Pressure Sores In Late Stage Alzheimer’s

When your loved one reaches the late stage of Alzheimer's disease, his or her body will need extra care and attention.

As Alzheimer's and dementia patients age, they may lose their ability to move about freely and become bedridden. This level of immobility can lead to many maladies or co-morbidities, including one of the most troubling, a pressure sore.

Pressure sores come in four stages. Stage I is a reddish mark that has not broken the skin as of yet. This stage is the easiest to heal. Stage II have broken the skin, but are also healable over time. When you get into Stage III and IV ulcers, you are dealing with deep wounds in the skin and muscle that have been eaten into by pressure and lack of blood flow. Some Stage III and IV pressure ulcers show muscle, bone, and even necrotic, or dying, tissue, that need to be healed over with scar tissue, or cleaned out with a wound vacuum.

How can someone let his or her loved one waste away like that? The simple truth is that you might not know, as a caregiver, that these sorts of injuries exist. They thrive on unseen areas, like your loved one's sacrum or his or her heels. Other body parts that are vulnerable to pressure sores are elbows, heels, buttocks, shoulder blades and the back of the head. Plus, you might lose the ability to communicate with your loved one as the dementia progresses, or the damage might be so great that nerves are dead as a result of the pressure, time and death of tissues. He or she might not even be able to feel a gaping wound like a Stage III pressure ulcer.

You and other caregivers need to be observant. Watch for red areas of skin on your loved one's body while helping him/her dress or bathe. If your loved one is immobile, it's imperative that you learn to turn him or her every two hours whether in a chair or in bed, to keep pressure ulcers from forming. Cushion his or her body with pillows to make him or her comfortable. Then, switch his or her position two hours later.

Also, strive to keep your loved one's skin healthy, clean and dry. Wet or damp skin can lead to a break in skin integrity and a pressure ulcer. If incontinence has become an issue, you'll need to be extra vigilant. Your loved one's skin is fragile now, so use minimal force when cleaning his or her body. Wash the skin with mild soap and blot dry. Help your loved one maintain a balanced diet and keep their body hydrated, for healthy skin. You can also improve the skin's condition by massaging their arms, hands, and legs with oil or moisturizer. Not only will it prevent irritation and dryness, but touching your loved one will provide reassurance that he or she is loved.

Resource: Alzheimer's Association