About pressure injuries

Anyone who cannot easily change position is at risk, at any age. That includes people recovering from a hip fracture or major surgery, people with a spinal cord injury or advanced multiple sclerosis who use a wheelchair full time, people weakened by a stroke, and people in the later stages of dementia or another serious illness.

Loss of feeling matters as much as loss of movement. Someone with nerve damage may not notice the ache that tells the rest of us to shift. Very thin people have less padding over bone. People who wear oxygen tubing, splints, braces or casts can develop the same kind of injury wherever a device presses on skin. Several of these risks often appear together in one person.

What the treating clinician looks at

After the assessment, the treating clinician writes orders and explains them to the people who will carry them out. A pressure injury plan usually has several parts:

  • Wound orders: how the wound is cleaned and covered, and how often the dressing is changed
  • Pressure relief: the mattress, cushion or heel protection to use
  • Positioning: which positions to use, which to avoid and how often to change
  • Skin care: keeping the area clean and dry after incontinence
  • Follow-up: when the wound will be checked again

Gateway follows up on the supply and equipment orders and shares the plan with the caregivers, home health nurses or facility staff involved.

Pressure injury and bed sore care in Arnold

Across Arnold, the main family caregiver often works a full day and has a commute on top of it. That can leave a person with a pressure injury in one position for many hours. Tell the treating clinician exactly when help is and is not in the house. The plan can then lean more on the support surface, on paid caregivers or home health, and on positions the person can manage alone, instead of a turning schedule no one is home to follow.

Cross the Meramec River on Interstate 55 and the first city you reach is Arnold, the largest in Jefferson County. Subdivisions spread over the hills on both sides of the interstate, and Jeffco Boulevard carries much of the local traffic. For daily errands Arnold is self-contained, but a good deal of specialty care sits north of the river in St. Louis County. For someone with a wound that needs frequent attention, or for a caregiver who works, that bridge crossing adds up. Care that comes to the home or facility takes the trip out of the week.

Care at home

Most pressure injury care happens in the hours between visits. Someone has to change the dressing as ordered, help the person turn, keep skin clean after incontinence and look over the bony areas for new color changes. Before the clinician leaves, ask who is expected to do each task and what to do if a dressing comes loose early.

A simple written log helps. Note position changes, dressing changes and anything that looks different, and show it at the next visit so the clinician can see what the days are really like. Call Gateway at 314-325-0126 if supplies are running short or a visit needs to be moved.

Care in skilled nursing and assisted living

Pressure injuries in memory care come with particular challenges. A resident with advanced dementia may not be able to say that a spot hurts, may resist being turned, may sit in one favorite chair for hours, or may pull at a dressing. Staff who know the resident are usually the first to notice a change in mood, sleep or willingness to sit.

Partner clinicians see residents in the memory care setting, which spares the resident a trip to an unfamiliar clinic. The treating clinician takes behavior into account when writing orders, and Gateway shares the plan with nursing staff and the family member or representative who makes decisions.

What to report and when to call 911

Pressure damage can start before the skin opens. Check the tailbone, hips, heels and other bony areas when you help with bathing or dressing, and tell the treating clinician or nurse if you see:

  • A patch that stays red, purple, maroon or darker than nearby skin after the pressure is off
  • Skin that feels warmer, cooler, firmer or softer than the skin around it
  • A blister, a shiny area or a shallow break
  • A spot the person says is sore, burning or itchy

Call 911 if the person has trouble breathing, chest pain, or is suddenly very hard to wake.

Primary care and overall health

Several everyday medical issues affect how much pressure the skin takes. Medications that cause drowsiness can reduce the small movements a person makes while sitting or sleeping. Untreated pain makes people hold still and resist turning. Diarrhea, urinary infections and constipation with leakage keep skin wet. Stiff, contracted joints limit the positions a person can use.

A primary care clinician can review the medication list, pain control, bowel and bladder problems and whether therapy would help with mobility. Do not stop or change a medication on your own. Bring the concern to the clinician, and ask Gateway to share it with the wound care team as well.

Primary care at home in Arnold →

How to get started in Arnold

Before anything is scheduled, Gateway checks two things for every request for pressure injury care in Arnold: whether a partner clinician serves that address and care setting, and what the patient’s plan requires from the treating provider. Neither is assumed. If both line up, we arrange the visit and gather records. If something stands in the way, we say so, and our guide to following up on a request explains what to ask next. Gateway coordinates the care and does not make clinical decisions. Those belong to the treating clinician who sees the wound. Start by calling 314-325-0126, or ask a family member to call for you.

Before you call about care in Arnold, write down the patient’s address and the nearest cross street, the best phone number, the insurance cards on hand and the name of the doctor who knows them best. If a home health agency is already involved, tell us that as well. Because Arnold sits at the top of Jefferson County, visits here can be planned together with nearby Imperial, Oakville, Mehlville and Fenton. Addresses farther into Jefferson County are welcome too, and availability is confirmed case by case.

  • County: Jefferson County, Missouri
  • ZIP codes: 63010
  • Nearby hospitals: Mercy Hospital South; Mercy Hospital Jefferson in Festus; SSM Health St. Clare Hospital in Fenton (not affiliated with Gateway)
  • Nearby communities: Jefferson County, Oakville, Imperial, Fenton, Mehlville
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Arnold

Read the full guide to pressure injuries, or see everything Gateway arranges on the mobile wound care in Arnold page.

Common questions

How do we start pressure injury care for a family member in Arnold?

Call Gateway or send the request form with a name and phone number only. You do not need a referral to call. On the phone we will ask where the person lives, how long the sore has been there, which hospital or doctor has seen it and what insurance they have. From there we gather records and work on scheduling with a partner clinician.

Can a wound care clinician come to a home in Arnold to look at a bed sore?

Gateway arranges home visits by partner clinicians for people with pressure injuries, and availability is confirmed by location and care setting. When you call 314-325-0126, we ask for the address, whether the person is at home or in a facility, and who is already involved in their care. We then tell you what can be arranged for that address.

How do you spot early pressure damage on darker skin?

Redness can be hard to see on dark skin, so color alone is not a reliable guide. Look for a patch that appears darker, purplish or ashen compared with the skin around it, and use touch as well. An area that feels warmer, cooler, firmer or puffier than nearby skin, or that the person says is tender, should be reported to the treating clinician.

Can a caregiver who works in St. Louis arrange care for a parent in Arnold by phone?

Yes. A son or daughter can make the first call from anywhere. Give us your parent’s name, address and phone number, and tell us who should be the main contact. With the patient’s permission, we can keep you updated on scheduling and next steps, so you do not need to be in Arnold for every visit. Please keep medical details out of the web form.

General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.