Pressure sores, commonly seen in the elderly, are areas of skin and tissue damage. Also known as bed sores, they're caused by constant pressure and friction on sensitive areas, which restricts blood flow and results in tissue damage.
Everyone, especially those caring for the elderly, should be aware of them. Spotting the early signs can reduce their occurrence and improve the affected person's quality of life. In this article, we'll discuss pressure sores and their importance in elder care.
What are Pressure Sores?
Pressure sores, often called bedsores, are painful spots that happen when skin and tissue get damaged from sitting or lying in one position for too long.
They're common on hard body parts like hips and heels. These sores can form because the blood can't flow well to these areas, which can cause skin damage or even deep wounds. Doctors rank these sores in four levels, from mild red spots to bad sores that can show muscle or bone and may get infected.
Why Do People Get Them?
Being unable to move for a long time is the main reason. Those who are bedridden or in
wheelchairs have a higher chance. Sliding in bed or a chair can also cause them. Older people get them easier because their skin is thinner and they might not eat well. Other health issues like diabetes or heart problems make it even worse.
Pressure sores start as red spots. Then, they can open into wounds. If they get really bad, you can see fat, and in the worst cases, muscle or bone. If untreated, they can lead to serious infections.
How Does the Skin React?
The skin protects us, but pressure sores can break it down. They start as red areas and can turn into big open sores if not treated. These sores can reach deep layers of the skin and even muscles or bones, which can cause very serious infections.
Blood gives our body what it needs to work well. If pressure stops blood flow, skin and tissue can get hurt. Lack of blood can also make infections happen easier.
Pressure Sores in the Elderly: A Common Challenge
Older people get pressure sores more often.
This is because their skin gets thinner and less stretchy as they age, which makes it easier to damage. They also heal slower because they may not have as good blood flow. Illnesses like diabetes or heart problems can make this worse.
Prevention Strategies for Pressure Sores
There are steps you can take to reduce the risk factors for pressure ulcers and sores; from lifestyle changes to specialised bed or chair supports.
Specialized Support Surfaces
Invest in pressure-relieving devices and mattresses. These can include alternating pressure
mattresses, foam mattresses, or gel-filled cushions. They are designed to redistribute pressure more evenly across the body, thereby reducing the risk of pressure sores.
For those who spend significant time in wheelchairs, tailored cushions can provide the necessary support to alleviate undue stress on vulnerable areas.
Regular Movement is Key
Consistent movement plays a pivotal role in preventing pressure sores, particularly in older adults. It becomes imperative for individuals, whether they are sitting or lying down, to change their positions on a regular basis.
Due to the natural decline in movement during sleep as one ages, it falls upon caregivers to ensure that the elderly adjust their sleeping positions throughout the night.
Eat Right for Skin Health
Maintaining a balanced diet is fundamental for optimal skin health and its healing processes.
Eating a healthy diet with foods rich in protein, ensuring adequate hydration, and integrating essential vitamins such as C, D, E, along with minerals like zinc and copper, can significantly bolster defenses against the onset of pressure sores. Moreover, in cases where a nutritious diet lacking, turning to supplements can be a practical approach to achieving the necessary nutrient levels.
Regular Skin Inspections
Given that the early stages of a pressure sore can be subtle, it's essential to carry out daily skin checks. Pay special attention to high-risk areas like the sacrum, heels, elbows, and hips.
Any signs of redness, swelling, or skin breakdown should be addressed promptly. Using a mirror or asking for assistance can help ensure all areas of the body are inspected.
Maintain Skin Cleanliness and Moisture
Clean the skin with mild soap and water, avoiding the use of hot water. It's essential to keep the skin dry from sweat and moisture while maintaining its natural hydration. Moisturizers can be applied to prevent dryness, but the area should be kept free from excessive moisture, particularly from urine or feces, which can exacerbate skin breakdown.
Educate and Engage
Both the individual at risk of developing pressure sores and their caregivers should be educated about the risks, early signs, and preventive measures for pressure sores.
A collaborative and informed approach ensures consistent and thorough care. Having the person involved in their own care where possible can empower them to speak up when they notice early signs of discomfort or skin changes.
Early Signs and Symptoms of Pressure Sores
Pressure sores, often deemed "silent invaders", can develop rapidly and become severe if not detected early. For caregivers and seniors, understanding the initial warning signs can be the difference between a manageable condition and a complex medical challenge.
​Skin Discoloration | ​One of the earliest signs of a pressure sore is a noticeable change in skin color. On lighter skin tones, this may manifest as reddened, non-blanchable skin. For those with darker skin, the area might appear purple, blue, or shiny. It's crucial to note that when pressed, this area doesn't quickly return to its normal color.
|
​Skin Temperature | ​The affected area might feel warmer or cooler to touch than the surrounding skin. A warmer spot can indicate increased blood flow due to inflammation, while a cooler area might suggest reduced blood circulation. |
​Swelling and Hardness | ​The potential sore site may become swollen or feel hard. This change in consistency can be an early indicator of tissue damage or inflammation. |
​Sensitivity | ​The skin may become painful, itchy, or have a burning sensation. Even if visible signs are subtle, any persistent discomfort in a specific area, especially over bony prominences, should be taken seriously. |
​Texture Changes | ​The skin may feel either unusually damp or overly dry. Moisture from sweat or incontinence can exacerbate the risk, while excessive dryness can make the skin more fragile and prone to damage. |
​Formation of Blisters or Sores | ​Even small blisters or abrasions can be an early indication of pressure sores, especially if they appear on areas that are in constant contact with a bed or chair. |
For caregivers and seniors, conducting daily skin checks can be instrumental in early detection.
This involves visually and tactilely examining the skin, especially in areas under consistent pressure. The importance of proactive observation cannot be overstated.
If any of the above signs are noted, immediate action, such as repositioning and consulting a healthcare professional, is advised to prevent progression.
Regular skin assessments, combined with knowledge of these early signs, offer the best defense against the detrimental effects of pressure sores.
Risk Factors for Bed Sores: Existing Health Conditions
Several health conditions can make the risk of developing pressure sores more likely due to factors like decreased mobility, reduced blood flow, impaired sensation, and more.
Here's a closer look at some of these health issues:
Diabetes: This condition can lead to reduced blood flow and nerve damage (neuropathy), especially in the feet. As a result, a person might not feel the sore developing, and healing can be slower because of poor circulation.
Peripheral Vascular Disease: This disease affects blood vessels away from the heart, often in the legs. Reduced blood flow can slow wound healing and make tissues more prone to damage.
Spinal Cord Injury: Individuals with spinal cord injuries often have areas of reduced or absent sensation, meaning they might not feel a pressure sore forming. Additionally, immobility is common with such injuries.
Stroke: After a stroke, some people experience paralysis or weakened muscles on one side of the body, leading to decreased mobility. This increases the risk of bed sores for those who remain bedridden or seated for long periods and don't relieve pressure by moving.
Dementia and Alzheimer's Disease: Cognitive impairments can lead to decreased mobility and reduced awareness of the need to shift or move. Furthermore, those with advanced dementia might not communicate pain or discomfort, allowing pressure injuries to go unnoticed.
Arthritis: Severe joint pain and stiffness can limit movement, making it hard for a person to change positions frequently and restrict blood supply.
Congestive Heart Failure (CHF): People with CHF might be bedridden because of extreme fatigue or shortness of breath, raising their risk for pressure sores.
Respiratory Conditions: Diseases like chronic obstructive pulmonary disease (COPD) can lead to decreased activity levels or prolonged bed rest.
Obesity: Extra weight can put additional pressure on bony prominences, and decreased mobility can be an issue.
Fractures or Other Mobility-limiting Injuries: Broken bones, especially in the hips or legs, can lead to prolonged periods of bed rest or reduced mobility.
Incontinence: Moisture from urine or feces can make the skin vulnerable to breakdown and infection, heightening the risk of pressure sores.
It's essential for caregivers and healthcare providers to be aware of these conditions and their links to pressure sores. Regularly monitoring individuals with these health issues for early signs of pressure sores can lead to faster intervention and better outcomes.
Quick Guide to Pressure Sore Stages
Stage 1
Skin appears reddened on people with lighter skin tones or has a different hue (blue or purple) on people with darker skin tones.
The area may feel warm to the touch.
The skin is intact, but it may be painful.
Does not blanch (lighten) when pressed.
Stage 2
Stage 3
Stage 4
Seek professional treatment for pressure ulcers
While this guide is intended to provide a clear understanding of pressure sores and how to prevent pressure sores in the elderly, it should not replace professional medical attention or be used to diagnose a condition. Always seek the advice of your trusted health practitioner or wound specialist.
This article is not sponsored, but it does include affiliate links. We do not include links to products solely for the purpose of earning a commission. Our product suggestions are provided based on our genuine opinions.
Click here to subscribe to our newsletter to receive our healthy living tips for seniors and caregivers. Fall prevention, self-care, mobility, and independence.
The Adaptive Clothing Australia Team
.png)