Return to C & R Medical Supplies homepage
Resource Center
Medicare & Insurance Guide
Glossary of Medical Terms
Best of Medical Websites
Help for Patients and Caregivers
Return to C&R Medical Supplies homepage Customer Service Online Catalog Qualifications Become a Patient
About Us
Extra Large Font Size Large Font Size Normal Font Size
Locate Us
Contact Us
Product Categories
Our Location
2908 SE Loop 820
Fort Worth, TX 76140

Toll-Free: 877.551.9328
Local: 817.590.8166
Fax: 817.590.8277
View a map to our location

Patient and Caregivers

Health Issues - below are some of the most common health issues. Please feel free to read the information we have collected. Some of this information includes risks, tips, explanations, and prevention tips for patients and caregivers.
Alzheimers Diabetes Osteoporosis
Asthma Epilepsy/Seizures Parkinson's Disease
Breast Cancer Hepatitis C Sleep Apnea
CHF Multiple Sclerosis Urinary Incontinence
COPD Muscular Dystrophy Wound Care
Cystic Fibrosis Obesity  
     

Help for Patients and Caregivers : Wound Care

What is a Wound?
Preventing Pressure Ulcers
How do I care for my child's wound?
When do the stitches need to be taken out?
When should I call the clinic?
Questions


What is a wound?
A wound is a laceration (cut), abrasion (scrape), or puncture that breaks through the skin. Some wounds need stitches to close them. All wounds heal by developing a scar. The scar will be kept smaller by removing stitches at the right time, preventing infection, and protecting the wound from being hurt again while healing.

<<Back to Top>>

What Are Pressure Ulcers?
A pressure ulcer is an injury usually caused by unrelieved pressure that damages the skin and underlying tissue. Pressure ulcers are also called bed sores and range in severity from mile (minor skin reddening) to severe (deep craters down to muscle and bone).Tissue under pressure

Unrelieved pressure on the skin squeezes tiny blood vessels, which supply the skin with nutrients and oxygen. When skin is starved of nutrients and oxygen for too long, the tissue dies and a pressure ulcer forms. Skin reddening that disappears after pressure is removed is normal and not a pressure ulcer.

Other Factors cause pressure ulcers too. If a person slides down in the bed or chair, blood vessels can stretch or bend and cause pressure ulcers. Even slight rubbing or friction on the skin may cause minor pressure ulcers.

Where Pressure Ulcers Form:
Pressure ulcers form where bone causes the greatest force on the skin and tissue and squeezes them against an outside surface. This may be where bony parts of the body press against otherPressure Points body parts, a mattress, or a chair. In persons who must stay in bed, most pressure ulcers form on the lower back below the waist (sacrum), the hip bone (trochanter), and on the heels. In people in chairs and wheelchairs, the exact spot where pressure ulcers form depends on the sitting position. Pressure ulcers can also form on the knees, ankles, shoulder blades, back of the head, and spine.

Nerves normally "tell" the body when to move to relieve pressure on the skin. Persons in bed who are unable to move may get pressure ulcers after as little as 1-2 hours. Persons who site in chairs and who cannot move can get pressure ulcers in even less time because the force on the skin is greater.

Your Risk:
Confinement to bed or a chair, being unable to move, loss of bowel or bladder control, poor nutrition, and lowered mental awareness are "risk factors" that increase your chance of getting pressure ulcers. Your risk results from the number and seriousness of the risk factors that apply to you.

  1. Bed or chair confinement. If you must stay in bed, a chair, or a wheelchair, the risk of getting a pressure ulcer can be high.
  2. Inability to move. If you cannot change positions without help, you are at great risk. Persons who are in a coma or who are paralyzed or who have a hip fracture are at special risk. Risks getting pressure ulcers are lower when persons can move by themselves.
  3. Loss of bowel or bladder control. If you cannot keep your skin free to urine, stool, or perspiration, you have a higher risk. These sources of moisture may irritate the skin.
  4. Poor nutrition. If you cannot eat a balanced diet, your skin may not be properly nourished. Pressure ulcers are not more likely to form when skin is not healthy.
  5. Lowered mental awareness. When mental awareness is lowered, a person cannot act to prevent pressure ulcers. Mental awareness can be affected by health problems, medications, or anesthesia.

Fortunately, you can lower your risk. Following the steps in this booklet can help you and your health care provider to reduce your risk of pressure ulcers.

Key Steps:
The following steps for prevention are based on research, professional judgment, and practice. These steps can also keep pressure ulcers from getting worse. Some steps apply to all prevention efforts; others apply only in specific conditions. It may help to talk to a nurse or doctor about which steps are right for you.

  1. Take care of your skin.
         Your skin should be inspected at least once a day. Pay special attention to any reddened areas that remain after you have changed positions and the pressure has been relieved. This inspection can be done by yourself or your caregiver. A mirror can help when looking at hard-to-see areas. Pay special attention to pressure points. The goal is to find and correct problems before pressure ulcers form.
         Your skin should be cleaned as soon as it is soiled. A soft cloth or sponge should be used to reduce injury to skin.
         Take a bath when needed for comfort or cleanliness. If a daily bath or shower is preferred or necessary, additional measures should be taken to minimize irritation and prevent dry skin. When bathing or showering, warm (not hot) water and a mild soap should be used.
    • To prevent dry skin:
      - Use creams or oils on your skin.
      - Avoid cold or dry air, minimize moisture from urine or stool, perspiration, or wound drainage. Often urine leaks can be treated. To obtain a copy of Managing Urinary Incontinence: A Patient's Guide, call 1-800-358-9295 or write to the AHCPR Publications Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907.
    • When moisture cannot be controlled:
      - Pads or briefs that absorb urine and have a quick drying surface that keeps moisture away from the skin should be used.
      - A cream or ointment to protect skin from urine, stool, or wound drainage may be helpful.
  2. Protect your skin from injury
         Avoid massage of your skin over bony parts of the body. Massage may squeeze and damage the tissue under the skin and make you more likely to get pressure ulcers.
    • Limit pressure over bony parts by changing positions or having your caregiver change your position:
      - If you are in bed, your position should be changed at least every 2 hours.
      - If you are in a chair, your position should be changed at least every hour. (if you are able to shift your own weight, you should do so every 15 minutes while sitting.)
      - Reduce friction (rubbing) by making sure you are lifted, rather than dragged, during repositioning. Friction can rub off the top layer of skin and damage blood vessels under the skin. You may be able to help by holding on to a trapeze hanging from an overhead frame. If nurses or others are helping to lift you, bed sheets or lifters can be used. A thin film of corn starch can be used on the skin to help reduce damage from friction.
      - Avoid use of donut-shape (ring) cushions. Donut-shape cushions can increase your risk of getting a pressure ulcer by reducing blood flow and causing tissue to swell.
    • If you are confined to bed:
      - A special mattress that contains foam, air, gel, or water helps to prevent If you are confined to a bedpressure ulcers. The cost and effectiveness of these products vary greatly. Talk to your health care provider about the best mattress for you.
      - The head of the bed should be raised as little and for as short a time as possible if consistent with medical conditions and other restrictions. When the head of the bed is raised more than 30 degrees, your skin may slide over the bed surface, damaging skin and tiny blood vessels.
      - Pillows or wedges should be used to keep knees or ankles from touching each other.
      - Avoid lying directly on your hip bone (trochanter) when lying on your side. Pillows or wedges should be used to keep knees or ankles from touching each other.Also, a position that spreads weight and pressure more evenly should be chosen - pillows may also help
      - If you are completely immobile, pillows should be put under your arms from midcalf to ankle to keep heels off the bed. Never place pillows behind the knee.
    • If you are in a chair or wheelchair:
      - Foam, gel, or air cushions should be used to relieve pressure. Ask your health care provider which is best for you. Avoid donut-shaped cushions because they reduce blood flow and cause tissue to swell, which can increase your risk of getting a pressure ulcer.
      - Avoid sitting without moving or being moved.
      - Good posture and comfort are important.
  3. Eat well
    Eat a balanced diet. Protein and calories are very important. Healthy skin is less likely to be damaged. If you are unable to eat a normal diet, talk to your health care provider about nutritional supplements that may be desirable.
  4. Improve your ability to move
    A rehabilitation program can help some persons regain movement and independence.

Be Active in Your Care
This information tells how to reduce your risk of getting pressure ulcers. Not all steps apply to every person at risk. The best program for preventing pressure ulcers will consider what you want and be based on your condition.

Be sure you:

  • Ask Questions
  • Explain your needs, wants, and concerns.
  • Understand what and why things are being done.
  • Know what is best for you. Talk about what you can do to help prevent pressure ulcers - at home, in the hospital, or in the nursing home.

Information provided by the U.S. Department of Health and Human Services
Public Health Service
Agency for Health Care Policy and Research
Executive Office Center, Suite 501
2101 East Jefferson Street
Rockville, MD 20852

<<Back to Top>>

How do I care for my child's wound?
Gently clean the stitches or wound as instructed with soapy water 2 times a day until the stitches are removed or the wound is healed. Dry the wound after cleaning.

  • After cleaning, apply a small amount of antibiotic ointment to the stitches or wound for 2 or 3 days.
  • For stitches on the face, antibiotic ointment should be used until they are removed. This will help stitches to come out easier.
  • Covering the wound is not necessary after 24 hours, unless otherwise instructed.
  • No swimming or tub baths while stitches are in place. Showering is OK.
  • No real active play or contact sports; take care to protect the wound for ____________________.
  • For 1 year after the scar heals, apply sunscreen when in the sun. This will prevent darkening of the scar.

When do the stitches need to be taken out?
The stitches should be removed in ___________ days by your child's doctor. Call the office for an appointment as soon as possible so this can be done on the correct day. Stitches removed too late can cause more scarring. If any stitches come out early, apply a bandage and call the clinic.

When should I call the clinic? Call if a wound has any signs of infection:

  • more redness
  • more swelling
  • more pain
  • pus draining from wound
  • red streaks going out from the wound
  • fever higher than 101° F

Questions?
This sheet is not specific to your child, but provides general information. If you have any questions, please call the clinic. For information on health, parenting, injury prevention, or community resources, please call the Family Resource Center at (612) 813-6816 or (651) 220-6368.


CAREGIVER TIPS & INFORMATION:
  • 10 Tips for Family Caregivers
  • Questions to Ask Your Healthcare Provider
  • How to Communicate with an Insurance Provider
  • Find a Doctor
  • Information on Seating & Mobility
  • Tips for Family Caregivers from Doctors
  • Care Management Techniques You Can Use
  • Compare Home Health Agencies in Your Area
  • Keep loved ones connected & updated!
  • Additional Resources

 


10 Tips for Family Caregivers.
1. Caregiving is a job and respite is your earned right. Reward yourself with respite breaks often.
2. Watch out for signs of depression, and don't delay in getting professional help when you need it.
3. When people offer to help, accept the offer and suggest specific things that they can do.
4. Educate yourself about your loved one's condition and how to communicate effectively with doctors.
5. There's a difference between caring and doing. Be open to technologies and ideas that promote your loved one's independence.
6.Trust your instincts. Most of the time they'll lead you in the right direction.
7. Caregivers often do a lot of lifting, pushing, and pulling. Be good to your back.
8. Grieve for your losses, and then allow yourself to dream new dreams.
9. Seek support from other caregivers. There is great strength in knowing you are not alone.
10. Stand up for your rights as a caregiver and a citizen.
<<Back to Top>>

Tips for Family Caregivers from Doctors

  • Write questions down so you won’t forget them
  • Be clear about what you want to say to the doctor. Try not to ramble.
  • If you have lots of things to talk about, make a consultation appointment, so the doctor can allow enough time to meet with you in an unhurried way.
  • Educate yourself about your loved one’s disease or disability. With all the information on the Internet it is easier than ever before.
  • Learn the routine at your doctor’s office and/or the hospital so you can make the system work for you, not against you.
  • Recognize that not all questions have answers—especially those beginning with “why.”
  • Separate your anger and sense of impotence about not being able to help your loved one as much as you would like from your feeling about the doctor. Remember, you are both on the same side.
  • Appreciate what the doctor is doing to help and say thank you from time to time.
<<Back to Top>>

Care Management Techniques You Can Use
Did you ever wish you could just pick up the phone and call someone who would take stock of your situation, help you access the right services, counsel you and your family to help resolve some of your differences, then monitor your progress with an eye toward channeling your energy and abilities as effectively as possible? If your answer is "yes," you're not alone. Having the help of a care coordinator (often called a care manager) could make all of our lives easier and less lonesome, and help us be more capable family caregivers. While most of us may not have access to a care coordinator, we can all learn how to think and act like one, thereby reaping numerous benefits for our loved ones and ourselves.

What Is Care Coordination?
Although every case is different, the care coordination approach usually involves:

  • Gathering information from healthcare providers;
  • An assessment of your care recipient and the home environment;
  • Research into available public and/or private services and resources to meet your loved one’s needs; and
  • Ongoing communication between all parties to keep information up-to-date and services appropriate and effective.

Unfortunately, an assessment of your abilities and needs is not necessarily a standard part of the process, but it should be. A complete view of the situation cannot be gained without one. An objective analysis of your health, emotional state, other commitments, etc., are key elements in determining how much you can and cannot do yourself, and what type of outside support is needed to ensure your loved one's health and safety.

Become Your Own Care Coordinator
By learning and applying at least some of the care coordination techniques and ideas that follow, you'll be in a much better position to develop an organized course of action that will, hopefully, make you feel more confident and in control - a goal well worth working toward.

Educate yourself on the nature of the disease or disability with which you're dealing. Reliable information is available from the health agency that deals with your loved one's condition and the National Institutes of Health. When using the Internet, stick with well-known medical sites. Understanding what is happening to your care recipient will provide you with the core knowledge you need to go forward. It will also make you a better advocate when talking with healthcare professionals.

Write down your observations of the present situation including:
  • Your loved one’s ability to function independently, both physically and mentally.
  • The availability of family and/or friends to form a support network to share the care.
  • The physical environment: Is it accessible or can it be adapted at reasonable cost?
  • Your other responsibilities — at work, at home, and in the community.
  • Your own health and physical abilities.
  • Your financial resources, available insurance, and existence of healthcare or end-of-life documents.

This assessment will help you come to a realistic view of the situation. It will let you know the questions to which you need answers. It can be a handy baseline for charting your caregiving journey and reminding you just how much you've learned along the way.

Hold a family conference. At least everyone in the immediate family should be told what's going on. A meeting can set the stage for divvying up responsibilities so that there are fewer misunderstandings down the road when lots of help may be needed. A member of the clergy, a professional care coordinator, or even a trusted friend can serve as an impartial moderator. A family meeting is a good way to let everyone know they can play a role, even if they are a thousand miles away. It can help you, the primary family caregiver, from bearing the brunt of all the work all of the time.

Keep good records of emergency numbers, doctors, daily medications, special diets, back-up people, and other pertinent information relating to your loved one's care. Update as necessary. This record will be invaluable if something happens to you, or if you need to make a trip to the ER. If you can maintain a computer-based record, that will make updating all that much easier and it might even allow you to provide the medical team with direct access to the information.

Join a support group, or find another caregiver with whom to converse. In addition to emotional support, you'll likely pick up practical tips as well. Professionals network with each other all the time to get emotional support and find answers to problems or situations they face. Why shouldn't family caregivers?

Start advance planning for difficult decisions that may lie ahead. It's never too early to discuss wills, advance directives, and powers of attorney, but there comes a time when it is too late. It is also vital that you and your loved one think through what to do if you should be incapacitated, or, worse, die first. It can happen.

Develop a care team to help out during emergencies, or over time if your situation is very difficult. In an ideal world there will be lots of people who want to help. More likely you'll be able to find one or two people to call on in an emergency or to help with small chores. The critical thing is to be willing to tell others what you need and to accept their help.

Establish a family regimen. When things are difficult to begin with, keeping a straightforward daily routine can be a stabilizer, especially for people who find change upsetting and confusing.

Approach some of your hardest caregiving duties like a professional. It's extraordinarily difficult to separate your family role from your caregiving role, to lock your emotions up in a box while you focus on practical chores and decisions. But it is not impossible to gain some distance some of the time. It requires an almost single-minded approach to getting the job at hand done as efficiently and effectively as possible. It takes practice, but is definitely worth the effort.

©National Family Caregivers Association | www.nfcacares.org | Phone: 800/896-3650

<<Back to Top>>

Seating & Mobility - As a caregiver, you need to be very understanding to the individual's needs. This is a very hard time as they are being told they need to start living their life in a different manor than they had done so previously. It will be most beneficial to educate them, either with a professional, or through a support group. By becoming involved in different activities with others in the same condition, the individual will be able to make the transition much easier. As far as the actual device, you will want to make sure that the individual is fully capable of performing all the operations of the mobility device and can do so in a comfortable manner. Areas to pay close attention to include an adjustable backrest, a suspension system, a fore-and-aft track adjustment, an up-and-down seat adjustment, an armrest and/or footrest, and lumbar region support.

How do you care for your mobility device?

The most important areas that you need to pay attention to are referred to as the 3 B’s…Bad batteries, bent wheel rims and failed bearings. If you notice something that doesn’t seem right, but it isn’t all too annoying, you should still get it looked at right away. This could prevent a more severe accident from happening. So as the saying goes “it’s better to be safe than sorry”.

When a wheelchair is purchased, you will want to make sure that all the correct adjustments and modifications are made. This needs to be done by a professional and should take up to a couple of hours if done correctly. As long as the proper measures are taken initially, the work of maintaining the device will be substantially easier.
<<Back to Top>>

Additional Resources

It's always wise to find out what your county and state have to offer in the way of services, even if you think you won't qualify for them. Check the blue pages of your phone book for the numbers, or go on line. Counties and states all have web sites. Type the name of your state or county and state into any major search engine i.e. Iowa, or Montgomery County, PA. Navigate from there to locate the Department of Health and Human Services and the specific office most relevant to your needs, such as office on disabilities, elder affairs, or maternal and child health.

Other good sources of information include your local hospital or clinic (social work department), area adult day centers, social service and faith-based agencies, and/or the local chapter of the health agency that focuses on your loved one's condition. It is by no means certain that any of these will offer caregiver support services, but they are good places to check, and they are good sources for information about services to directly support your loved one.

National Family Caregivers Association
10400 Connecticut Avenue, Suite 500
Kensington, MD 20895
800-896-3650
Web site: http://www.thefamilycaregiver.org
e-mail: info@thefamilycaregiver.org

The National Family Caregivers Association (NFCA) is a grassroots organization created to educate, support, empower, and advocate for the millions of Americans who care for chronically ill, aged, or disabled loved ones. NFCA is the only constituency organization that reaches across the boundaries of different diagnoses, different relationships, and different life stages to address the common needs and concerns of all family caregivers. NFCA serves as a public voice for family caregivers to the press, to Congress and the general public. NFCA offers publications, information, referral services, caregiver support, and advocacy.

Caregiver-Specific Web Sites
There are a variety of Web sites that offer information and support for family caregivers, in addition to those from specific organizations.

<<Back to Top>>