Bedsores is one of the hidden, lesser known, prevalent, yet quite preventable problem of nursing homes.
Bedsores, also known as pressure ulcers are comparatively more common in the elderly population, especially those with disabilities, or difficulties in movements. They may occur in those suffering from neurological or vascular diseases. They are not uncommon in those living with dementia, Alzheimer’s, diabetes, and so on. In fact, research shows that in some nursing homes almost one-fifth of adults have some degree of bedsores. Depending on the severity, they can be classified as stage one to stage four. It should be understood that any kind of bedsores requires immediate medical attention, as they touch the weakest of elderlies and are thus challenging to cure.
These sores occur due to the absence of movement over an extended period leading to disruption in blood flow. In healthy or active individuals, they do not happen as they keep on moving/changing posture while asleep. Thus the parts or body that are continually in contact with bed or wheelchair are at higher risk of developing pressure ulcers (like hip, lower back, spine, tailbone, elbows, heels, and shoulder blades).
Factors that contribute to the bedsores are:
- Long-term confinement to bed, and higher level of friction between the body and bedsheet due to slower movements
- Wet skin due to excess sweating, urinary inconsistency would make the skin weaker and more prone to developing bedsores.
- Reduced sensation in certain parts of the body due to disease, neurological condition, hence person does not feel the effect of prolonged pressure
- Circulatory diseases like atherosclerosis, diabetes, local edema all more prevalent in elderly, making the skin weaker
- Many of the older adults do not eat enough, lack of enough dietary proteins, minerals, and vitamins increases the risks.
Stages of Bed Sores
Treatment and prognosis would depend on the severity of bedsores:
Stage 1 – there is reddening of skin, but it is still intact
Stage 2 – upper layer of the skin called epidermis is broken, but ulcer is still superficial
Stage 3 – Ulcer extends deeper into the skin, up to the subcutaneous fat layer
Stage 4 – the most severe form, when ulcer is deep enough to extend up to underlying muscles or even bones
Other factors like size of the ulcer and presence of infection would also affect the chosen treatment.
Bedsores are not always the indicator of inadequate care in elderly, some of the precautions may help in prevention.
- The most important strategy is to relieve the pressure from the single point by frequently changing the position. One may use soft pads or pillow under the areas more prone to sores, or regions already showing the signs. Using special mattresses like water mattress or sheepskin may help.
- Avoid dragging somebody on the bedsheet, instead lift a person to change the position, wash or sponge the skin gently, avoiding unnecessary friction.
- Inspect the skin of the elderly on a regular basis, as due to a reduced feeling person may not be able to tell about it.
- Particular care should be taken of the diet, using nutritional supplements whenever needed is not a bad idea.
- Even mild exercise done on a regular basis can help to improve blood flow, strengthen blood vessels, nerves, and improve the skin.
- Keep the skin dry, in case of inconsistency use pads or ask a medical specialist about controlling the problem.