Controlling Skin Infections
Skin infections are related to the times incontinence wear is examined, the hours each garment is used, urine production, hot weather, and preventative skin care. The hot summer of 2018 was a disaster. The summer of 2019 exhibited almost perfect control with Vitamin A&D ointment.
The coronavirus CODE RED order restricted us to our apartment. I realized the Arlo video cam could now record all the times Margaret received services (time chart). The lapse hours between services (hours chart) shows the variability in the hours each garment was used.
The events on Monday, 30 March, are what alerted me to something new was going on after Margaret was accepted into hospice care. Three times that day, I asked when she would be checked. “I will be back in a bit.” [I earned “a bit” equals 1.5 hour]. My impression of this is that new caregivers had the idea that hospice was coming to do that task.
Given all of the above, I realized we needed to make plans for a predicted warmer than average 2020 summer. Things happen in memory care. We need to be ready to manage them.
The seven observations made on Tuesday, 24 March, average 3.4 hours apart. The five made on Friday, 17 April average 4.8 hours apart. Urine develops a strong odor in about 3 hours and irritates the skin.
The Molicare products used four years ago when Provision Living opened in 2015 contained curly fibers. These fibers change the pH of urine from skin irritating basic to acidic.
Only Molicare pull-ups were provided as part of the full-service memory care plan for mobile residents. It took about three per day instead of five to seven. Now the caregivers want only tabbed briefs for changes on the bed.
The three-week series reveals other things. In general, all services are drifting to later in the day. The timing of night services is less variable. This is related to staffing.
Afternoon dryness checks are the most erratic (not charted). This Is also the case for pain medications (that are charted in the eMAR computer system).
Observant, familiar, trained, and skilled caregivers can provide an optimum memory care performance when provided with the appropriate supervision and supplies. I think we can be ready for another hot summer. Pain and bowel medications are reducing urine output.
I would judge that outlier situations can be handled when “things happen”. And, that optimum performance this summer is obtainable on most days.
