Pressure Ulcers in the Elderly
Have you ever seen bedsores or pressure ulcers on a loved one? It can be quite disturbing. Skin that was once healthy starts to fall apart, so instead of seeing a smooth surface of skin with good blood flow and color, you might see redness or an open area where you least expect it. These pressure ulcers are caused by an area of skin being pressed up against something hard, such as a bed, bone or chair. This causes damage to skin tissue over time and the damage can cause the skin to die.
Once the skin is broken, the damage can go through layers of fat and nerves and even into muscle.
Pressure ulcers are graded by health professionals in stages. Stage 1 is the first sign of a pressure ulcer and is usually marked by a painful, red area. Stage 4 is the deepest and worst stage where the wound has traveled to a joint, muscle or tendon. These sores can last for weeks, months or years and put your senior loved one at greater risk for infection.
Risk Factors for Pressure Ulcers
Healthy, strong skin is able to stand up to quite a bit of pressure. However, there are four major risk factors that increase the chances of developing pressure ulcers:
1. Not getting the fluids and nutrition that is needed.
Healthy skin is created from the inside out. Adequate calories, fluid, hydration, minerals, protein and vitamins need to come from diet. This helps the skin to prevent injury and stay strong.
2. Not responding to discomfort or pain.
Diseases that affect the ability to react to what you feel can lead to missing signs of damage. These can include Alzheimer’s disease, confusion or nerve injury.
3. Poor blood flow.
Diabetes and heart disease can increase damage to the skin because blood flow may be impaired.
4. Staying in one position for a long time.
This can be caused by a spinal cord injury, unconsciousness or weakness.
The Symptoms of Pressure Ulcers
The best defense against pressure ulcers is to catch them early and put changes into place that will help the area of skin to heal. Here are the places that you should check for changes on a daily basis:
- Back and side of the head
- Backs of arms and legs
- Lower back
- Shoulder blades
- The skin behind the knees
You might notice some symptoms of pressure ulcers, which include:
- Areas that look like blisters or have pus-filled spots
- Burning, itching or pain in one area
- Puffy or swollen areas of skin
- Skin that feels cooler or warmer than the skin around it
- Skin that is blue, red or purple and doesn’t return to its normal color
The Mayo Clinic advises that at the first sign of a pressure sore, you should assist with changes to how your parent or senior loved one is positioned. If there is no improvement within 24-48 hours in your loved one, then you should immediately discuss it with their health professional.
Ways to Prevent Pressure Ulcers
The U.S. National Library of Medicine recommends these steps to prevent pressure ulcers from forming in a parent or senior loved one:
1. Baby the skin.
Be gentle with aging, fragile skin. Use a soft cloth with non-irritating body washes. Make sure that the skin is patted dry and then apply a moisturizing cream. If your loved one is incontinent, pay special attention to regular cleaning and drying.
2. Check the body from head to toe.
Pay special attention to the bony areas and make note of any red areas and try to determine what is causing the pressure.
3. Dress for success.
Clothes could cause a pressure ulcer as well. Watch out for buttons, seams, wrinkling and zippers. Sitting on a thick seam for eight hours can cause damage to tender skin.
4. Feed and water the skin.
A diet high in nutrition and with adequate amounts of protein will stay stronger. Also, make sure the skin stays stretchy by staying hydrated.
5. Move it, move it.
Ideally, you want to help your loved one to change positions. If they are in a wheelchair they can readjust every 15-20 minutes during the day by leaning forward or shifting from side to side. In bed, it is recommended to move every 1-2 hours. Make sure that the surface is dry and smooth underneath them.
Ways to Treat Pressure Ulcers
Pressure ulcers that are caught early will typically heal with careful attention. You may need the help of your parent or senior loved one’s health care professional to put together a plan.
The National Institute of Health lists these suggestions for helping a sore to heal:
- Change what is causing the injury
- Keep the area clean
- Never rub or slide on the affected area
- Use a protective dressing
Pressure ulcers are costly and draining on everyone involved. Take these tips and use them to prevent and treat pressure ulcers forming in your elderly loved one.