Mr John Tyson, aged 48, has ha

Mr John Tyson, aged 48, has had arthritis since he was a
child. He is married and both he and his wife Jenny (48) have moderate learning
disabilities. John was admitted after a fall at home, when Jenny could not get
him back into his wheelchair. His BMI is 18.5, he looks grey, emaciated and
frail. On further examination, John is found to have a grade 4 pressure ulcer
to his left trochanter (hip) which tracks to his perineum.