Care Assistance – What Every Caregiver Needs to know.

Home care assistance is just that, assistance with care in your home.Most home care assistants don’t provide any type of nursing, but depending on your loved one’s condition, a nurse may be what you need.Home care assistants are there to help with bathing, cooking, feeding, dressing, and some will even run errands and provide transportation.This can ease the mind of a working family member who has to work and cannot be home 24/7 to assist in their care.There are many different types of home care assistance out there, and it depends on each circumstance as to which type is best for your situation.If you need help in deciding which is the best assistance for you, schedule a FREE Consultation with one of our Compassionate Senior Advisors Today!👉 Personal care aide or senior companion.

These types of companions can usually be found on care.com, caring.com, or Angie’s list, this way you can see reviews and recommendations.

This is probably the safest way to find someone to stay with your loved one unless you know of someone personally who recommends a companion.

They can provide light housekeeping, transportation, meal preparation, and companionship.

👉 A home health aide is needed should you require a little more assistance.

They can monitor their condition, check vital signs, and assist with bathing, and dressing. They also have to have a certain number of hours of federal training that must be met and they must be certified.

👉 A licensed nursing assistant or certified nursing assistant.

They can observe and report changes, take vitals, set up medical equipment, change dressings, clean catheters, monitor infections, conduct range-of-motion exercises, help with walking assistance, and administer some treatments.

👉 Licensed practical nurses.

They are licensed by the state and have met federal standards for health and safety. They can evaluate, manage, observe, and provide direct care that others cannot.

Examples are: administering IV drugs, tube feedings and shots, changing dressings, and diabetes care. Some are even trained in providing therapy.

👉 Registered nurse.

They hold a nursing diploma or have an associate’s degree and have passed the National Council Licensure Exam. They provide direct care, administer medications, operate medical monitoring equipment, and assist doctors in procedures.

So, the level of declination of your loved one will tell which kind of home care assistance you will need.

How much is home care assistance?

The cost of home care assistance varies with the level of care needed.Personal aides or companions charge anywhere from $12.00 – $17.00 per hour, they are not normally covered by insurance. Which means it is an out-of-pocket expense.They set their own hourly rate.Home health aides, licensed nursing assistants, and certified nursing assistants charge about the same as home companions and again are usually out-of-pocket expenses.Some of them set their own rates as well unless working for a company.Licensed practical nurses can earn more than the above aides and usually come to you from a doctor’s office.Sometimes they have retired but kept their license active so they can provide a service to you on their terms. This is a great way for retired nurses to make extra income.Registered nurses will come to you from a hospital or doctor’s office and they are usually always covered by Medicare, Medicaid, or your insurance.You would need to check your specific policy to see what benefits are available. Again, sometimes registered nurses retire and keep their license up-to-date so they can assist clients as well.If this is the case, they would NOT be covered by insurance.

How to qualify for home care assistance?

Once again, how you qualify depends on the level of assistance needed. If you live with a family member and they work and just want someone with you during the day, there is no qualification from you needed. Just make sure to do your research before leaving someone in the home with your loved one.For more intensive care, you need to be under the care of a doctor who would write a referral for home health care assistance. You must also be homebound and unable to visit a doctor due to mobility issues.

What local agencies provide home care assistance?

There are many agencies around who provide home care assistance as well as private companions and caregivers.They can be found on such websites as care.com, caring.com, and Angie’s list.The websites will allow you to view reviews and references for the caregiver listed. Agencies will be registered with the state and follow certain guidelines, so you should be able to perform a google search on the specific company.You could also give Assisted Living Made Simple a call at 386-847-2322 for a list of local companies and companions you may call to compare prices and services provided. This is a big decision, you don’t have to make it alone!!!

Senior Home Safety Checklist

Senior Home Safety Checklist

How do I Know the Home is Safe?

Wonder if your loved one(s) home is safe?

Whether your loved one is still in their own home, an Assisted Living Facility, or a Home for Independent Living, you want to reduce their chances of falling by making sure the home is safe.

Below you’ll find a senior home safety checklist to spot some possible safety problems which may be present.

Check all cords

➤ Lamp cords, extension, and telephone cords that are within the flow of traffic. These are potential tripping hazards.
➤ Cords are beneath furniture and rugs or carpeting. These can create bulges in the rugs or carpeting, again a potential tripping hazard.
➤ Electrical cords are frayed or cracked. These need to be replaced immediately as they are a potential fire hazard.

Check all rugs and mats

➤ Small rugs and runners are not slip-resistant. There should be no rugs or runners that are not slip-resistant. Any that have the potential to move can cause your loved one to slide across the room.

Check smoke detectors

➤ Ensure smoke detectors are in proper working order and located in proper places.

Check bathtub and shower

➤ Bathtubs and showers are not equipped with non-skid mats, abrasive strips, or surfaces that are not slippery. Make sure the tubs have non-skid mats or strips on it to ensure they don’t slip in the shower.

➤ Bathtubs and showers do not have at least one (preferably two) grab bars. It is extremely important that showers and bathtubs have grab bars so they have something to grab a hold of to keep steady.

➤ An unstable elder does not have a walk-in tub or shower. Invest in a shower chair or remodel shower with a fitted seat.

Check electrical outlets and switches

➤ Outlets or switches are not cool to the touch. All outlets and switches do not have cover plates. Unplug all cords from outlets that are not being used. If cords or switches are warm or hot to the touch, have an electrician replace them immediately.

Check the Kitchen Area

➤ Kitchen ventilation systems or range exhausts are not functioning properly. Replace these systems if they are not working correctly.

➤ Appliance and power cords are not clear of sink and range areas. Ensure there are no power cords in or around the sink or range.

Check Passageways

➤ Hallways, passageways between rooms, and other heavy traffic areas are not clear and well lit. Install adequate lighting and make sure all traffic areas are clear.

Check areas around beds

➤ Lamps, light switches, and telephones are not within reach of the bed. Move lamps and telephones closer to the bed to enable easier reach.

Check outside areas

➤ The garage and outside areas are not well lit. Have an electrician install lighting at each entrance to a dark area to make it easier for them to see.

For this Safety Checklist and many other invaluable resources be sure to download our FREE Ebook for Seniors and Their Families. Or get a physical copy here.If you need help or encouragement as a Caregiver give us a call at 386-847-2322and one of our Senior Advisors will walk with you through this journey.

What Do Seniors Need Most?

What Do Seniors Need Most? Passionate Senior Advocates!
The number one thing we find our seniors need most is advocates!!Not traditional advocates, they need advocates with HEART!!!!Senior Advocates who do the job because they love it and love the seniors, not just because they are getting paid for it. Money should not drive an advocate.What do Seniors Need Most? Senior Advocates that will fight for themLove and heart should be the driving force. If money drives them, then they won’t fight for the seniors like they need to fight. Someone has to fight for those who cannot fight for themselves. Advocates fight for children and the homeless.

What about our seniors?

They get forgotten.People have lost heart through the years and most of them are so much more about the money. For five (5) days a week, eight (8) hours a day, they will do what the system allows them to do for our seniors. What happens when something arises on the weekend? Does that senior have your cell phone number? No, they have your office number, but you’re not there.An advocate needs to be readily available because anything can happen at any given moment. And this is usually exactly when something happens when you’re not available.So, you say, “But I don’t get paid to work weekends.” Really? What if it was your mother or father?Wouldn’t you want someone fighting for them no matter what time of day it was? I would!!!The advocates I refer to are the social workers and case managers, but the heart has been lost in their positions.It’s not all their fault.They now have agendas because our health-care system has failed them.The system won’t let them do what is really needed for the people. The policies they have are unfortunately the wrong ones, as most agendas are filled with their own fulfillment. If it’s not my family, I won’t worry about it type of attitude.Not everyone thinks this way, but many have these thought patterns. However, if you are an independent advocate, you don’t have to answer to the “system”. Well, I ask you to do one thing. Put yourself in that person’s shoes and think of them as your family. Your mother and/or father don’t have enough money to go to assisted living, yet you can’t care for them and you don’t want them fading away in a nursing home.Especially these days where COVID has been rampant in the nursing homes due to patients being sent to the hospital and brought back with COVID.

What does one do?

The advocates need to have the resources and the ability to help the seniors receive financial assistance.They need financial help in the way of government subsidies, other than Medicaid. So, if you’re thinking Medicaid will help, let me share this with you.Medicaid is backlogged years! It can take up to five (5) years for a person to receive Medicaid benefits. This is unacceptable when someone needs this money to survive.If you are at the end of your rope and don’t know where to turn or what to do to help, wouldn’t you like to know there are advocates that will help you with no hidden agenda?An advocate that has only you and your loved one(s) best interest at heart?Wouldn’t it be great to have someone say, “I got you!”?Let us help you! We can take the stress out of finding the perfect solution for your unique situation.Here at Assisted Living Made Simple, we will fight for you and your loved ones. Schedule a FREE Consultation with us or pick up the phone and give us a call at 386-847-2322 Today!

The Health Care System is Failing Our Parents & Grandparents

The health care system is failing our parents and grandparents

As a senior advocate every day I get frantic phone calls and every day I see people in crises. I help people navigate our health-care system. It’s broken and it’s heartbreaking.

The other day I received a phone call from a wife, “Can you please come help me? Will you please come to my house? I don’t know what to do.”

I walk into her house and I see her husband sitting in feces. No one is there to help them. She’s so sick she can’t possibly do anything. She has home health which her physician ordered, but they weren’t there.

She keeps calling and begging them to come, but they can’t because Medicare only allows them to come once a day.

They are trapped in our broken health care system. This is unacceptable!!!

Once a day, really???

This is one of many calls I’ve received over the years. It’s getting worse, not better.

A dear friend called me because her husband was in the hospital. The doctor told her that he had to go to a rehabilitation facility.

She told him no, COVID is rampant in rehabs and she was going to send him to an assisted living facility where he could receive care and physical therapy.

The doctor informed her that if she didn’t do what he informed her to do, he would discharge him against medical advice and Medicare would not pay her hospitalization bill.

As if she didn’t have enough to worry about, let’s add more stress. Thankfully, she called me.

That is simply not true. He can go to an assisted living community and he’s been in one for 3 weeks now.

And guess what, he’s thriving and getting stronger every day.

I could write about my experiences for pages and pages. This was only two days this month, and I work seven days a week.

We as human beings have to step up. People are suffering.

Our system is turning a blind eye. It’s our seniors who are falling into the dark hole we call the health-care system and this just shouldn’t be happening.

Our medical community must stand up to the insurance industry for something to change. Business people, insurance agents are NOT licensed doctors. Doctors go to school for 10 plus years. The people making decisions for our health care may or may not have gone to school at all. It’s time to stand up!

By the way, I did help the gentleman sitting in his feces. I gave him a bath and made his wife a cup of tea. You would have done the same, RIGHT?

If you need help or encouragement as a Caregiver give us a call at 386-847-2322 or check out our Caregiver Support Group. Our Senior Advisors are here to walk with you through this journey. 

3 Signs That Aging in Place Isn’t Working Anymore

If your senior parents want to age in place, they’re not alone: Three out of four seniors prefer to stay in their home as long as possible.

However, what an aging parent wants and what they need isn’t necessarily the same thing. How can loved ones recognize when aging in place isn’t working out, and how can you convince a senior who is insistent on staying put that they need to move? If you’re concerned about an aging parent living at home, look out for these three signs that it’s no longer safe to age in place.

1. Getting around the house is becoming dangerous

Does it seem like your elderly parents are testing fate every time they walk through the house? Families have a lot of options for aging-in-place remodeling or downsizing to an age-friendly home, but if you’ve taken these steps and your parent is still struggling with mobility problems, it may be time for a much bigger downsize.

2. Your parent is growing confused and forgetful

Mobility isn’t the only factor that determines a senior’s ability to live at home. Cognitive impairment can also make home a dangerous place. Seniors with dementia may forget about food on a stovetop, fail to pay the heating bill in mid-winter, or wander away from home. While many seniors can continue to live at home in the early stages of cognitive decline, more help is needed as dementia progresses.

3. Your parents need help, but there’s no one to provide it.

This is a common problem for seniors with long-distance loved ones. While millions of seniors rely on unpaid family caregivers for help at home, those who can’t are faced with a hefty bill: Full-time home care costs over $4,000 a month on top of a senior’s other living costs.

How to Talk About Senior Living

Often, families recognize the need for help before a senior does. As a result, it’s up to loved ones to broach the senior living conversation. How can you do it sensitively and productively? These tips can help.

1. Understand the senior living options

It’s important to go into the senior living conversation informed so you can focus on the facts. Understand the types of senior living, including assisted living, independent living, memory care, and continuing care retirement communities. While independent living sounds appealing to many seniors, it may not provide enough hands-on care for your loved one. Independent living offers senior-friendly housing and amenities but not the caregiving services found in assisted living. Meanwhile, memory care facilities exclusively serve seniors with dementia, and continuing care communities provide a variety of care levels in one setting.

2. Don’t force the issue

It’s important to understand the options, but that doesn’t mean you should start the conversation talking about assisted living. Instead, discuss the challenges your senior parents are facing at home and how they can solve them. Use examples of other seniors who have hired help or moved to senior living to demonstrate how people you know are managing the challenges of aging.

3. Hear your loved one’s concerns

Even if a senior recognizes assisted living as the right choice, they may have fears about moving. Listen to their concerns and offer reassurance and solutions. For example, you could help find a pet-friendly community, hire a senior move manager to help downsize, or set up a regular time when the family will visit.

Senior Living Resources

To learn more about senior living, turn to these helpful resources:

Remember that the assisted living conversation may be a long one. It takes time for seniors set on aging in place to come to terms with accepting help. Start the conversation before it’s urgent so your senior parents can get the help they need when they need it.

Image via Unsplash

Don’t Panic Over Coronavirus!

Seniors should take precautions, but not panic.

Coronavirus has been front-page news for a while and we are told it is now starting to spread in the U.S.

Yes, it is a serious situation, it’s extremely important not to panic. It’s equally important to learn the facts and follow the recommended prevention tips to protect yourself and your senior family member.

Quick facts and prevention tips

Today. the risk of getting coronavirus in the U.S. is low. But if the illness does spread, seniors and people with chronic health conditions are at higher risk, just as they are with the flu.

To reduce the spread of disease, CDC recommends using common-sense prevention practices:

  • Get a flu shot.
  • Wash your hands often with soap and water for at least 20 seconds.
  • Always wash your hands after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
  • Don’t touch your eyes, nose, and mouth with unwashed hands.
  • Stay home when you are sick, this may seem to be common sense but for some it is not. A mask does not protect others if you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.

Where Can You Get Updates on Coronavirus?

The U.S. Centers for Disease Control (CDC) is monitoring the situation closely and is the best source of information about coronavirus. For the latest information and recommendations, visit the CDC’s Situation Summary page. And check the CDC’s quick tip sheet Share Facts, Not Fear for key coronavirus facts that put a stop to rumors and misinformation.

What is Coronavirus?

Coronaviruses are a large family of viruses. In general, human coronaviruses cause respiratory tract infections that range from the common cold to more serious illnesses like Severe Acute Respiratory Syndrome (SARS).COVID-19 is the name for a new virus that’s been spreading across the globe since late December 2019. It hadn’t previously been seen in humans.

How Does Coronavirus Spread?

Similar to seasonal flu, COVID-19 is passed between people through coughing, sneezing, or close contact like touching or shaking hands. It can also be transmitted by touching a surface with the virus on it and then touching the eyes, nose, or mouth without washing hands. Hand washing is very important. Just like the flu, the virus spreads very easily, which makes it hard to contain, and easily contracted if exposed. The incubation period is between 2 and 14 days, so it can be spread by people with no symptoms.

Prevention

To protect from coronavirus, the CDC recommends the same methods that you’d use to protect against the flu or other common respiratory diseases.

Preventive measures include:

  • Have you gotten a flu shot
  • Washing hands often with soap, especially after going to the bathroom; before eating; and after blowing the nose, coughing, or sneezing.
  • carry an alcohol-based hand sanitizer in the event soap and water is not available.
  • Avoiding touching eyes, nose, and mouth with unwashed hands.
  • Avoiding close contact with people who are sick.
  • If you are sick. stay home.
  • Covering coughs or sneezes with a tissue, then immediately throwing the tissue in the trash.
  • Cleaning and disinfecting frequently touched objects and surfaces like doorknobs, remote controls, phones, computers, and mobile devices.

CDC recommends considering “social distancing” for those at higher risk
People who are over the age of 60, pregnant, or on medications that weaken the immune system are at higher risk of infection and complications of infection. Someone who’s at higher risk should consider “social distancing

That means if there’s any reported risk of COVID-19 transmission in the local area, avoid large gatherings of people and public transportation (bus, subway, taxi, rideshare). In addition, keep a safe distance from other people.

What are the Symptoms of Coronavirus?

Patients with COVID-19 have symptoms that are similar to other respiratory illnesses like colds or flu. Common symptoms include mild to severe symptoms of fever, cough, and shortness of breath that usually begin two to 14 days after exposure. Less comm is sore throat and diarrhea. Many patients with severe complications from the virus develop pneumonia in both lungs, particularly those with already weakened immune systems.

Seniors are at higher risk of complications and death

Seniors are more vulnerable because their immune systems are weaker due to age and may be made worse by frailty or chronic illnesses. This reduces the body’s ability to cope with and recover from illness.

Does the flu shot provide protection against coronavirus?

According to the CDCRespiratory Diseases, there’s no evidence that the flu or the vaccination for pneumonia will provide protection from the coronavirus. In spite of that infectious disease specialists strongly recommend flu vaccination as a way to prepare for coronavirus. For seniors, having both the flu shot and the pneumococcal vaccine can increase the chances of staying healthy.

Do face masks protect you?

Surgical masks are a common sight in areas with coronavirus outbreaks. But are they effective in protecting from infection? Experts say that they offer some protection. Currently, the CDC doesn’t recommend that people who are not sick wear a face mask, they should only be worn if a healthcare professional recommends it.

However, face masks should be worn by people who show symptoms of COVID-19. This helps prevent the spread of the disease to others. They should be worn by people who are taking care of someone who is sick.

Is there a coronavirus treatment?

Currently, there is no cure for coronavirus. Treatments to help patients heal or to relieve symptoms are already in clinical trials. Currently, researchers are focused on testing the existing antiviral drug Remdesivir and a combination of HIV and flu drugs.

The best treatment for coronavirus is prevention.

Disclaimer

All content provided on this blog is for informational purposes only about senior living topics. The information provided on this blog is accurate and true to the best of our knowledge but there may be errors, omissions, or mistakes. It is not intended to be medical advice.

 

Do You Have a Backup Plan?

If you are responsible for the day to day care of a friend or family member you know what a challenge it can be. Seeking help with caregiving is not a sign of weakness.  It means you care enough to put together the best care for your loved one.

At some point, everyone needs help, one of the best things you do as a caregiver is to get some help

Many caregivers have a hard time doing this. They feel that getting help means they are not living up to their duties or responsibilities or even promises made. 

As you struggle with these thoughts, it can be helpful to talk about your feelings with other caregivers in a support group or with a counselor.  The other issue which makes seeking outside help difficult is knowing what kind of help you need, where to locate reliable, trustworthy help and how to best use these resources.  

The caregiving journey can be tough and a care team can help. 

Your care team may consist of other family members, medical professionals, professional caregivers, church members and volunteers, neighbors and more.  

Here are some of the common questions (or concerns) we hear from caregivers about bringing professional caregivers into the home or even to visit loved ones in an assisted living facility when we cannot be there. 

How will my loved one adjust to having a stranger coming into their home?

Every individual reacts differently, but time and time again, we find family members are surprised by how well their loved one adjusts and benefits in ways they didn’t anticipate. For example, a new face means new conversations and experiences for them to enjoy!  

I worry that no one can provide the care I do.  I feel it might be more work to deal with problems, it is easier to do it myself.

No one can provide the care you do, but that doesn’t mean it cannot be a successful solution for both you and your loved one.  Ask any home care agency you are considering how they work with you to select appropriate home caregivers and how they prepare the caregivers to help your loved one.  Interview and get to know all potential caregivers so YOU are comfortable.

Things feel almost out of control for me as a caregiver when something unanticipated happens, I get a crisis call, or have to deal with sudden issues in the middle of work or other plans.

The unanticipated can be the most stressful part of caregiving.  A care team does not solve this problem but can provide you some support to ease things.  Having a relationship with a relief caregiver means that when you have emergencies or responsibilities that arise, you have someone to call.  Care team partners can be your backup and help you with conflicts.  A professional caregiver, family members, or community members can help with errands, taking a shift with your loved one at the hospital or visit them in their assisted living or nursing home when you cannot. 

 

Contact the professionals at Assisted Living Made Simple for more resources or more information on assisted living and other senior resources. 

How To Prevent Bedsores

How to Prevent Bed Sores?

If you are caring for anyone with limited or no mobility, being able to identify, treat, and knowing how to prevent bedsores is incredibly important.

Bedsores, also know as pressure ulcers/ sores, can progress into life-threatening infections very quickly and as a caregiver, we know how important it is for you and your loved one to avoid these at all costs.

When helping caregivers find an assisted living facility for their loved ones, some of them are on the verge of being bedridden or already are. One of the hardest things to witness when caring for a loved one who is immobile is the pain they have when it comes to bedsores.

In order to address the question, we want to help you in identifying them, knowing the different stages, the risk of developing them, and the steps you can take to prevent them from appearing.

What are bedsores?

Bedsores are also known as pressure sores or pressure ulcers, they are open wounds on the body where skin and tissue are breaking down because of prolonged pressure from bones.

Someone who spends most of their time lying or sitting in the same position has bones placing pressure on internal tissues. This cuts off blood circulation and leads to tissue damage and skin breakdown.

Common areas for a bed sore to appear:

  • Shoulder blades
  • Tailbone
  • Hips
  • Elbows
  • Heels

 What causes bedsores?

  1. Lack of movement – Any lack of movement over a long period of time, usually caused by a debilitating illness can cause a breakdown of the skin and bedsores.
  2. Old age – Elderly people have thinner, less elastic skin. The loss in skin strength in older adults who spend a lot of time sitting or lying down makes them more prone to bedsores.
  3. Inadequate nutrition – Many older adults have poor nutrition and lack of vital vitamins and minerals in their diet. This can escalate the problem of skin breakdown. Without proper nutrition, tissue cannot repair itself.
  4. Being underweight – Older folks often due to the poor nutrition mentioned above are underweight. The less fat and padding there is on the body, the more the bones protrude, and the easier it is to develop bedsores.
  5. Incontinence – Urine and feces from incontinence can make the tail bone and even hip areas more susceptible to skin breakdown. Bacteria can get into these areas and cause serious infection.

The 4 Bed Sores Stages you need to know about

Stages of Pressure ulcers

Stage I – Redness and discoloration of the skin at a bony pressure point is the first warning sign that a bedsore is developing.

Stage II – If not treated, it will continue to worsen and the skin breaks open and an ulcer forms. The area will feel tender and can be painful.

Stage III – A stage III bed sore forms a deep crater through skin and layers of tissue to the subcutaneous fat underneath. The less blood flow the area gets, the more tissue that decays and infection can set in.

Stage IV – The most serious of bedsores will progress so far that the ulcerous crater goes all the way down through the soft tissue to show bone.

If a bedsore gets to this stage the patient is at extremely high risk for infection and this is a life-threatening condition.

Common signs of developing bed sores:

  • Unusual changes in skin color or texture
  • Swelling
  • Pus-like draining
  • Skin that feels cooler or warmer to the touch than other areas
  • Tender areas

If you suspect bedsore or pressure ulcers, seek medical attention quickly.

A bedsore can develop and worsen significantly within just a few days.

Contact the professional Senior Advocates at Assisted Living Made Simple for information on a variety of senior topics.

5 Ways to prevent bedsores

  1. Reposition yourself regularly to avoid stress on the same area of the skin.
  2. Keep your skin clean and dry.
  3. Eat well and drink plenty of water.
  4. Manage your stress.
  5. Try to exercise daily.

Contact the professional Senior Advocates at Assisted Living Made Simple for information on a variety of senior topics.

Disclaimer: All content provided on this blog is for informational purposes only about senior living topics. The information provided on this blog is accurate and true to the best of our knowledge but there may be errors, omissions, or mistakes.

Preventing Pressure Ulcers

Dr. Madhuri Reddy, from the Harvard-affiliated Hebrew Rehabilitation Center in Boston, wrote a wonderful letter on  https://www.health.harvard.edu/newsletter_article/Preventing_bedsores and I thought it very informative and worth sharing. This can help PREVENT pressure ulcers before they can begin to form.

Support surfaces. Support surfaces include mattresses and added padding that goes over them. There are several types of “dynamic” surfaces that mechanically change the pressure under the patient. Some work by alternating the air pressure in the mattress.

Expensive ($30,000 per bed) air-fluidized mattresses contain silicone-coated beads that liquefy when air is pumped through them. Almost all intensive-care unit beds are now equipped with dynamic surfaces. To the layperson, they don’t look any different, but you may hear a motor switching on and off.

Repositioning. Many bed sores prevention protocols recommend moving an immobile patient every two hours. The thinking is that if the patient can’t shift position, then the nursing staff should do it for him or her.

The few clinical trials that have examined repositioning don’t provide clear guidance on how often it should be done. Even so, Dr. Reddy believes that repositioning is probably one of the most effective means of pressure ulcer prevention: “We just need to find out which positions, and how often, is most effective.”

Nutrition. Some experts believe increasing a patient’s protein intake is the key to healing bed sores. Five nutrition studies were included in Dr. Reddy’s analysis. Only one found a nutritional supplement to be beneficial, but it was also the largest and best-designed study.

Skincare. Dry skin is a known risk factor for bedsores, probably because it creates friction. Three studies examined specific topical agents, but none evaluated a simple moisturizer.

So, what do we do? Dr. Reddy suggests the following:

  • If a loved one is in the hospital, and she can be moved safely, make sure she is repositioned often, even in the emergency room. Ask for pillows to help her lie in various positions. Keep the patient’s heels off the bed or stretcher, using pillows under the calf muscles. You want to minimize any pressure on the skin.
  • Keep an eye out for early-stage bedsores. Heels and the area around the buttocks are the “hot spots.” The skin will be red. Normally when you press on skin, it turns white. If a bedsore is forming, it will stay red. The skin may also feel warm and hard.
  • If you think you see a developing pressure ulcer, point it out to a nurse or doctor. Ask that a wound specialist be consulted.
  • Even if there’s no evidence of bedsores, make sure that preventive measures are being taken. Ask questions. Nursing-home administrators at long term care facilities are aware of the problem, partly because some homes have been sued for providing inadequate bedsore care.
  • Keep the skin moist because of friction and shear cause bedsores, not just pressure. Any inexpensive, odorless moisturizer should help.
  • Specialized foam and sheepskin overlays that go on top of the mattress are better than a mattress alone. Regular sheepskin is too thin; it should be Australian sheepskin or something equivalent.
  • The jury is still out on which nutrients, if any, might speed healing, but malnourishment is a common problem for older patients, with or without bedsores. Make sure your loved one is eating enough.