Wounds that do not heal are one of the main reasons people end up back in hospital, and most of them are treatable at home by a nurse who sees them regularly and knows what they looked like last week.
This is nursing work. It is provided by a registered nurse or registered practical nurse, not by a personal support worker, and we are precise about that distinction because getting it wrong causes harm.
The wounds we most often see at home
- Pressure injuries, which develop over bony areas in people who spend long periods in a bed or chair, and which are far easier to prevent than to heal.
- Diabetic foot ulcers, which can be painless because of nerve damage and are therefore often found late.
- Venous leg ulcers, which need compression as much as they need dressings, and which recur without it.
- Surgical wounds that have opened, become infected, or are healing more slowly than expected.
- Skin tears, which are common in older adults on blood thinners or long-term steroids.
How we help
- Assessment and regular dressing changes by an RN or RPN, on a schedule the wound actually needs
- Measuring and recording the wound each visit, so a wound that is not progressing is identified in weeks rather than months
- Watching for infection — spreading redness, heat, odour, increasing pain, fever — and escalating quickly
- Compression for venous ulcers where it has been prescribed and assessed as safe
- Pressure relief and repositioning schedules, and personal support workers who carry them out between nursing visits
- Skin care and prevention for people at risk, which is where most of the value in wound care actually is
- Nutrition support, because wounds do not heal in people who are not eating enough protein
- Coordination with the family doctor, surgeon or wound clinic, including photographs where consented to
Who provides the care
All wound assessment and dressing is done by a registered nurse or registered practical nurse. Personal support workers support the parts that are not regulated acts — repositioning, skin care, keeping areas clean and dry, and reporting changes. Nobody outside their scope touches a wound.
Common questions
Can a PSW change a dressing?
No. Wound care is a regulated act and it is done by a nurse. A personal support worker can keep skin clean and dry, follow a repositioning schedule and report changes — all of which matters — but the dressing is nursing work.
How often will the nurse come?
It depends on the wound and the dressing. Some need daily attention, many need two or three visits a week, and some need weekly. The nurse will tell you after assessing it rather than before.
Is nursing wound care publicly funded?
Frequently, yes — nursing for wound care is among the most common services Ontario Health atHome arranges, and that is the first place to ask. Private nursing is used where public visits are not frequent enough or where there is a wait.
Can you prevent pressure sores rather than treat them?
Yes, and it is far better care. Repositioning schedules, pressure-relieving surfaces, keeping skin clean and dry, and daily skin checks prevent most pressure injuries in people at risk.
The wound is not getting better. What then?
That gets escalated rather than continued. A wound that is not progressing after a reasonable period needs review — by the family doctor, a wound clinic, or a specialist — and part of our job is making sure that review happens.
Where we provide this care
We provide this support across 146 communities in Ontario, from the Greater Toronto Area to Thunder Bay. If your town is not listed, call us — we will tell you honestly whether we can staff it properly rather than promising and then failing to turn up.
Related
- Hip and knee replacement
- Falls and fractures
- Ostomy, catheter and continence
- Home care — what it covers
- Respite care for family carers
- 24-hour home care
- All 146 communities we serve
Not sure what you need? That is the normal starting point. A free consultation is a conversation about what is actually happening at home — no charge, no obligation, and we will point you at publicly funded care first where you may qualify for it.