Pressure Sores: From Superman to Seniors

5 Tips for Preventing Bedsores in Seniors by Geriatric Care Manager C. Charlotte Bishop

Health care providers call them decubitus ulcers, but most  people know these pressure wounds on the skin as bedsores.  Although bedsores as a medical condition are not tracked by the Centers for Disease Control, it is generally estimated that about two million Americans suffer with these ulcers any given year.  

The vast majority of pressure ulcers occur among adults in their 70’s or 80’s, but the real cause is not age; it is lack of mobility.  An unfortunate – and high profile – case in point was the late actor, Christopher Reeve.  He did not succumb to his paralysis, per se.  He died of a systemic infection that began in a pressure ulcer in 2004.

But older adults are the more common victims of bedsores for a lot of reasons.  They have more fragile skin to begin with, a natural outcome of aging.  They also tend to be less hydrated and have relatively poorer nutrition, both conditions which make for less healthy skin and for poorer circulation and healing if there is a wound.  Elders who may be bed ridden or confined to a wheelchair also are less likely to move themselves enough to take pressure off their skin.

Bedsores result when there is enough pressure between a bony mass and the skin beneath it.  The resultant poor circulation deprives the skin of sufficient blood flow that a portion of the area may be starved of oxygen and nutrition and simply dies.  It starts out as a reddened area, but can quickly progress to a deep wound that may form a hole that goes all the way to the bone below the skin surface.

Bedsores are a significant enough concern that Caregiverlist includes the bedsore instances in the nursing home ratings.  Nursing home care can be directly connected to the amount of C.N.A.'s (Certified Nursing Assistants) on staff as they will have the ability to reposition a patient if they are able to adequately care for the number of patients they are given.  Caregiverlist also tracks the C.N.A. to resident ratio at nursing homes nationwide. Review the daily costs and ratings of nursing homes in Caregiverlist's nursing home directory.

So why don’t babies or infants get bedsores with all the lying about and sleeping that they do?  And how about teens?  Very simply, younger individuals are on the move constantly.  Even when asleep, researchers have found that a healthy individual will shift position about once every fifteen minutes.  A rolling stone may gather no moss, and a sleeping youth will gather no ulcerations.

If you are a caregiver to an elder who may live in a nursing home, see to it that the providers on the job are being duly attentive to your loved one.  Here are five things providers should be doing to avoid pressure sores:

1. On admission to a nursing home or if a patient becomes hospitalized, they should be evaluated for their bedsore risk; there is an actual scale called the Braden Scale that providers should use.

2. An older adult’s skin should be regularly cleaned and always kept appropriately dry; however, there are times when moisturizer may be called for.

3. Make sure that your loved one gets plenty of water and nutrition; this will make for healthy skin.

4. See that your elder is helped by a team that includes nurses and nutritionists, but also even beauticians 

and laundry workers.

5. In addition to having an appropriate sleeping surface, the older adult needs to be repositioned frequently, 

especially if they have mobility issues that make it hard to move themselves.

Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals 

who are geriatric advocates, resources, counselors and friends to older adults and their families in Illinois. 

C. CHARLOTTE BISHOP, PRESIDENT, MS, CRC, CCM, CDMS, LCPC, GCM

www.creativecasemanagement.com