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Bedsores: Causes, Risk, and Prevention For Seniors
Lisa Reisman • Aug 28, 2019
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Bedsores: Risk and Prevention
According to the Centers for Disease Control, as many as 1 out of 10 nursing home residents suffers from bedsores. Bedsores, also called pressure ulcers and decubitus ulcers, are injuries to the skin and underlying tissue resulting in pressure on the skin. Bedsores commonly develop in areas of the body with thinner tissue, like bony areas such as the hips, ankles, or tailbone. People that are most at risk for developing bedsores are those with a limitation on movement most likely from a medical condition, and unfortunately for seniors is a large part of how and why they’re getting them so often. Whether they’re sitting in a chair without help getting up, or neglected and confined to a hospital bed, understanding the risk factors and ways to prevent bedsores for seniors is important to their remaining years of care.
How Bedsores Form
Our bodies are designed to be in constant motion— even in our sleep we’re tossing and turning, circulating our blood. When we become immobile, the more sensitive, thinner tissue areas of our bodies lose circulation and the pressure of our skin on something like a wheelchair or bed, can create a sore. Bedsores can form in as little a timeframe as 12 hours. While the tissue on thinner body parts is pressing up against something and blood circulation has stopped, tissue is depleted of oxygen and nutrients and can wither away— thinning tissue can occur over a half a day, but can take several weeks to show any real damage.
Different surgeries and injuries can make a person bedridden. For seniors, they’re more at risk because they can’t recover as quickly as a younger person. In many cases, bedsores form as a result of improper medical care in nursing facilities. Nursing home negligence and bedsores don’t always go hand in hand, but seeing that it’s a preventable medical concern makes it all the more important to establish a trusting relationship between the senior and health care provider.
According to an article on A Place for Mom, things like shear and friction can also form bedsores: Shear occurs when the skin moves in one direction while the underlying bone moves in the opposite. Shear can occur while a person is sliding or slumping in a bed or chair, causing the skin to stretch and tear. Friction causes skin to thin based on constant movement on the sensitive area. Friction over the tailbone, elbows, buttocks, and hips needs to be looked out for especially while medical professionals are moving senior patients between beds and chairs.
Risk Factors and Stages
Age, of course is the largest risk factor for bedsores. Seniors who have already experienced compromised, thinning skin or who have become slightly more immobilized have higher chances of developing bedsores. Lack of sensory perception is another major risk factor for bedsores. Spinal cord injuries, neurological disorders, and certain pain medications can cause the inability to feel discomfort, causing seniors to not know when they need a change in position to prevent bedsores. Poor diet and dehydration can play a role in bedsores as well being that our bodies need proper proteins and fluids to regenerate healthy skin cells. If you have a senior loved one in a nursing home, pay attention to the quality of their skin and ask the proper questions about their diet to get a better understanding of ways to keep them nourished when you’re not around.
Prevention
Regular repositioning is the most important thing you can do to prevent bedsores. If patients are confined to a hospital or nursing home bed, they should be moved every 30 minutes. As for those in a wheelchair, the Mayo Clinic suggests repositioning oneself every 15 minutes. Depending on the mobility of the senior, help may be required in the repositioning process. Try to use upper body strength in assisting the movement or by doing “wheelchair pushups” to raise your body slightly above the chair to circulate blood flow and relieve any pressure to the tailbone. Specialized wheelchairs are available for purchase that have added cushions and the ability to tilt back and may be good to consider if a senior is sitting for most of their day. Adjusting the elevation in ones bed can also help with the prevention of bedsores— if possible, raise it no more than 30 degrees. In addition to making sure the senior is comfortable, making sure that their skin stays dry and clean is very important in preventing bedsores. If they are in a care facility and suffer from incontinence or are unable to control their bowels, they should be thoroughly cleaned and dried after each changing. Many times this small, yet major detail is overlooked as another contributing factor in nursing home negligence. Paying attention and inspecting the senior's skin can help prevent these sores from forming as well as help make sure she's getting the proper care she needs.
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