Management of Bedsores for the Elderly

Bedsores also called pressure ulcers and decubitus ulcers are injuries to the skin and underlying tissue resulting from prolonged pressure on the skin. Elders confined to beds or wheelchairs for longer periods are particularly vulnerable to bedsores because of their limited ability to change positions. Bedsores most commonly occur on skin and around the body's bony areas, such as the tailbone, ankles, heels, hips, shoulder blade, spine, and backs of arms and legs.You might also notice that bedridden seniors are also prone to developing sores along the back and sides of their heads, including the ear rims.

Bedsore can be very challenging and painful for the elders. This painful skin condition can become debilitating and even deadly when left untreated. Unfortunately, bedsores can develop even with great caregiving efforts. Sometimes, elders are received back to their home or an assisted living home from a hospitalisation with a bedsore of second to third degree.

There are 4 stages of bedsores:

• Stage 1: Redness on the skin
• Stage 2: Have a break in the top two layers of skin.
• Stage 3: Affect the top two layers of skin, as well as fatty tissue
• Stage 4: In this stage, the deep wounds may impact muscle, tendons, ligaments, and bone.

At Epoch, there have been times, we have received an elderly with bedsores, either from hospitals or from their own homes.

There are many reasons for getting bedsores, especially for elders which are shared below:

• Prolonged lying down in the same position/lack of blood flow
• Absence of caregiver to change frequent positions every 2 hours

Other contributing factors include:

• Weight loss due to medical conditions
• Poor nutrition and inadequate hydration
• Excess skin moisture or dryness
• Incontinence
• Medical conditions which affect blood flow
• Limited mental awareness
• Frequent muscle spasms

Treatment and management of bedsores:

• Proper cleaning and dressing (an important part of keeping bedsore wounds cleaned, preventing infection, and promoting healing)
• Pain management
• Antibiotics if required
• Changes in diet (high protein diet for healing)
• Incontinence management
• Muscle spasm relief
• Negative pressure therapy
• In extreme cases, surgery may be required

Prevention of bedsores:

• Positioning of bedsores in case the elder is bedridden
• Use of air mattress or water air mattress
• Keep the skin dry and clean
• Frequent check of skin for redness
• Maintain healthy diet

The best way to prevent bedsores is through frequent position changes, adequate maintenance of skincare, healthy eating, quitting smoking, and regular exercise. Pressure sores are a very serious and debilitating issue with the elders who have got strokes or are paralyzed. I’ve learned the hard lesson of not disregarding pressure spots on my resident’s skin as “not a big deal,” because every red spot and every mark has the potential to become a very big deal. Take care of your loved ones and prevent them from pressure sores!