Pressure sores, also called bedsores, are one of the most common injuries suffered by elderly Americans. With new reports suggesting a 63 percent increase in the prevalence of bedsores in the last decade, here are 8 things families and caregivers should know about bedsores to prevent serious injury or illness.
8 Things Families and Caregivers Should Know about Bedsores
Whether you are a family member or a professional caregiver, bedsores are a very real concern for anyone caring for an elderly individual. Every year, bedsores (and pressure-related injuries) are responsible for 60,000 deaths. Many of these are preventable or treatable. To help protect the health and livelihood of elderly family members or patients, consider the following.
1. Understand what Bedsores Are
When you think of bedsores, you may initially envision an open wound or blister-type injury. Bedsores often begin much less obvious. Known as bedsores, decubitus ulcers, or pressure ulcers, bedsores start as an inflammation of the skin in areas where constant pressure or friction is applied and there is little fatty tissue to protect underlying structures and blood supply.
Most often, bedsores appear on the hips, trunk, shoulder blades, elbows, heels, or ankles. If left unrecognized or treated, the inflammation spreads to the deeper layers of skin and eventually into the fat and muscle tissue. It is important to monitor these areas and ensure that pressure is evenly distributed and pressure points are rotated.
2. Learn How to Prevent Bedsores
The best way to prevent bedsores is to keep pressure off sensitive areas of the body. This is important for anyone with limited mobility, or those confined to a wheelchair. It is especially important for individuals with a history of stroke, or who have paralysis, as it may be more difficult to sense pressure or move one’s own body to relieve pressure or friction.
There are also products available to help prevent development of bedsores, such as specialized foam mattresses, cushions, pillows, and monitoring tools. Also important to the prevention of bedsores is maintaining a healthy diet and getting the proper nutrients.
3. Bedsores are Dangerous for Many Reasons
Aside from being painful, bedsores are dangerous for many reasons. When left untreated, the wounds caused by bedsores can escalate damaging surrounding tissue. These wounds allow bacteria access to important bodily structures, which often results in infection, tissue death, or amputations if severe enough or untreated. Bedsores also cause a great deal of pain, limit mobility, have a foul smell, and can be embarrassing for patients.
4. Caregiver Vigilance can Prevent Bedsore Injuries or Illness
Whether at home, in a hospital, or in a nursing home setting, caregivers are a frontline of defense against developing bedsores. It is important for caregivers to assess patients on a regular basis. Nursing homes and home health caregivers should assess the patient’s skin as soon as they begin their position as a caregiver and note skin condition as a starting reference point for future assessments. Every time a caregiver assesses skin condition, the findings should be noted, and if needed, sent to the patient’s doctor.
5. Proper Skin Care can Reduce Risk of Bedsores
Another important line of defense against development of bedsores is proper skin care. The Medical Director of organization Skilled Wound Care, Bardia Anvar, MD, recommends the following:
- Limit patient baths to three times per week or less.
- Limit bath time to no longer than five minutes each.
- Baths should be lukewarm and bath oil added.
- Do not use washcloths during baths, as they can break down skin.
- When drying, use a patting motion instead of rubbing the skin.
- Apply skin moisturizer immediately after bathing, and reapply throughout the day.
6. Be Aware of Everyday Risks
In addition to bathing, immobility, and lack of assessment, there are other risks that can contribute to development of bedsores. Skin tears, which are a common cause of pressure injuries, are often caused by improper turning or lifting of the patient. Improper turning or lifting occurs when the caregiver:
- Does not know how to properly lift the patient.
- Lifts or turns the patient without using sheets or clothing to limit skin-on-skin contact (creates friction and can cause skin injuries).
When skin is exposed, it is more vulnerable to injuries. Having patients wear long sleeves and stockings or pants can help reduce friction and skin injuries.
7. Know How to Respond to Bedsore Wounds
If properly recognized and treated, most bedsores resolve with few, if any, long-term side effects. Part of ensuring this happens is caregivers recognizing and responding properly when bedsore wounds appear. Dr. Anvar recommends caregivers do the following:
- Use saline and NOT hydrogen peroxide when cleaning wounds. Hydrogen peroxide can kill healthy tissue and hinder healing.
- Measure wounds every week and document changes.
- Use proper dressings to keep the wound clean and dry.
- Check regularly to be sure that wounds are not contaminated with stool, urine, sweat, or other fluids.
- Limit stationary time (the time the patient is in the same position) to 30 minute intervals. Move, turn, or lift the patient to promote mobility, reduce pressure and friction, and inspect skin condition.
8. Know When it is Time to Get Help
So now you are doing everything possible to prevent bedsores from developing or worsening. But how do you know when it is time to get medical attention if a bedsore develops or worsens while you are caring for someone?
As a general rule, it is always best to contact the patient’s doctor at the first signs of worsening. The doctor can make a recommendation for treatment options, and should advise you whether you need to bring the patient in. If you are caring for an individual who already has a bedsore, contact his or her doctor at the first signs of a foul odor, changes in skin coloration, or the presence of discharge from the wound.
If the patient develops a fever or has other symptoms like vomiting, difficulty breathing, or severe pain, it may be best to call 911 or take the patient directly to the emergency room.