I’m trying to find any useful information around maintaining healthy skin for a geriatric female with double incontinence - we have managed great for around 30 months using Sudocrem for any first signs of bedsores or irritation and everything has been fine until the DN withdrew its use and provided nhs pads - previously and currently using tena pull on type - the lady now has rapid deterioration of the skin - sore at base of spine so is being tilted often - pressure sores on legs and irritation around her bottom! DN refuses to approve Sudocrem and has now suggested that sores are either psoriasis, eczema or allergic reaction to washing products!
It’s so frustrating as we’d managed really well until now and delighted there’d been no major issues.
Sorbaderm has been prescribed but only to be used every third soiling!
Any advice?? We’re unable to use anything that hasn’t been prescribed.
My mum used Sudocream, but apparently the hospital didn’t like it. Anyone know why it’s gone out of favour?
Hi Ann,
It’s very frustrating when professionals meddle and don’t listen to those providing the day to day care. I would make an appointment for her with the GP, explain what did work, what has happened since stopping the sudocrem and ask for advice.
Melly1
Hi Ann,
My Mum also used sudocrem for years and years and it always did the trick then it was suddenly frowned upon and I was told not to use it. Something about it being drying, She used to have ‘break outs’ of sores under her breasts, under her tummy and in her groin. She was a large lady. I was advised to use BP Emulsifying cream on dry areas such as her shins, where the skin was very thin and liable to break down. It’s very thick and keeps moisture in/out while protecting.
She was prescribed a cream which was rather like hand cream in texture. Cannot remember the name apart from it started with ‘D’. Dipro-something maybe.
Tall container with a plunger.
I would definitely go the her GP. Is one of the GP’s a specialist in skin problems or a specialist in ‘women’s’ problems? You need to be very wary of pressure sores. Don’t be fobbed off by ‘allergies’. Pressure sores can get very deep, very painful and very hard to heal. Has mum been given pressure cushions or a pressure mattress? I’d start kicking up a fuss about her current symptoms before they get beyond help.
It’s so hard to keep on top of everything all of the time and sore patches can appear between one check and the next. What’s more if your Mum is like mine she doesn’t complain until it’s bad.
KR
Hi. Have you tried Proshield Plus spray and Proshield cream? You can get it on prescription via your gp
.
There’s something wrong with your District Nurses, my wife’s had a couple of small pressure sores and the DNs have been like flies around shit.
As a general treatment when there’s no problems she has a barrier cream applied to her bum - LBF Barrier Cream, if it needs a bit more help, then Zeroderm is used. For small sore areas (just a bit red) where her catheter sometime rubs on her thigh or her belly I use Doublebase Dayleve Gel, and if the one small sore on her bum gets worse, (which it does every few weeks), I put a Hydrocolloid plaster on it.
The District Nurses should have access to a tissue viability specialist. We were prescribed Cavilon cream for everyday use. My husband also has cushioned dressings for the sacral area. If it is really bad I use Inadine patches underneath the dressing. However the best thing I have used are Aquacell dressings. They really help if the wound is weepy or infected. They are not used as a preventative but during the time the wound needs bringing under control. He has an air mattress and I raise the affected area by using the 30 degree tilt method. Put the patient on their side and push a pillow under them to give a chance for the pressure to be relieved for a short period. Obviously it’s a matter of trial and error but do not be afraid to push for help from the District Nurses.
Cavilon is great and much more expensive than Sudocream. It lasts through a couple of washes too.
When my hubs was diagnosed with pressure sores, it was exactly as Ayjay has said.
Within a week, he had an air cushion for the chair and a pressure mattress.
They are still coming three times a week, even though his back is almost healed. No problems whatsoever with creams or dressings.
Go and see mum’s doctor and explain that your mum’s skin is deteriorating.
I want to show an interest in this post, with the greatest respect to Ann.
Mum currently screams with pain when her bottom is wiped, I’ve had the carers putting cream on Mums bottie, when I gave the carers a choice between Sudocreme and E45, her answer was I don’t care. She then proudly walked into Mums bedroom telling the other carer, I’ve got E45…
I think district nurses are a joke, today I was told that the pads they offered were better than the ones I bought. When I gracefully told the district nurse she was wrong, I was told Pads they offered could hold 2.5 litres…
She then reiterated on the phone the pads could only hold 1 litre admitting she was wrong.
I was then told to keep a weeks worth of Mums wet pads so they could weigh them! Asking me to keep 28 urine soaked pads in my house, so they could take them away and weigh them.
I’m done with this, District Nurses are a joke. I will now be paying for our own pads.
You could always say that you don’t have room at your home, but you could drop them off to her home instead?!
I would strongly advise speaking with GP, in spite of the fact they seem to have massive barriers up around them in the form of pharmacists (who are mainly interested in selling the most profit-making items), DNs (who strangely have too much power - or rather they believe they do) and doctor’s receptionists (you really do not have to tell them at all what you need to speak to a doctor about either - just say it is a private matter, and insist.
There are plenty of creams that may be much more appropriate to use on the person you care about, and the GP can determine better - can even refer to a skin specialist to be sure of the correct treatment. Sudocrem is no doubt excellent for many skin conditions, but if there is a chance of an area of skin becoming sore because of excess sweating, and there has been an overgrowth of the yeast bacteria, Sudocrem will irritate it further.
It is in the interests of everyone - DNs included - to ensure a condition does not worsen; surely they would come under great scrutiny if one of the people under their care had to go into hospital for pressure sores for example, when they have a whole array of products available to them.
But do speak with GP please. Wishing you the very best, and that you see improvements soon.
Mum’s district nurses used Proshield cream and special cushioned wound dressings. The GP also prescribed E45. A health care assistant in hospital liked the E45 lotion that came in a red-topped container.
The district nurse also ordered a comfortable electric recline to stand chair for mum. It had a special pressure relieving seat/legrest.
Certainly mum’s district nurses kept on top of her bedsore and created a big fuss after it had worsened during a short stay in hospital!
Pressure sores can be very dangerous if not addressed properly, I’m surprised your DN hasn’t taken this more seriously.
Hi Ann, My mother (almost 90 yrs), has had pressure sores on her bottom for over 12 months now (on and off), which occurred during a hospital admittance. She is unable to stand without assistance and sleeps sitting upright due to breathing difficulties. We were provided with a pressure cushion for her riser recliner, wheel chair and a profiling bed with pressure mattress. She isn’t incontinent, so doesn’t wear pads unless she has to travel. The skin on her bottom is very fragile though, it varies on a daily/weekly basis. Sores have appeared repeatedly and been treated with Flaminal Hydro and/or Flaminal Forte. Skin area is usually very red and been treated with Xemacort cream for short periods. Skin edge around red area/normal skin is generally dry/cracked/peeling, so we have tried several products provided by the District Nurses, either as a barrier to protect from moisture (sweat, urine) or to moisturise the skin. Barrier creams such as Derma S (also available in a spray) and Derma Pro, Cetraben cream for general dryness, and the latest cream we’ve been issued - Conotrane (still assessing it’s effectiveness). We also stopped using soap to wash her bottom and switched to Tena Wash Cream which seems to have reduced the skins general dryness. It is an ongoing battle to find a solution, and like the weather, her skin condition changes constantly and quickly. All of the mentioned creams were issued either by District Nurses or GP (apart from the Tena Wash).
hi
I don’t know if their is anything available for bottoms etc. after weeks and weeks of district nurses coming and going, she was prescribed by gp zinc impregnated socks for pressure sores on her toes and heals.
it took about a month of wearing them, changing them every couple of days, but they worked so well. district nurses never ever mentioned these.