Ways To Prevent Bedsores
For seniors and their caregivers, it is very important to know the risk factors of bedsores and how to prevent them. Clinically known as pressure ulcers, bedsores are skin and tissue injuries that form on the tight skin over bony areas, such as the ankles, heels, hips, shoulder blades, and tailbone, as a result of constant pressure on the skin. Bedsores can cause severe pain and occasionally a host of infections such as cellulitis, meningitis, and endocarditis.
Seniors are especially at risk of developing bedsores due to weakening the skin and heightened vulnerability to other conditions that may compound them. Bedsores can develop quickly and leave lasting scars and even fatal complications if not treated, so this article details the risk factors, symptoms, and prevention techniques you will need to know.
Risk Factors of Bedsores
Knowing the risk factors of bedsores makes it easier to prevent. Some common risk factors are as follows:
- Immobility or poor mobility: being unable to move one’s body puts skin under significant pressure that reduces blood flow, causing hypoxia and bedsores with it. Older adults most commonly experience immobility due to Arthritis, hip fracture, osteoporosis, stroke, or Parkinson's disease.
- Incapacitation: patients who are not fully conscious may not recognize their discomfort or be able to move their bodies adequately.
- Pain: patients who have difficulty moving due to pain might risk staying under pressure, and pain medications may also sedate them to the point of not changing position frequently enough or noticing bedsores.
- Support surfaces: lying on the same surface without frequent adjustment to the surface or one’s body compounds the risk of bedsores.
- Skin pigmentation: medical providers occasionally fail to recognize bedsores on darker skin. They also may not recognize them due to skin disorders that change their normal appearance.
- Shear: the rubbing of skin and tissue over bone may occur when patients lie with their heads raised or move from beds to wheelchairs and vice versa, sometimes tearing the skin.
- Friction: when a patient slides down or assumes a wrong position, friction can compound the effects of shear.
- Moisture: patients who experience sweating or incontinence may lose oils their skin needs to stay firm and protected.
- Incontinence: besides weakening skin with moisture, incontinence can damage skin and increase risks of infection due to bacteria and enzymes.
- Sensory loss: patients with difficulty feeling pain due to neurological conditions may not notice bedsores in time.
- Poor nutrition: patients who experience weight loss and/or malnourishment will have more sensitive skin.
- Age: as mentioned, skin becomes thinner as we age and therefore more vulnerable to bedsores.
Handling these risk factors sometimes involves making sure the healthcare providers know and will meet the patient’s particular needs, and other times involves actions the patient can take to recognize and handle symptoms.
Besides recognizing symptoms, it is important to know the sites where bedsores typically form as a result of the patient’s support surface. In wheelchair users, bedsores are likely to develop on the shoulder blades, spine, tailbone, and arms and legs where they touch the chair. In bedridden patients, they are likely to develop on the shoulder blades, lower back, tailbone, hips, heels, ankles, the skin under knees, and back or sides of the head where it presses against the pillow. Depending on the surface, healthcare providers will examine the areas according to symptoms that tend to develop the same way.
Bedsores develop in four stages. During the first stage, a patch of skin will start to hurt or itch; it will feel either warm and spongy or hard. Lighter skin will appear red while darker skin will appear purple or ashen. During the second stage, bedsore resembles a discolored abrasion and will have compromised the outer skin –possibly causing swelling or pus drainage. During the third stage, bedsore becomes a deep wound damaging the muscle –having destroyed all layers of skin above. During the fourth stage, bedsores can lethally damage muscle, tendons, joints, and bone.
Of the above bedsore stages, the first may disappear and the second gradually heals upon relieving the pressure. However, later stages may require surgery to repair due to intense damage to underlying tissue. In between, physicians often help the patient grow new skin by improving their position and nutrition, applying saline solutions to the open sores, and frequently changing bandages. Due to the complications of these treatments and surgery, however, preventing bedsores before they can fully form will save patients a great deal of pain and discomfort.
As the list of symptoms above implies, shifting positions is one of the most crucial and effective prevention techniques. Physicians will often take it upon themselves to move patients who have significant difficulty moving on their own. However, patients can protect themselves through simple exercises such as wheelchair pushups, elbow bending, arm or leg raising, and shifting weight every 30 minutes in a wheelchair or every two hours in bed. Adjustable beds and wheelchairs can help patients relieve pressure, as can placing pillows under the potential sites of bedsores.
Patients can protect their skin by keeping it dry and clean. Physicians will often help patients clean the fragile skin with hot water and soap that they pat dry. This treatment will limit the skin’s exposure to weakening moisture. Lotion and changes to bedding or clothing can also treat the skin sensitively. But most crucially, inspecting the skin frequently will inform patients and physicians of any developing bedsores so that they can prevent or treat them promptly.
The potentially fatal effects of bedsores make them especially daunting, but the above prevention techniques have proven reliable in healing the skin before bedsores can fully form. Just as untreated bedsores contribute to a variety of negative health effects, treatments for bedsores such as exercise and nutrition will contribute positively to a patient’s overall health. With the above medical knowledge in mind, seniors, caregivers, and healthcare providers can address the issue of bedsores before it even arises and makes the healing process for the patient’s other conditions a lot easier.
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