As seniors age, one factor that is likely to play a large role in their health is limited mobility. Many of the elderly suffer from conditions such as arthritis or osteoporosis, or have to undergo treatment that requires extended bed rest. They may be confined to a wheelchair or bed for the majority of their day, and lack the strength to move themselves freely.
It is exactly these conditions that can lead to one of the most worrisome and dangerous injuries that can befall a senior: pressure ulcers, more commonly known as bedsores. Bedsores develop when pressure from a person’s body is continually applied to a single area, leading to swelling, loss of skin and tissue, sepsis and infection, and ultimately death if left untreated. While treatment of serious bedsores is difficult even for medical professionals, prevention requires little more than attentiveness and care.
There are 4 stages of bedsores, each with its own noticeable characteristics and problems. The later stages can be easily fatal, but knowing the early signs can help prevent the conditions from worsening. The 4 stages, according to the Mayo Clinic, are:
- The skin is not broken.
- The skin appears red on people with lighter skin color, and the skin doesn’t briefly lighten (blanch) when touched.
- On people with darker skin, the skin may show discoloration, and it doesn’t blanch when touched.
- The site may be tender, painful, firm, soft, warm or cool compared with the surrounding skin.
- The outer layer of skin (epidermis) and part of the underlying layer of skin (dermis) is damaged or lost.
- The wound may be shallow and pinkish or red.
- The wound may look like a fluid-filled blister or a ruptured blister.
- The loss of skin usually exposes some fat.
- The ulcer looks crater-like.
- The bottom of the wound may have some yellowish dead tissue.
- The damage may extend beyond the primary wound below layers of healthy skin.
- The wound may expose muscle, bone or tendons.
- The bottom of the wound likely contains dead tissue that’s yellowish or dark and crusty.
- he damage often extends beyond the primary wound below layers of healthy skin.
An Unstageable bedsore is one where the layers of necrotic tissue and pus prevent an accurate evaluation of the depth of the wound.
Consequences of Bedsores
As the stages indicate, bedsores are serious, life-threatening injuries, and proper prevention is essential to preventing the worst outcomes. Among the known results of even early-stage bedsores are sepsis, a blood infection that can lead to organ failure; cellulitis, a skin infection that can lead to numbness, allowing bedsores to progress unnoticed; septic arthritis and osteomyelitis, joint and bone infections that can lead to further loss of mobility; and even cancer, specifically squamous cell carcinoma, a condition which develops from chronic open wounds.
Once a bedsore develops, and especially if it gets past the first stage, it becomes a job for a physician rather than a caretaker. Treating a bedsore is a long and involved process, and requires doctors, wound specialists, dieticians, and skilled nurses. The specifics can vary based on the patient’s medical history and the location and stage of the bedsore, but there are a few step that are always taken.
- It’s essential to keep wounds clean to prevent infection. If the affected skin is not broken (a stage I wound), gently wash it with water and mild soap and pat dry. Clean open sores with a saltwater (saline) solution each time the dressing is changed.
- A dressing promotes healing by keeping a wound moist, creating a barrier against infection and keeping the surrounding skin dry. Dressing choices include films, gauzes, gels, foams and treated coverings. A combination of dressings may be used.
- Debridement, a process which involves cutting away dead tissue to prevent it from infecting the surrounding healthy tissue.
- Using a mattress, bed and special cushions that helps the patient lie in an appropriate position, relieves pressure on any sores and protects vulnerable skin. If they are in a wheelchair, use a cushion. Styles include foam, air filled and water filled. Select one that suits their condition, body type and mobility.
- A pressure sore that fails to heal may require surgery. The goals of surgery include improving the hygiene and appearance of the sore, preventing or treating infection, reducing fluid loss through the wound, and lowering the risk of cancer.
- If the seniors needs surgery, the type of procedure depends mainly on the location of the wound and whether it has scar tissue from a previous operation. In general, most pressure sores are repaired using a pad of muscle, skin or other tissue to cover the wound and cushion the affected bone (flap reconstruction).
Bedsores are a very preventable condition for seniors who have someone who can help reposition them, change their bedclothes and keep them dry, and check them for early warning signs that bedsores may develop. For family members who want to spend time with an ailing loved one, this isn’t too much to ask. Unfortunately, the owners of some residential care facilities for the elderly consider the staff and training required to carry out this level of care to be too costly, and as a result, seniors are at an increased risk for bedsores. If your loved ones are in a home, the best way to ensure they don’t develop bedsores is to visit regularly, make sure they’re doing well, and discuss their situation with their caretakers.
If your loved ones have experienced bedsores while in the care of a nursing home of home caretaker, contact the Evans Law Firm at (415) 441-8669, or by email at firstname.lastname@example.org. Our attorneys have experience handling nursing home abuse, physical and financial elder abuse, and caregiver fraud, and are devoted to helping our clients seek justice for their loved ones.