While many people link Christopher Reeve's death with a fall from a horse, his cause of death was actually something very different: complications from infected bedsores. And while it's easy to think of bedsores as a mere nuisance when caring for an aging loved one, they're much more problematic than that -- particularly when left untreated. The truth is that bedsores can happen despite your best caregiving efforts, but there are some things you can do to prevent these painful pressure ulcers. Let's take a closer look at this common senior health issue, along with causes and prevention.
Keeping senior skin well-hydrated is an effective preventative measure against bedsores.
What Are Bedsores?
Bedsores are simply injuries to skin caused by prolonged pressure. Seniors who are confined to beds or wheelchairs for long periods of time are particularly vulnerable to bedsores because of their limited ability to change positions.
In addition to being caused by sustained pressure, bedsores can also result from friction caused by movements, including transfers; and shear -- which occurs when two surfaces move against each other in opposite directions. (Picture the movement of a patient's body when a hospital bed is raised or lowered.)
Bedsores most commonly occur on skin on and around the body's bony areas, including the tailbone, ankles, heels, hips, shoulder blades and spine, and backs of arms and legs. Common sites seen just among bedridden patients include the back and side of the head and the ear rims.
The Four Bedsore Stages
The National Pressure Ulcer Advisory Panel has defined four severity-based stages of bedsores.
- In the first stage, skin is not yet broken but may appear red or discolored. It may feel painful or tender to the touch.
- In the second stage, the skin's outer layer and part of the underlayer becomes damaged resulting in a shallow pink or red wound which may look like a blister.
- In the third stage, the ulcer becomes a deep, crater-like wound which may show exposed fat and dead tissue. The damage may now also be penetrating beneath the primary wound to the healthy skin below.
- In the fourth most severe stage, a bedsore is likely to contain dead tissue and exposed bone, muscle and tendons.
The further bedsores progress, the harder they become to treat and cure.
Seniors and Bed Sores
In addition to immobility, a number of other factors can also increase the risk of bedsores. These include the fragility of older skin; loss of sensory perception and the resulting inability to feel discomfort; weight loss; poor nutrition and inadequate hydration; excess skin moisture or dryness; incontinence; medical conditions which affect blood flow; smoking; limited mental awareness; and frequent muscle spasms.
The best way to prevent bed sores is through frequent position changes, adequate skin care, healthy eating, quitting smoking, and regular exercise.
Many people associate bedsores with immobility, but they can also be caused by friction during transfers.
Treatment for Bedsores
Unfortunately, bedsores can occur very quickly, and are challenging to treat once they develop. If you are caring for someone showing early signs of a bedsore, relieve pressure by changing the patient's position. If no improvement happens within the next 24 to 48 hours, follow up with a medical professional. If left untreated, bedsores can give way to a number of complications, including sepsis, cellulitis, bone and joint infections, and even cancer.
Treatment will typically involve a multidisciplinary approach, including specialists in wound care and wound management. Physical therapists, social workers, and dietitians can also be invaluable resources for caregivers in managing bedsores.
Proper cleaning and dressings are an important part of keeping bedsore wounds clean, preventing infection, and promoting healing. Other interventions may include pain management or antibiotics, changes in diet, incontinence management, muscle spasm relief, and negative pressure therapy. In extreme cases, surgery may be required.
Bedsores don't just impact aging loved ones, but also the people who care for them. If treating, managing and preventing bedsores becomes overwhelming, there are community resources available offering everything from education to support services. The sooner you reach out, the sooner you and your aging loved one can start feeling relief.
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