DEAR DOCTOR K:

I care for my elderly mother, who is confined to her bed most of the time. I'm worried about her getting bedsores. How can I prevent them?

DEAR READER:

You're right to be concerned, since bedsores cause pain and can lead to serious infections. Fortunately, there are several things you can do to prevent your mother from getting them.

Bedsores are areas of broken skin that are more likely to develop in people who are confined to a bed for extended periods. They form where the weight of a person's body presses against the firm surface of the bed. This includes the hip, spine, lower back, tailbone, shoulder blades, elbows and heels.

Bedsores begin with a patch of redness. If this red patch is not protected from additional pressure, the redness can form blisters or open sores. Broken skin can allow bacteria to enter and cause a skin infection, which can spread to the bone beneath the skin and to the blood. It can then be carried by the blood to other organs, including the brain and heart. What begins as a little patch of red skin can lead to a life-threatening infection.

To reduce the risk of your mother developing bedsores:

-- Relieve pressure on vulnerable areas. Change your mother's position frequently. Move her every two to four hours from the back to one side, to the other side, and again to the back. When she is on her side, she should be only partly on her side (about a 30-degree tilt); if she is completely on her side, her hip bone will push down hard on her skin.

Use pillows to raise her arms, legs, buttocks and hips. Relieve pressure on her back with an egg-crate foam mattress or a sheepskin. Place pillows or wedges made of foam between her ankles and knees, so that they don't press against each other. Use pillows or special heel protectors under her heels, so that they don't press against the mattress when she is lying on her back.

-- Reduce irritation. Avoid dragging your mother across the bedsheets. Either lift her or have her use an overhead trapeze to briefly raise her body. Keep the bed free from crumbs and other particles that might rub and irritate her skin.

-- Inspect your mother's skin at least once each day for the earliest signs of bedsores. If you find a suspicious area, promptly contact her nurse or doctor.

-- Encourage good nutrition. Your mother's diet should include enough calories, protein, vitamins and minerals. If she cannot eat enough food, consider nutritional supplements.

-- Encourage daily exercise. Even bedridden people can do stretches and simple exercises.

-- Keep her skin clean and dry. Clean with plain water and very gentle soap. Use absorbent pads to draw moisture away from vulnerable areas.

We have a lot more information on caring for the elderly in our Special Health Report, "The Caregiver's Handbook." You can find out more about it at my website.

(Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: www.AskDoctorK.com.)

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