Pressure ulcers, more commonly referred to as "bedsores" are primarily a concern for bedbound, hospitalized or immobile individuals, TRUE or FALSE?
The correct answer to this question is FALSE. While its certainly true that immobile persons are at higher risk for developing a bedsore, other, less likely candidates may also be at risk.
During a recent physician's appointment, my friend, Kate, was surprised to learn that her elderly aunt had developed a bedsore even though she is mobile and for the most part gets around independently. The sore, located, in the tailbone region, was classified as Stage II, not an insignificant matter. How did Aunt Pat, develop a bedsore? It turns out that a couple of key risk factors were present. Aunt Pat, is 90 years old, very thin, diabetic and lives a sedentary life style. Her skin is very thin, almost transparent looking. She is prone to sitting for long periods of time in her favorite arm chair while she reads or knits. Getting in and out of her chair is sometimes uncomfortable so she tends to "stay put". In addition to weak skin, stressed under the pressure of sitting for long periods, reduced blood flow to the area probably exacerbated the problem. Since she is also a diabetic, sores are slow to heal and frequently become infected. My friend recalls her aunt mentioning once or twice that her backside was sore but didn't take it seriously.
Kate's aunt complains of aches and pains so often that she just assumed it was nothing out of the ordinary. Fortunately, Aunt Pat's case was treatable with topical ointment and did ultimately heal well. As a result of this incident, Kate has become very diligent about checking Aunt Pat's skin regularly for signs of breakdown. A practice which is recommended for anyone charged with caring for an elderly loved one.
Bedsore Basics
Pressure ulcers or "bedsores" can develop when a person stays in any one position for a long period of time. Sores most commonly develop over pointy, bony areas like the tailbone, heel or hip but can develop anywhere on the skin. The blood flow to the area slows down or stops, causing the skin tissue to die, resulting in the pressure ulcer. The ulcer starts on the inside and works its way out to the skin's surface. Pressure ulcers can start forming within several hours but may not be visible until 3 to 7 days later. Any changes in skin condition or color (redness) over bony areas can indicate the start of a pressure ulcer. Prompt reaction is essential! Simple pressure ulcers can quickly progress to life threatening open sores. At the first sign of skin breakdown, contact your health professional for guidance.
Prevention Tips
Seniors who are mobile should get up from bed or chair every couple of hours to increase blood flow.
Bedbound individuals must change their position every 2 hours. Keep ankles and knees from touching each other using a pillow or air cushion. Use a heel cushion to protect this pressure point. Never drag or pull the body to change positions. Consider purchasing a specialty mattress or overlay designed to stimulate circulation and reduce pressure.
If the primary caregiver is not able to handle the repositioning either physically or due to scheduling issues, consider hiring an In-Home Care Provider to assist with this duty. Certified Nursing Assistants are trained in proper positioning technique along with other essential personal care tasks.
For those who spend large periods of time in a chair or wheelchair, weight should be shifted every 15 minutes to reduce risk of pressure ulcers. Consider purchasing a specially designed seat cushion to minimize pressure on sensitive areas.
Do your best to ensure that your loved one maintains a balanced diet. Diets rich in protein, vitamins A,C, E, Zinc and Iron all promote wound healing. Small, frequent meals are generally recommended. Adequate fluid intake (primarily water) is also essential. Offer small quantities of liquids throughout the day. Seek the advice of a qualified dietician for special dietary concerns or needs.
Individuals with bladder or bowel control problems are at increased risk for pressure ulcers. Contact with urine or bacteria from stool can weaken the skin tissue or cause skin infections. Make sure skin is kept clean and dry. Use mild or hypo-allergenic cleaning products. Check with your physician about the possibility of using skin barriers and ointments to help keep moisture away from the skin. Use absorbent pads or adult diapers to assist in keeping skin as dry as possible. Always remove these products immediately when soiled and cleanse the area thoroughly.
Inspect the skin on a daily basis for signs of redness or breakage. Feet are often overlooked. Do not forget to remove coverings and check feet, especially heels for signs of pressure sores. Look for redness, warmth, swelling, sores, or complaints of tenderness. Report concerns promptly to a medical professional.
Bedsores can lead to serious infections and even death. They should be taken seriously and treated by a medical professional. Caregivers should be vigilant about bedsore prevention. However, it is important to recognize that not all cases of pressure ulcers are preventable. Sometimes sores develop despite the best efforts of a conscientious caregiver.
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