Mum has always been pretty careful with her skin. When we lived in East Africa, we always wore long-sleeved dresses, and big-brimmed hats to protect us from the worst the sun could do and, for a long time, Mum's skin has been in a very good state.
Over the past few years, the rate at which Mum's skin has thinned has accelerated - only to be expected, I suppose, as she is now 99! - and we are careful to keep a close watch on any bumps and bruises she gets.
We have put foam rubber "lagging" around the pull-up sides of the bed, so at least she has something very soft which can protect her arms and legs if she gets restless in the night. Over the last 18 months or so, we've seen a variety of livid marks on her legs - mostly the right leg, below the knee, although both legs have been affected - and we took these photographs show the doctor:
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| Mum's arm that caused us concern |
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| ...and Mum's leg |
Every night, after the carers have left, we go in to check on Mum's pins to see how they are. We have tubs of Sudocrem, a healing, antiseptic cream, and I slather it on, like a plasterer gone mad with his trowel and up to now this has been very effective. We also have Mepilex dressings, which are breathable, padded and - most importantly! - easily removed when they have to be changed. With this care, marks might come up, but mostly after a while they fade, and Mum never complains of them hurting her.
Last Friday, one of the marks on her leg went from red to purple, and you could see a little reservoir of blood just under the skin; then we noticed the skin had broken in one small area, and it was weeping. The carers were also concerned, so I rang Mum's GP, and she was put on the list for a home visit.
When Mum's doctor and his assistant came round, they immediately understood why we were worried. As a temporary measure, they put a sterile pad and fresh dressing on the wound, and said they would arrange for a District Nurse to visit on Monday.
When the District Nurse called, she was very reassuring, and said Mum's leg wasn't too bad, but of course, we don't want it to get any worse! She changed the dressing, and said another District Nurse would visit on Thursday.
Mum's skin is so thin now, that we have to be extremely careful when removing old dressings; you cannot just "gently peel them off," because Mum's skin starts to lift with the sticky area, and it looks just like that very thin transparent skin that lies between the layers of an onion. I have to say it makes me feel awfully "squidgy," and it is quite a technique, to hold down Mum's skin very gently, keeping it in place, whilst easing the dressing off a little bit at a time.
Mum has not had other issues with her tissues; even though she can't walk anymore, she is still quite active whilst sitting in the chair, and we encourage her to move about, stretch, lean over to one side or the other, and as she keeps moving, and doesn't sit or lie still in one place for very long, we hope this will continue to prevent any area getting a pressure sore.
She also has a very good orthopaedic mattress which is excellent for preventing bed sores; it isn't an air bed mattress, but so far, Mum has not had any other problems.
We are now trying out various ideas to protect her from hurting her legs in the night. A member of the family loaned her a pair of his old, long, white fishing socks - we drew the line at the wellington boots! - and these seem to be working well. We keep Mum's room temperature up to (nearly) East African standards, but we hope these socks, apart from giving her added protection, will also keep Mum toasty and warm during this very cold weather!
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