The underlying mechanics behind the development of bed sores (also called: pressure sores, pressure ulcers or decubitus ulcers) is relatively simple-- unrelieved pressure on the body results in restricted blood circulation and consequential lack of nutrients and oxygen to skin and tissue.  When pressure goes unrelieved for extended periods of time, tissue dies and a wound develops in the area.

Armed with a basic understanding of the mechanics behind the development of bed sores, medical professionals suggest alleviating the pressure on the body on regular intervals. 

If a patient is mobile, they should be encouraged to get active on a regular basis. Obviously, for physically incapacitated patients who are unable to move on their own, staff assistance is necessary to relieve pressure. 

In today's series on causes of bed sores and how caregivers can prevent them in conjunction with David Terry, I am going to discuss the most widely accepted method of preventing bed sores -- turning.

What is turning and why is it necessary?

'Turning’ refers to exactly what it sounds like– turning the patient to prevent the build-up of pressure on the skin that can result in the development of bed sores. Turning is universally considered to be the most important factor in bed sore prevention. Yet, despite its universal acceptance, many facilities (hospitals and nursing homes) fail to properly implement turning techniques– it is hard, labor-intensive work.

Turning should be completed at intervals set forth by a physician. However, turning of patients at least every two hours is usually considered to be the minimally accepted interval. In bed-bound residents, the staff should rotate the patient to their sides. In residents who spend most of their time in wheelchairs, staff need to lift the residents out of their chairs.

Caregiver tip:

Caregivers need to recognize the importance of relieving pressure on a regular basis and be on the look-out for facilities that make rotating patients a priority.  Many nursing homes that incorporate facility-wide turning programs have:

• Charts in all patient rooms to help staff keep track of patient positioning in bed
• Have regularly scheduled music to remind patients and staff to change position
• Provide additional staff for assistance with rotating patients
• Dim lights on regular basis to remind staff and patients of turning interval

Similarly, if you don't see any of the above indications that the nursing home your loved one is ask, don't be afraid to ask the staff or administrators about the facilities bed sore prevention program.  As I see over and over again, patients tend to receive better care when they have an advocate looking out for their best interest.