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Pressure Ulcers Occupational Therapy

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<strong>Pressure</strong><br />

<strong>Ulcers</strong><br />

<strong>Occupational</strong><br />

<strong>Therapy</strong><br />

This leaflet is for both yourself and Carers


Contents<br />

What is a pressure ulcer? 3<br />

Who is at risk of developing a pressure ulcer? 4<br />

How can I avoid developing a pressure ulcer? 5 & 6<br />

Where might I develop a pressure ulcer? 7<br />

What else can I do? 8 & 9<br />

Individual recommendations 10


3<br />

What is a<br />

<strong>Pressure</strong> Ulcer?<br />

A pressure ulcer is an area of damaged tissue. It is caused by being in<br />

the same position for too long without moving. In some people this may<br />

not just be damage to the surface of the skin, but the deeper layers of<br />

tissue under the skin may also be affected. They are also known as<br />

bedsores or pressure sores.<br />

What are the Causes of a <strong>Pressure</strong> Ulcer?<br />

Prolonged unrelieved pressure<br />

The weight of the body can squash the skin and tissues causing<br />

damage.<br />

Shearing<br />

When you slide down the bed or are dragged up the bed, this may cause<br />

a strain on the skin and tissue layers. This may cause damage.<br />

Friction<br />

This occurs when two surfaces rub together i.e. skin rubbing against a<br />

chair or bed.


Who is at risk of<br />

developing a <strong>Pressure</strong> Ulcer?<br />

Anyone who has a lack, or limited, mobility<br />

This may be as a result of:<br />

• Having to stay in bed<br />

• Being in a wheelchair<br />

• Having difficulty in moving around<br />

• Spending long periods of time in an armchair<br />

• Having a serious illness<br />

• Being elderly or frail<br />

• If you have diabetes or have had a stroke – your<br />

body may become less sensitive and you may<br />

not feel the need to change position<br />

• If you have had a pressure ulcer in the past, then<br />

this area of skin is at risk of further pressure<br />

development<br />

• Having moist or damp skin. This is usually caused by not<br />

drying well after washing, sweating or through incontinence<br />

• Being under or over weight<br />

• Not eating a balanced diet<br />

• Not having enough to drink<br />

4


5<br />

How can I avoid<br />

developing a <strong>Pressure</strong> Ulcer?<br />

The best way to avoid developing a pressure ulcer is to get out<br />

of your bed or chair and walk for a short distance at least every two<br />

hours, or at least change your position. This will allow the blood to flow<br />

and help tone up your muscles. Your district nurse will advise about<br />

your own needs.<br />

If you are in bed:<br />

• You should change your position as often as your district<br />

nurse has told you to. Alternate between lying on your<br />

back and your side. You may need help to do this, to<br />

prevent dragging your skin along the sheets.<br />

• Use pillows to stop your knees and ankles touching,<br />

especially when you are lying on your side, as this can<br />

cause soreness on the skin.<br />

• Take care to avoid crumbs in the sheets.<br />

• If you sit up in bed, make sure you do not slide down as this<br />

can drag on your buttocks and heels, causing soreness.<br />

• Keep your skin clean and dry<br />

• It is important that your carers know how to help you and not<br />

put themselves at risk. A healthcare professional will be able<br />

to help advise you.<br />

General:<br />

• Dry well after washing, sweating or through incontinence<br />

• Keep within a healthy weight range<br />

• Eat a balanced diet<br />

• Drink plenty of fluids.


If you are in a wheelchair or armchair:<br />

How can I avoid developing a <strong>Pressure</strong> Ulcer?<br />

Take the weight off your buttocks every half hour by...<br />

• Leaning forward and pushing up on the arms of your chair –<br />

or roll from side to side for a while.<br />

• Use the correct size armchair to give support to your spine<br />

and shoulders.<br />

• Your knees should be level with your hips and bent at 90º.<br />

Your feet should be flat on the floor.<br />

• If you need more advice on seating your occupational therapist<br />

can help.<br />

6


7<br />

Where might I<br />

develop a <strong>Pressure</strong> Ulcer?<br />

Heels >> Buttocks >><br />

Ankles >> Base of spine >><br />

Knees >> Elbows >><br />

Hips >> Shoulders >>


What else<br />

can I Do?<br />

• Eating a well balanced health diet is important. It helps your<br />

skin to stay strong and healthy – remember to have plenty<br />

of fluids.<br />

• If you are unable to move yourself seek help. This can be from your GP,<br />

physiotherapist, occupational therapist or district nurse. Your doctor’s<br />

surgery or health centre will advise you of the best person to help you.<br />

8


9<br />

What else can I do?<br />

• If you are worried about your skin or think you may be getting a<br />

pressure ulcer, seek help and advice. Your doctor’s surgery will help<br />

you contact the best person.<br />

• Try to avoid rubbing or massaging your skin too hard especially over<br />

the bony parts. Pat skin dry after washing or bathing.<br />

• It is better not to use creams unless a doctor or nurse has<br />

prescribed them.<br />

• Do not use talcum powder as it soaks up the natural oils in the skin<br />

and dries it out.<br />

• For areas that are too hard to see, use a mirror or ask your carer to<br />

check for you.


Individual<br />

Recommendations<br />

10


A Tip for Success<br />

If you find that you a have a pressure ulcer, try not to worry.<br />

If you get the right treatment, advice and take care of yourself,<br />

a pressure ulcer can be healed.

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