EARLIER this year, there was an unfortunate news item in which a grieving mother vented her despair at the condition of her son’s body while under the care of one of Jamaica’s public hospital.

Her son, a former member of the Jamaica Constabulary Force, was reportedly shot while in the line of duty and later succumbed to his injuries.

The mother’s contention was that when he was removed to another medical facility overseas for further treatment, the doctors there, she said, were alarmed at the bedsores on parts of his body, which she alleged contributed to and hastened his demise.

While I cannot comment on this particular case, it is a known fact that a bedsore or pressure sore, also called a decubitus ulcer, is a serious skin problem which may occur when there is lack of quality patient care when individuals are either bedridden, immobile for an extended period, unconscious, or unable to feel pain.

Ulcers that appear on some 12 areas of the body may be caused from the continuous pressure on one area, where the patient remains immobile while lying in bed, sitting in a wheelchair, or wearing a cast for a prolonged period.

This problem also occurs frequently among the vulnerable group of seniors, whether in nursing homes or in their own environment, where supervision is not at a professional level to prevent this from occurring.

Causes of bedsores and prevention

If an immobile or bedridden person is not turned, positioned correctly, and given good nutrition and skincare, bedsores can develop.

They usually appear near the buttocks area, the heels or feet, shoulder blades, the back of the head or the backs and sides of the knees. Individuals among the high-risk group are those with diabetes, circulation problems, and poor nutrition.

Additionally, bedsores develop when blood supply to the skin is cut off for more than two to three hours. As the area of the skin becomes numb, the bedsore starts to manifest as a red, painful area, which eventually turns discoloured or purple.

The patient usually complains of itching, a burning sensation and pain. If left untreated, the skin can break open and the area can become infected. This could extend deep into the muscle and bone and very often take a long time to heal, and, depending on the severity, the patient may need surgery to speed up the healing process.

Role of the nursing assistant

The nursing assistant/patient care technician (PCT) operates under the supervision of the registered nurse (RN) and as a part of the health care team, he or she assists in providing good skin care, which is vital for the elderly. The PCT or nursing assistant helps by providing gentle and consistent care, relieving pressure, controlling moisture and observing and reporting any problems or changes in the patient’s skin.

Often times, it is the keen observation and reporting of the nursing assistant or PCT that helps patients to avoid getting painful and difficult-to-heal ulcers, which can lead to life-threatening infections such as cellulitis or sepsis (the presence of microorganisms in the tissue).

Are bedsores fatal?

According to the United States Nursing Home Abuse Guide website, the prevalence of bedsore death cases is frightening. This has been corroborated by the Centers for Disease Control and Prevention, which estimates that roughly one out of 10 patients suffer from bedsores at any point in time. An estimated 13 per cent of men and 11 per cent women who are currently in nursing homes develop bedsore symptoms.

They further state that although this problem can be caught and treated in the early stages, poor patient care could cause it to reach a life-threatening state.

Training nursing assistants or PCTs

At SMTC Career Institute (SMTC-CI), a great deal of care is taken in training students in understanding the four stages of pressure ulcer development preventive care that will reduce the incidence of pressure ulcers, as well as the important role they can play in reducing the risks with soft supports and frequent positioning.

Established four years ago, SMTC-CI is owned and operated by Strategic Management & Training Consultants Ltd, which is a leading organisation in managing professional medical associations and coordinating international conferences.

Beverley Dinham-Spencer is a certified nursing assistant in Florida, USA and the principal/director of SMTC Career Institute. Contact SMTC Career Institute at Management House, Unit 20, Seymour Park, 2 Seymour Avenue, Kingston 10, or by calling 8769782276 or e-mail theinstitute@smtcworld.com. Visit their website at www.smtcinstitute.com