Information - Ideas - Suggestions

We know that questions come up when you’re considering renting a hospital bed for home.

This section may help clarify some issues you may have.

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Frequently Asked Questions (FAQ's)

If your questions are not answered below, please call & we’ll help in any way we can.

Contact us whenever you you want;

  1. Call us on (01) 5033 700 or (083) 8649 471
  2. Fill in our contact form and one of our friendly staff members will call you back.
  3. Email us on: info@r2o.ie

A profiling bed (sometimes referred to as a medical bed /hospital bed) is specifically designed to provide support to users.

Electronically operated, our range of profiling beds offer ease of movement and comfort for both patient and carer.

The profiling platform has an adjustable knee break, head section and the entire bed frame is height adjustable. Safety and durability are key aspects of our design ethos – each bed has something different to offer.

A pressure relief mattress is designed to increase comfort for an individual suffering from (or at risk of developing) pressure ulcers. The mattress provides high levels of support for the head and body to relieve any mounting stress on pressure points.

Unlike a regular mattress, pressure relief mattresses have carefully designed air pockets, specifically designed to place less pressure on the main pressure points in the body.

STATIC:

Foam mattresses are mostly designed for the prevention of pressure ulcers rather than the treatment.

Responding to an individual’s body shape, heat, and movement, they are comprised of single or multiple pressure relieving foam.

Their surface remains static and relieves pressure overtime by evenly distributing an individual’s weight over a large surface at a continuous low pressure.

ALTERNATING (Active)

Recommended for Grade 3 and Grade 4 pressure ulcers, alternating air pressure mattresses are mostly used to treat developed ulcers as well as preventing them for those unable to move themselves.

Providing constant relief to the individual, they also bring the benefit of reducing the need for manual repositioning by a carer.

Assembled with a row of lateral air cells that constantly alternate, they relieve and redistribute pressure through a dynamic lying surface. Air-flow is controlled via a pump unit connected to the mattress, with the pump inflating deflated cells and deflating the inflated cells.

Inflated air cells provide pressure to support the user whilst the deflated cells provide relief for the skin above them. The pump ensures that there is constant movement under the user’s skin as well as periods of no pressure.

Absolutely! Our existing clients range from HSE nursing homes, private nursing homes and private individuals. You can rent or purchase our equipment. We deliver and install the equipment in your home (or a holiday home or hotel).

We accept Debit Cards, Credit cards, Bank Transfers, Cheques or cash.

R2O provides a full nationwide service. We have a dedicated team of trained and experienced staff for delivery and maintenance of all our equipment.

The term bariatric was coined around 1965, from the Greek root bar– (“weight” as in barometer), suffix –iatr (“treatment,” as in pediatrics), and suffix –ic (“pertaining to”).

 The term is also used in the medical field as somewhat of a euphemism to refer to people of larger sizes.

We at R2O understand the special needs and requirements of patients and their carers. We supply top of the line bariatric medical equipment that is noticeably larger, with a higher weight capacity, than standard equipment.

The bariatric range is carefully designed to keep caregivers safe and patients comfortable. Browse our shop to see our range.

 

Pressure Ulcers (bedsores)

What are pressure ulcers?

Pressure ulcers – also referred to as pressure damage, pressure injuries, bedsores or decubitus ulcers – are usually seen on the skin as red, purple or discoloured areas, which may progress into blistering or open wounds. These can develop on bony areas of the body such as the back, bottom or heels or in areas where the blood supply to the tissues has been reduced due to prolonged pressure.

They can happen to anyone, but usually affect people who spend more time in bed or those who sit in a chair or wheelchair for long periods of time. If you are at risk of pressure damage you should be offered advice on how to reduce your risk and this will usually include information on:

  • How to assess your skin for early signs of damage
  • What type of mattresses, cushions or special devices may help to relieve pressure from vulnerable areas
  • How to keep moving. Even small changes in position are really important to reduce the risk of damage
  • If you have problems with your bladder or bowels that mean that your skin is wet or soiled, there may be creams and products that will help to prevent skin damage
  • How to make sure that you eat a healthy diet and take sufficient fluid to keep the skin nourished and hydrated.

 

While pressure ulcers can appear anywhere on the body, they are most commonly seen over bony areas such as the heels, ankles, hips, spine and buttocks.

Why do pressure ulcers develop?

Pressure ulcers form when blood flow to the tissues of the skin and surrounding area is reduced.

Capillaries are the smallest blood vessels. They bring oxygenated blood from the arteries into the organs, skin and underlying tissue, as well as taking deoxygenated blood away from the skin and tissues back into the veins.

When a person is sitting or lying on a surface the pressure between the seat/mattress and the body compresses the capillaries in this area. This is especially noticeable over bony areas, like your heels, buttocks and tailbone (coccyx). Just like squeezing a hosepipe if this pressure is high enough it can reduce blood flow through these capillaries or even stop it altogether.

Pressure is not the only issue. Shear forces (such as sliding down the bed or slouching in a chair) also play a part in the development of pressure.

How do we naturally prevent pressure ulcers?

If someone’s blood vessels are closed or compressed due to pressure, then the oxygen supply to the surrounding tissues falls.
Interestingly, in healthy people, this fall in oxygen prompts a reflex to move; this is the reason you cross and uncross your legs or roll over in bed at night without really thinking about it! Ignore this reflex and you will start to feel pain and discomfort, a sign from your body that it’s time to get moving again.

If the pressure is relieved, and the circulation is restored, the capillaries open up again and blood flow increases to the area again. For those with pale skin, this may be observed as the pink patch that is visible if you have had your legs crossed for a sustained period.

This pink patch is called ‘blanching erythema’. Blanching erythema is identifiable by the pale spot you can see when you press on it with a finger on Caucasian skin. In dark skin tones, this may not be visible, therefore when checking the skin, any change in skin colour or appearance should be checked carefully in case it is a sign of increased vulnerability.

What happens if the skin remains under pressure?

If pressure continues, then reduced oxygen levels starts to cause damage to the capillaries and surrounding cells.
The first sign in the skin is often a change in colour. For those with light skin tones, non-blanching erythema may be visible, where the skin colour is a persistent red and the skin colour does not change when lightly pressed with a finger.

For those with dark skin tones, a change in skin colour may be observed, but is unlikely to present as redness. It is therefore important to compare any changes in colour observed with areas of unaffected skin to determine if early signs of pressure damage are developing.

It is also important to understand that damage may occur deep within the tissues, presenting as a Deep Tissue Injury. This may present as a purple or dark discoloured area, a thin blistered area over an area of dark discolouration or an area of thin dark eschar. The affected area may be painful and may be harder or softer, or warmer or sometimes cooler than the surrounding areas.

Signs and Symptoms of Pressure Ulcers

Pressure ulcers often develop slowly but can develop in just a few hours with the right conditions.

Pressure ulcers are likely to develop faster when there is higher pressure on a smaller area, and more slowly when there is lower pressure over a wider area.

What are the Early Signs of Pressure Ulcer Development?

Early signs of pressure ulcer development include:

  • A change in the colour of the skin. People with pale skin are more likely to see red patches on the skin, and people with darker skin area more likely to see purple or blue patches.
  • Reddening of the skin that does NOT turn white when you press it. This is called a ‘non-blanching erythema’.
  • Any unusual changes in skin texture may be related to pressure damage. Common changes include skin feeling spongy or ‘boggy’.
  • A patch of skin that feels cooler or warmer to the touch than others.
  • A sore or itchy patch of skin.

 

Bedsores fall into one of several stages based on their depth, severity and other characteristics. The degree of skin and tissue damage ranges from red, unbroken skin to a deep injury involving muscle and bone. Skin showing these signs of pressure ulcer development may be referred to as ‘category one’. (See Stages of Pressure Ulcers )

What are the Later Signs of Pressure Ulcer Development?

As pressure ulcers worsen, they may break the skin. Signs of worsening pressure ulcers include:

  • An open wound or
  • A deep wound that reaches the deeper layers of the skin.
  • A very deep wound that may reach the muscle and bone.

When should I get help for a Pressure Ulcer?

You should tell your healthcare team as soon as possible if you develop symptoms of a pressure ulcer as it will probably continue to get worse if nothing is done about it.

If you’re recovering from illness or surgery at home, or are caring for someone confined to bed or a wheelchair, contact your GP surgery if you think you or the person you’re caring for might have a pressure ulcer.

Get medical advice immediately if there is:

  • Red, swollen skin
  • Pus coming from the pressure ulcer or wound
  • Cold skin and a fast heartbeat
  • Severe or worsening pain
  • A high temperature (fever) of 38C (100.4F) or above

These symptoms could be a sign of a serious infection that needs to be treated as soon as possible

Staging / Grading of Pressure Ulcers

Pressure ulcers vary in size and severity of the tissue affected, ranging from reddening of the skin to damage to muscle and underlying bone.

How are Pressure Ulcers Staged / Graded / Classified?

According to the international classification system pressure ulcers can be staged as one of six categories.

Superficial

  • Stage 1: Intact skin with persistent reddening, known as ‘non-blanching erythema’. For more information on non-blanching erythema, click here.
  • Stage 2: An abrasion or a blister can be seen, without bruising. There is some skin loss or damage affecting the top skin layers.

Superficial ulcers are more difficult to spot than deep ulcers. For information on the warning signs of pressure ulcer development click here.

Deep

  • Stage 3: Full thickness skin loss which can expose fat in areas where this exists. Damage is limited to the skin and fat layers.
  • Stage 4: Full thickness skin loss with damage to the underlying structures, such as tendons or bone, which may be exposed.

Other

  • Deep tissue injury: Tissue injury hidden under intact skin. These appear as deep bruises and can quickly deteriorate into a high-stage pressure ulcer. For more information on why deep tissue injuries occur, click here.
  • Unstageable Pressure Injury: Pressure ulcer with an undetermined level of tissue injury because the entire base of the wound is covered by slough tissue

The grading of a pressure ulcer is a critical part of the process of caring for a person with pressure ulcers.

While treatment is tailored to the individual, as many factors can impact the development of a pressure injury, the grade of pressure sore is an important part of creating a treatment/management plan.

Preventing Pressure Ulcer Development

Pressure ulcers can develop rapidly given the right conditions.

Not all risk factors can be controlled. However, the key risk factors affecting the individual should be taken into account as part of a pressure ulcer prevention strategy. Preventive measures include:

Identify key risk factors that put the individual at higher risk of pressure ulcer development

Risk assessment may involve the use of a scoring system eg. Waterlow, Braden, or Glamorgan scales or a system for colour (RAG) rating risk eg. Purpose T.

Whichever system is in use, it is important to ensure that it is not used in isolation but supports clinical & holistic assessment of the person and their needs and preferences.

Frequently assessing skin for early signs of damage

People who are able to do so should be shown how to check their skin for any signs of damage

Carers can also be shown how to inspect the skin and what to look for

Early signs of skin damage may include discomfort, redness, or a change in colour to the skin. This may be more difficult to assess in dark skin tones

Use of equipment that reduces pressure

Mattresses/cushions that inflate and deflate to redistribute pressure
Static Viscoelastic (memory-foam) mattresses/cushions which conform to the shape of the body to distribute pressure evenly.
Positioning devices – these may include slide sheets for repositioning, and devices suitable for heels, etc. to remove all pressure from the heel and facilitate healing

Regular movement helps redistribute pressure

For those at risk of pressure damage, changes in position should be made at least every 4 hours

Even small changes in position are really important to reduce the risk of damage

This should be discussed with each person on an individual basis, and agreement on the frequency of repositioning should be recorded

Repositioning frequency may need to be increased if skin assessment shows any increased vulnerability

People who cannot reposition themselves need assistance to do so.

This repositioning should be done throughout the day and night.

Use barrier creams and appropriate containment products

Use barrier creams and appropriate containment products (eg. Continence pads) for those with bladder or bowel issues that lead to frequent episodes of wet or soiled skin

Barrier creams should be dimethicone based products rather than oil-based products

A thorough continence assessment should be undertaken to establish the most appropriate containment products for the person.

Ensure access to a healthy diet and adequate fluid intake to keep the skin nourished and hydrated

Ideas that may help carers...

If you are new to the role of being a carer or maybe just want a fresh perspective, here are some great tips that might help you.

Open and honest communications

It’s not uncommon for family members to have different views on the sort of care needed. The geographical challenges of people living in other parts of the country is an additional factor. In many instances, one individual is left to manage the care while others will dip in and out.

Talking to your family about what is happening is important. This includes how your loved one is coping from week to week, any changes to their behaviour or condition. The level of care you’re providing and where you’ve had to adapt. This is also a great way to involve other members of the family and get their opinion.

And don’t forget, it doesn’t have to be a face to face conversation every time. Use technology and the internet to keep everyone in the loop. A facetime call while you’re with your loved one to family members who live away. Set-up a WhatsApp group to send photos, videos and messages. It all helps to keep everyone up to date.

Accept help when offered

Being a carer can be an incredibly difficult job to do. It’s often not something you would choose to do but is taken on without hesitation when the need is there. Which is why accepting help when it’s offered is also the right thing to do.

Your local support network can be a life-saver. People you know are probably more than happy to help you out. Sitting with your loved one while you carry out other errands or asking them to pick up some shopping. It’s ok to work this into your care activities and will probably give them a sense of satisfaction to know they can help you.

Take care of yourself

Being absorbed in the role of a Carer it can take over your whole life. It’s important to take some time for yourself. Be mindful of your health and mental wellbeing it can be very easy to enter a downward spiral which can result in you not being able to continue to give the care you want.

Arranging time away with the help of family or friends can give you a real boost. If you have your own family you mustn’t neglect them but you will need to make plans. A weekend away with friends is another great tonic. Moments when you can recharge and rebalance the rigours of providing care.

Support from other carers

Talking to people in a similar situation to you is always helpful. They will understand what you are experiencing and can provide real empathy. You can compare notes, look at your situation from a fresh perspective even pick up some new ideas you hadn’t thought about.

There are organisations you can go to for support. You can search for a local group of individuals in the same situation as you as well as access online information. It’s good to know you’re not alone and most of what you are experiencing is similar to how other carers feel.

Care for the individual

When you become a carer for someone you must understand the individual. The level of involvement they want to have in their care should be taken into account. For some, it’s that moment of realisation when they cannot cope on their own any longer. So making sure they still feel in control is important.

This will depend on who you are caring for, their personality and level of needs. Conditions that deteriorate over time will need you to be flexible and adapt your care as needed. For example, those living with dementia are often in denial. You have to find ways to provide the support they need in a ‘matter of fact’ sort of way.

Building relationships with the local doctors and medical staff will help everyone. You will become a familiar face and they will know you understand the situation. It will also ensure that when you need additional help or a situation arises you can act quickly.