Pressure Injury Care in Monroe and Clinton Counties

Understanding pressure injuries

Several common beliefs about bed sores are mistaken. One is that a small opening means a small wound. Pressure damage is often wider beneath the skin than at the surface, which is why clinicians measure depth and check under the edges.

Another is that rubbing a reddened area helps. Current guidance is to avoid massaging skin that already shows pressure damage. Ring or donut-shaped cushions are also a frequent mistake, because they can concentrate pressure around the edge of the ring. And a sore that does not hurt is not a mild one. Lack of pain may simply mean the person has lost feeling there. When in doubt, ask the treating clinician before trying a home remedy or a new cushion.

What the treating clinician looks at

Where a pressure injury sits says a lot about what caused it, and the treating clinician reads the location as a clue:

Tailbone or buttocks: long hours sitting, or lying with the head of the bed raised
Heels: lying on the back with the feet resting on the mattress
Hip or outer ankle: time spent on one side
Ears, nose or cheeks: pressure from tubing or a mask
Back of the head or shoulder blades: lying flat for long stretches

The clinician then looks at the bed, chair or device involved and asks about the daily routine. A care plan that leaves the source of pressure unchanged is unlikely to succeed, whatever dressing is chosen.

Pressure injury and bed sore care in Monroe and Clinton counties

For people in Monroe and Clinton counties, pressure injury care often starts with an Illinois hospital discharge and an Illinois health plan. Illinois Medicaid and its managed care plans work differently from Missouri plans, and rules for wound visits, dressings and support surfaces vary. Before scheduling, Gateway confirms which partner clinician can see the person at an Illinois address and what the plan requires. Doing this first lowers the chance that a mattress or supply order is delayed later.

Monroe and Clinton counties sit on opposite sides of St. Clair County. Monroe County, to the south, follows Illinois Route 3 through Columbia and Waterloo, with Valmeyer out near the river bluffs. Clinton County, to the east, strings its towns along U.S. Route 50, including Trenton, Aviston, Breese and Carlyle, with Germantown a little to the south. Both are farm country, where a medical appointment usually starts with a highway drive. For someone with a wound or a chronic illness, care arranged at home or in a local facility saves real miles.

When care happens at home

Many people with a pressure injury at home also have a home health agency involved. When that is the case, the wound orders from the treating clinician need to reach the home health nurse, and the nurse’s observations need to reach the clinician. Gateway helps pass that information in both directions so the family is not left carrying messages.

If no home health agency is in place, tell us who is available to help: a spouse, adult children, a paid aide or no one. The treating clinician can decide whether to order home health nursing, and the plan can be shaped around the help that really exists.

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

An infected pressure injury can make the whole body sick, and in frail older adults the first sign is often a change in behavior, not a change in the wound. Contact the treating clinician promptly about:

Fever or shaking chills
Redness, warmth or swelling spreading out from the wound
Pus or cloudy drainage
Pain that is new or clearly worse
New confusion, unusual sleepiness or refusing food and drink

Call 911 if the person is very confused or unresponsive, is breathing fast or with difficulty, or looks suddenly and seriously ill.

How primary care fits in

The body builds new tissue from what a person eats and drinks, and a pressure injury raises the demand. Someone who has lost weight, eats only a few bites at meals, has trouble swallowing or has poorly fitting dentures may not be taking in enough protein, calories or fluid to keep up.

A primary care clinician can look for the reason appetite has fallen, review weight over time and decide whether a dietitian or a swallowing evaluation would help. Gateway can arrange primary care in the same home or facility where wound visits take place, so the clinician who orders the dressing and the clinician who looks at nutrition are working from the same information.

Primary care at home in Monroe and Clinton counties →

Arranging pressure injury care in Monroe and Clinton counties

Setting up pressure injury care for someone in Monroe and Clinton counties usually goes in this order:

You call 314-325-0126 or send the request care form, which asks only for a name and phone number.
Gateway talks with you about the wound, the address and the insurance.
We confirm availability for that location and gather records for the treating clinician.
The clinician visits, assesses the wound and writes the orders.
We follow up on supplies, the next visit and communication with your other clinicians.

You do not need a confirmed diagnosis to start.

For a request from Monroe and Clinton counties, start with the town, the street or rural route address and directions from the nearest highway. Add a phone number, the patient’s doctor and any recent hospital stay. Gateway also arranges care in Belleville, the rest of St. Clair County and the wider Metro East, and in Oakville on the Missouri side. Longer distances mean visit times here are planned with travel in mind, and availability is confirmed for each location and care setting.

County: Monroe and Clinton counties, Illinois
ZIP codes: 62236, 62298, 62230, 62231
Nearby hospitals: HSHS St. Joseph's Hospital in Breese; Memorial Hospital Belleville; Mercy Hospital South (not affiliated with Gateway)
Nearby communities: Belleville, Illinois, St. Clair County, Illinois, Metro East, Oakville
Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Related care in Monroe and Clinton counties

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

Common questions

How do we start pressure injury care for a family member in Monroe and Clinton counties?

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.

What do the stages of a pressure injury mean?

Stages describe depth. Stage 1 is unbroken skin with a color change that does not fade. Stage 2 is a shallow open area or blister. Stage 3 extends into the fat layer under the skin. Stage 4 reaches muscle, tendon or bone. A wound is called unstageable when its base is hidden, and a deep tissue injury is a dark purple or maroon area where the damage lies below the surface.

Should a bed sore be left uncovered so it can dry out?

In general, no. Clinicians usually keep pressure injuries covered with a dressing chosen to hold the right amount of moisture, protect the wound from stool and urine, and cushion it from rubbing. A wound left open to dry tends to form a hard crust that slows new tissue. Follow the treating clinician’s dressing orders and ask before changing anything.

Can residents of small-town assisted living communities in Monroe and Clinton counties be seen where they live?

Gateway arranges visits in assisted living, memory care and skilled nursing settings, including smaller facilities outside the larger suburbs. The family or the facility can make the request. We then coordinate with the staff on a visit time and the resident’s records. As with home visits, availability depends on the location, so we confirm it for the specific facility before scheduling.

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.