Management of Pressure Sores in the Inpatient Hospice Setting

ABSTRACT Hospice care is a valuable approach to persons with progressive, fatal illness, that emphasizes the relief of symptoms -making what time they have left the best possible -rather than a futile attempt at cure when cure is not possible. Pressure sores are a common problem in the hospice setting that may contribute to the suffering of the patient. Risk factors for pressure sores include immobility, poor nutrition and the catabolic state, moisture, and sheer forces. In managing pressure sores in the hospice, it is important to remember that the primary goal is to relieve symptoms and not necessarily to cure disease. The most important factor is having a dedicated nursing staff, while specific approaches are secondary. Beyond this, important factors are good positioning, optimizing nutrition and adequate analgesia. Once these are achieved, the general principal is “clean it up, cover it up and leave it alone.” Surgical procedures and cultures and systemic antibiotics are to be avoided in this setting....