Among the many health issues caregivers face as a result of COVID-19 is how to reduce the risk of skin breakdown, as residents are now being confined to their rooms. Before COVID-19, residents may have exercised by walking to the dining area for a meal, but today’s social distancing requires meals and other activities to be provided in their rooms. Because of these minimal opportunities for ambulation, residents may be sitting or lying down more frequently than before the pandemic, encouraging joints and muscles to weaken.
One way staff can help address skin integrity concerns is identifying a resident’s mobility and positioning needs while they are seated. Consider abnormal posture issues, such as posterior pelvic tilt or pelvic rotation due to the frequency of being supine or seated.
Take, for example, Mr. Smith, a resident who frequently slides into a posterior pelvic tilt. In this position, an enormous amount of pressure is driving down on his coccyx and greater trochanters, putting Mr. Smith at high risk for coccyx and hip wounds. To help correct this seating challenge, a cushion that is built up in the front, like a wedge, can be used to help with sacral sitting. These types of cushions help to position the pelvis back into the seat, which will redistribute pressure away from bony prominences.
In addition to cushions, several products can be used to help address an array of skin integrity issues, such as mattresses and assistive devices. As you evaluate these particular products in your community, here are some questions you can ask yourself:
Are you using an advanced pressure management surface under residents with existing pressure injuries? A previously healed wound would make them at high risk for skin breakdown. Think about using air cushions with cells that are pumped up to help “float” the pelvic region. Other air cushions have closed cells that fill into compartments within the construction of the cushion.
Are you using a good quality pressure redistributing mattress with a breathable cover? If so, be sure the resident is comfortable and not sitting “through” the mattress.
Does the mattress help to offload pressure from the heels, such as having softer foam, or does it slope to float the heels? A sloped heel section will help redistribute the pressure away from the heels and move to the resident’s calves. The calves are a bit meatier and better able to spread out the pressure.
Does the mattress have features like die-cuts, open-cell breathable foam and a breathable 4-way stretch cover? All of those features will help to create a cooler microclimate between the resident and the mattress.
Do your assistive devices allow independent residents to turn and reposition themselves while in bed? Where applicable, a resident could be allowed an assistive device to help them move or reposition in bed. This could be an assist bar, a trapeze or even a repositioning ladder – just something that will help them safely reposition on their own while in bed.
Are slide sheets available to assist with repositioning the resident in bed? Slide sheets are another way to reposition a higher-acuity resident in bed. Whenever possible, do not share slide sheets between residents. If they need to be shared, be sure to wash or properly disinfect between residents.
From cushions to mattresses and more, you can find a huge selection of healthcare equipment for Senior Living at Direct Supply. Please contact us or call 1-866-300-4074 for product selection assistance. And be sure to visit our Insights page for more about finding the right air mattress for your patients’ needs.