By Geri from Fort Worth, TX
TK, I agree that an AD patient probably does NOT need to be changed every 4 hours, however, they should be checked more than every 4 hours, to make sure they don't need to be changed. It's important to take care of it right away and not let then sit in it.
Geri, I feel for you my father in law is taken care of my mother in law and she has to wear depends and be changed also. She lets him do that but will not allow him to bath her she screams and says he is trying to kill her. My sister in law has to go over and give her a bath. Just try to keep her as clean as possible and try a diaper rash cream. Deeli most adults don't need changing more than every 4 hours they don't go that often do you? It is hard getting a person with alzheimers to do what you want them to do! They have a mind of their own, even thou it is not remembering us.
My son had macerated skin from fecal incontinance that was a side effect from treatment our peaditirician was giving him. firstly, you need to make sure there is no infection from thrush or otherwise that is causing the wounds to be unable to heal, so a swab is the first step. Secondly, there are creams that are suitable for use on bleeding skin that are purely designed for incontinence.
I'm in Australia so I'm not sure if these are called the same where you are, but we used Conveen by Coloplast and Cavilon wipes by 3M. Within two weeks the skin was healed, after 8 weeks of applying all kinds of salves, including heavier zinc creams. Thirdly, you need to keep the area really clean, I was washing him at least 10 times a day. Good Luck
Perhaps if you massage the buttocks it will stimulate circulation in the area and help her body to fight infection more efficiently - yes, you still need to worry about the incontinence, but I believe bedsores occur because of lack of movement and stimulation. It's a tough job, and best wishes.
I am not trying to be rude, but why would your mom be any different than a baby needing to have their diaper changed, booty cleansed and a protective ointment applied more often than every four hours? If her Depends diapers and/or poise pads are wet or poopied they need to be changed right away just like an infants diapers need to be :-(
We were told to use Hibiclens (we bought it at Walgreens) to cleanse the area when my husband had MRSA, and it worked great. This may help with her bedsores.
You might want to use a product that is called Butt Paste. You should be able to get it in any drug store. This is what the hospital used on my Mom. She had the same problem. It is a product that is used for babies, but works just as well for adults. Good Luck and God Bless.
A lack of zinc in the diet will slow down healing. You might try (with a doc's permission) zinc pills for a few days (crush and put in pudding or yogurt) and then figure out a way for her to get these foods naturally.
First,bathe her diaper area each time you change her,with soap, like Ivory or Dial,which is good to fight germs. Then pat dry and apply peroxide and pat on for several minutes. They dry with a blow dryer set on warm. After the skin is thoroughly dry, apply a Monistat type cream-you can ask for it at Dollar General, it is much cheaper to buy the Dollar General store brand,called MICONAZOLE.This fights the yeast which will try to grow in any cracks in the skin, fed by the sugar found naturally in urine.Do not use vagisil, it contains nothing to kill yeast.
After you have the sores healed up,continue to sponge bathe with soap and dry her each and every time you change her, same as you would a baby.
But please don't play around with this. My other wise healthy father died from a bedsore which developed after he wrenched his knee and was put in a "rehab" facility to learn how to walk with a knee brace. He never walked again,had a bedsore within three weeks, and within three months was dead from the bedsore which spread bacteria to his bones.
I also recommended the monistat to a neighbor whose 90+ mother suffered pitifully from urine on her skin,and within a couple of weeks, the neighbor was thanking me with tears in her eyes for the relief she was able to give her mother.
Sitting in urine for possibly 4 hours at a time is not good. She may also have a yeast infection from the moisture. I would get rid of the pull-ups and Poise pads and move directly to adult diapers. It's only a matter of time anyway, and will make your job easier.
My Mother had Alzheimer's for 10 years, bedridden for about 8 years. We put her on the toilet every couple of hours which cut down on the need for diaper changing, during the day. (Is your Mother eating or drinking something that is making her urine very acidic? Orange juice, other citrus fruits?) Give her yogurt daily to help with that. I would suggest that you check her diaper more frequently, say, every other hour to get the sores under control. Her skin needs to be kept dry. Try medicated powder once the sores are healed.
If she is sitting upright a lot, get her a donut to sit on (find in a medical supply store). If she is bedridden, you'll need to give her skin even more care to prevent pressure sores (bed sores). Once they start, they are difficult to heal and can get very bad, going right to the bone. Frequent turning, gentle massage, range of motion movements/exercises, a healthy variety of fresh foods, vitamins and supplements, etc. will help keep them at bay. Find a geriatric specialist in your area (check local hospital or Alzheimer's Association for referrals). Good luck to you, I know it's not easy. "An ounce of prevention is worth a pound of cure."
I think that its really important to have the area really clean before you put on any ointments or salves. The salves can hold in the acids and germs from the urine that has soaked into the skin. Can your mom sit in a tub? When my children were small I would let them soak in a baking soda bath under a watchful eye for 15 to 30 minutes. Then I would make sure the irritated area was really dry--air dried or dried with a Blow dryer on low. You don't want to abrade the irritated area by rubbing it dry with a towel. Then put on the ointment of your choice. Best wishes and good luck
I think spiderhannah is on to something. I would treat this like you would diaper rash in a baby and buy a diaper rash cream with the highest percentage of zinc oxide you can find (I think I've seen some with 40%.) I read somewhere recently that zinc oxide is clinically proven to speed healing, and the petrolatum (petroleum jelly) in the diaper rash creams will provide a barrier for the skin against the moisture. Yes, it's messy, and it will probably take a while with diligent use to see good results, but it may be worth it. Good luck!
truerblue in PA
Powder Alum will also help heal sores,mix with water, 1/2 teaspoon of alum in a pint of water. Apply with a wash cloth several times a day, get it in drug store, if the don't have it ask them to order it, 3 oz cost about $4.00, last a long time, good luck.
You might want to perhaps use a zinc oxide type of cream or a incontinence cream for bed sores between changing. It will help protect her skin. It is a little more of a mess to clean up each time but helps the skin not to break down as much.
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