Parkinson’s disease can be very demanding on the caregivers, especially in the end stages of Parkinson’s disease, when the patient is wheelchair bound or absolutely bedridden. This is the time when extra precautions have to be taken to prevent bedsore formation. Bedsores (also called pressure sores or decubitus ulcers) can be extremely painful and usually develop as a result of prolonged immobilization. It is better to take precautions to prevent bedsore formation because once they develop they can progress very fast and then become extremely difficult to heal.

How and why do Bedsores form?

Due to restricted movements towards the end stages of the disease, there is constant pressure (as a result of the patient’s own body weight) on certain areas of the body such as the buttocks, hips, back of thighs or heels. This constant pressure causes loss of blood circulation to those areas and as a result the tissues die and decubitus ulcers are formed.

Quite often, the friction caused by bed sheets when a bedridden person is moved causes the delicate and thinned-out skin (especially in the elderly patient) to break leading to bedsore formation in these areas. Furthermore, as a result of the various causes of weight loss in a Parkinson’s disease , the normal cushioning of the body by fat and muscles is lost. Chronic moistness of the skin due to inability to control the bladder in later stages also predispose to bedsore formation.

Symptoms of Bedsores in Parkinson’s Disease

In the early stage, there is persistent redness of the skin with slight pain or itching. If treated at this stage, bedsores usually heal rapidly. If not detected early enough, blisters or open sores may form with reddish discoloration of the surrounding skin, which may soon progress to a crater-like ulcer which gradually becomes more painful. In extreme cases, very deep ulcers are formed which involve the deeper structures such as muscles, bones and nerves and can be excruciatingly painful.

Prevention of Bedsores in Parkinson’s Disease

Caregivers have to be extremely alert to the first signs of a bedsore such as persistent redness of the skin, especially at pressure points of the body. Relieving of pressure by turning the patient on his side frequently will prevent formation of bedsores or their further progression. Eating a healthy balanced diet, keeping the skin clean and dry, and physiotherapy and exercises for a Parkinson’s disease patient help to prevent bedsores.

Complications of Bedsores in Parkinson’s Disease

Infection of the skin and adjoining tissues and deeper structures such as muscles, bones and joints. Extreme pain due to involvement of the nerve is another complication.

Treatment of Bedsores in Parkinson’s Disease

• Relieving of pressure by changing positions often, such as by turning the bedridden patient frequently.
• Using special cushions or mattresses.
• A healthy nutritious diet.
• Controlling incontinence of urine or using incontinence pads.
• Proper cleaning of the wound.
• Removal of dead or damaged tissue.
• Regular dressing of the bedsore.
• Use of local antiseptic creams.
• Antibiotics.
• Pain relievers.
• Surgical treatment is the last option in later stages.