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Aussiemndcarer

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Advice from those who sit all day in a chair and then sleep in a recliner please!
What do you do to avoid pressure sores?
I'm interested in other strategies. I hope someone out there has a plan that works.
 

Narrowminded

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Aussie - while Brian isn't in a chair, he is on his back 24/7 in bed. He has a wedge of foam that he's had for six years, it's not much of a wedge anymore, but it gives him a bit of a pelvic tilt and I think that helps, as the foam is softer than traditional chairs etc. However, in talking with other CALS, nutrition seems huge. I add collagen to his food. It's really good for your skin. Not sure what you can find there, but I order Great Lakes brand from Amazon. It disovles in anything and doen't thicken. Also, just trying as best you can to keep his nutrition as best as possible. Not too many sugars. I'm not sure what he currently eats, but that's what's worked for us.

Hugs,

sue
 

Diane H

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The only preventative for pressure sores is reducing pressure. Skin care helps the skin but pressure sores develop in the muscle below the skin, like a deep bruise. Skin sores, other than raw spots from friction, are usually the last thing seen with a pressure sore. The first sign is pain, then discoloration, either bruised darkness or redness. Break down of the skin is last.

Both the chair and the recliner need to have a ROHO cushion. I am not certain that even a ROHO can overcome the effects of sitting day and night every day. In addition to the ROHO, there needs to be full support for his arms to prevent shoulder subluxation and easy dislocation. The ROHO cushion will lift him up higher so, if he uses the armrests they have to be padded to raise them as well. Most often though the arms and hands are inside the armrests so the elbows need to be well supported. Also, even with the feet up in a recliner, swelling of the feet, ankles, and up into the lower legs has to be considered. Most recliners have the weight of the legs on the recliner's leg rest. That puts all the weight on the calves and that affects the ability of blood to circulate back up. Newer recliners may have better leg support but not all. A hospital bed with the head elevated would be far better for his circulation, but would still require a special medical quality pressure relief mattress or mattress pad. Since he will be sitting or semi-sitting even in bed, using a ROHO wheelchair cushion in bed would work well too. BiPAP is sometimes and understandably refused, but using BiPAP would allow him to lie down as well as turn on his sides. Switching from sitting up to lying flat to turning from side to side will prevent mucus from settling in the base of his lungs, thickening, and further reducing his lung capacity.
 

KateEmerson

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My husband is in a wheelchair about 1 1/2 hours a day now, a recliner around 7-8 hours, and bed the remainder. We have a ROHO in the wc and recliner and a full length ROHO on top of the mattress. Since we got the ROHO for the recliner he has not had any complaints, soreness, or pressure sores on his posterior. We also have a real sheepskin on the back of the recliner and there hasn't been any sores there either. Where we have had the pressure sores are the lower legs where his bones are prominent, just below the knee, ankle, just above the ankle as his legs roll out. So it seems the ROHOs are doing their job.
 

affected

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ROHO are amazing.

MND WA may be able to loan them to you, we had all of ours from MND NSW.
 

Diane H

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Pressure relief for the heals and ankles seems to be best accomplished with "bridging" rather than trying to get something soft enough under the pressure spots. With bridging you position a pad such as a rolled up wash cloth or a piece of memory foam above and below the bony part or heel to suspend the sensitive spot off the bed. With a piece of foam, you can cut a hole in it to fit around the sensitive spot. Because foam compresses considerably it needs to be about 3 or 4 inches thick. Heels are especially sensitive to pressure and the pain is incredible when they are under pressure. They can turn grey/ purple in just a few days of bedrest.
 

Aussiemndcarer

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Thank you for updates. I did try and post but lost my script,so here goes again.
We do have an alternating pressure cushion on the recliner.we have a special cushion on wheelchair and I alternate where we put Jim's feet. Up, down,on foam,on airline headrest cushions ( we find them very useful)
I even let him hang from hoyer lift for a while between transfers.kind of like aerial Pilates ,we joke.
Still,I've noticed red marks on skin near coccyx . Our hospice nurse has provided us with silicon dressing to protect the area.
There is no pain yet either but I'm so scared of pressure sores after reading up on them.
We have a hospital bed with state of the art pressure mattress waiting,but Jim doesn't want to go there! As he is on air 24/7 , he prefers sitting up.

Thnx for all your advice.
 

Duker52

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For those that have ROHOs, is there a preference for the small bubbles or the large bubbles? I want to order one from Amazon, it they come in two variations. Recommendations would be appreciated.

Bill
 

lgelb

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Most people here will have the High Profile Quadtro Select (smaller cells). Price-shop somewhere other than Amazon, too. But that is because they are using it in a wheelchair and need the 4" height for bumping around and tilt/recline. I would still want the smaller cells for most PALS, but in a recliner you could maybe get away with [and might be more comfortable in] a Low Profile, maybe even Single Compartment, depending on the type of chair and your weight.
 

GilWest

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Two hour turns is all that I found that worked. However, they can still form. As mom contracted, her head turned to where her left ear rubbed her pillow no matter how we turned her. Do the best you can and try not to be hard on yourself. Turning every to hours 24-hours a day can be exhausting. I set a clock at first to alarm every two hours. Our saving grace was a hospital bed with alternating pressure and low air loss mattress...
 
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