Potential Pressure sore and District Nurses

I wonder if I could run this by members please? My husband is 82 and non medically compliant. The District Nurses have been visiting for 3 years to try and manage his sores but discharged him in September with Cavalon sticks. In fairness, they did arrange the GP to phone to make sure he realised the potential consequences of being non compliant as in having a bath everyday so disturbing the sores and sleeping on a chair rather than the offered hospital bed! I was told by one of the nicer nurses that he would NOT be discharged and they would cut the visits down then one day they did not turn up and when I phoned I was told he had been discharged. In fairness, the skin on his buttocks, although fragile was not broken.

A couple of weeks ago, the skin seemed to be breaking down. Due to the blood thinners there was some bleeding which to me, seemed quite severe. I have no dressings. I did phone the GP Surgery since I was worried I might be considered ‘negligent’ if I did not get advice (despite husband having ‘Mental Capacity’ and myself having no medical training ) .We saw a Health care Assistant who told me not to dress the wound, and to use just the Cavalon. On Friday early evening, it bled very heavily - all over his gown and the bathroom. We managed to stop it but when he got up a few hour later it started again and the blood was coming down his legs not pouring but enough to be substantial. It has been more or less ok since then but there is a wound.

A kind friend has sent some large Allevyn dressings which she used for her late husband and I think I am going to suggest husband wears these when he goes out to protect the sore. He has a scan on 21st plus it is my 60th birthday later this month and with Xmas we do have things booked if he is well enough to go.

My plan I think is to monitor over Xmas period and if does get worse or no better, maybe write to the GP Surgery for advice in the New Year? If it does deteroiate then I will try to get him to the GP Surgery but it is a nightmare to get through. Also I am ambivalent about the nurses coming back as I had 2 days a week totally at their beck and call as had no idea when they were going to arrive. A key safe is NOT an option partially due to the cats, but also due to the fact that if they start coming 2x a week I need to be there to listen to what dressings I should put on the other days. I was always taught that if the wound bleeds cover it by the nicer nurses, but this is not what the Healthcare Assistant told me. I do know the nurses got frustrated with my husband having a bath every day, but he has damaged his bowel probably due to the non compliance re the lactulose, ad the Consultant told us that he would have to learn to live with the incontinence and in fairness, we have eventually got 4 incontinence pads a day for him. So I can understand him wanting and even needing a daily bath.

I just wondered how other Carers coped with District Nurses and Pressure Sores? I do realise they can become infected but think I could probably pick this up. I do worry about being accused of neglect but the bottom line is that my husband is known to be medically non compliant and has mental capacity. The sad thing is if I got some support from the Surgery, I would do my best to manage the sores and not get the nurses who are very busy involved. Husband does not want nurses back as he is worried about the covid risk and I do know they are very stretched and stressed. But I do feel rather abandoned right now and am torn between my instincts which is to dress the sore or the medical advice from the HealthCare Assistant which is to leave it - but I am not sure she has taken into account the effect of the blood thinners although I did stress this. Thanks for reading if you have got this far - feel so out of my depth.

Hi Helena,

no experience of this but if it was me I think I would want it checked again before Christmas as getting help over the Christmas and New Year period is even more difficult. Also, no disrespect to the health care assistant, but it has worsened since she/he saw it and the advice given conflicts with the advice given in the past.


Hi Helena,

Have a look at the NHS England website about pressure sores.
I know I did this when mum had them, but can’t remember chapter and verse now.

It really isn’t helping by everyone telling you to do different things.
When mum was in hospital, she told me that they took a photo of her sore very regularly.
Maybe you should do this too, if your husband will allow it, of course?!
Also, if it bleeds, take a picture if possible.

I really don’t think it’s fair them abandoning you due to his non compliance.
They should have a “monitoring role” if only every four weeks or so.

Thanks Melly. I do not think it has got dramatically worse - but the bleeding was scary on Friday night. Also husband now scared to move in case it starts bleeding again, which is not ideal as lack of moving around can cause the skin to degrade more. It is just so hard to get through to the GP Surgery plus I have a busy week with medication deliveries, my booster jab, hairdresser, and other appointments which are going to be very hard to move. It is very hard to get through to the GP Surgery even bang on 8am, plus I then have to stay in until someone calls me back and then we MAY get offered an appointment the next day or if all the app gone, be told to phone back. I shall monitor. He has a medication review by telephone tomorrow between 12-.3 so have to be by the phone from 11ish until 4ish as they sometimes phone early or late. He is very deaf so I cannot really let him go alone as he wont necessarily hear the advice to pass it on. The plan is to get him to mention the situation to the nurse - may not be her’ job’ but at least he can get the bleeding and my concerns on file. I think I am going to use the dressings as I think the skin is so thin, every bit of movement risks starting the bleeding again and if the skin sticks to the incontinence pad, then it can be very nasty. Frankly I do not think that the District Nurses should have just discharged him without at least discussing this with me - I would have been happy with telephone support and a monthly visit as they knew him and had seen the sores and how quickly they could flare up. If the medication review nurse thinks we should be seen before Xmas I will do my best to make an appointment.

Thanks BB - I am actually taking photographs so I can get an idea if the area is getting deeper and bigger. Nurses did this a lot when they visited. I shall monitor and hopefully speak to the review nurse who is phoning re his breathing medication tomorrow. If she feels he needs to be seen, and cannot make us an appointment I shall try to phone on Wednesday. I am just so sick of having to re arrange and change my appointments and WILL NOT delay or change my booster jab.

I totally agree I should not have been left to get on with it, as I am not the non compliant one and have been doing my best to follow instructions given by the nurses re dressings and Cavalon. I have worked with most of the District Nurses well for the last 3 years. I think it was an Admin decision to abandon us partially due the pressure on the services, and I do understand to a degree. But yes, a monthly phone call would have really helped me continue to try and stay on top of this.