Bedsore Prevention And Treatment For Seniors

Bedsore Prevention:
What you can do for seniors who spend hours in bed or sitting.

Anyone who spends a great amount of time lying in a bed or sitting in a chair or wheelchair can develop bedsores (pressure sores), but seniors are especially vulnerable because their skin usually becomes thinner and more fragile with age.

A bedsore is an injury caused by constant pressure to the skin and muscle or by shearing forces as one moves against a surface. They can develop within a matter of hours and can happen during hospitalization, in a nursing home or in a community setting. The severity ranges from mild, affecting the skin surface only, to severe when a deep decubitus ulcer reaches down to muscle and bone.

When a person cannot change position, pressure closes tiny blood vessels that nourish the skin and supply oxygen. When the skin lacks nutrients and oxygen for too long, the tissue dies and a bedsore forms.

Prevention and Treatment

The first step in preventing or treating a bedsore is to reduce the pressure that caused it.

Strategies include the following:

1.  Repositioning
If your senior loved one has a pressure sore, they need to be repositioned regularly and placed in correct positions. If they use a wheelchair, ask them to shift their weight every 15 minutes or so. Offer to help them with repositioning every hour. If they’re confined to a bed, they should change positions every two hours.

If the senior has enough upper body strength, and is lying in bed, they can try to reposition their body using a device such as a trapeze bar. Caregivers can use bed linens to help lift and reposition the patient. This can reduce friction and shearing.

2.  Using Support Surfaces
Air mattresses, bed cushions and other special cushions can be used to help the senior lie in an appropriate position, relieve pressure on any sores and protect vulnerable skin. If the senior is in a wheelchair, use a cushion. Styles include foam, air filled and water filled. Select one that suits the patient’s condition, body type and mobility.

3.  Cleaning and Dressing Wounds
Care that helps with healing of the wound includes the following:

-- Cleaning
It’s essential to keep wounds clean to prevent infection. If the affected skin is not broken (a stage I wound), gently wash it with water and mild soap and pat dry. Clean open sores with a saltwater (saline) solution each time the dressing is changed.

-- Applying Dressings
A dressing promotes healing by keeping a wound moist, creating a barrier against infection and keeping the surrounding skin dry. Dressing choices include films, gauzes, gels, foams and treated coverings. A combination of dressings may be used.

Other interventions

Other interventions that may be used are:

• Pain Management
  Pressure ulcers can be painful. Nonsteroidal anti-inflammatory drugs — such as ibuprofen (Motrin IB, Advil, others) and naproxen (Aleve, others) — may reduce pain. These may be very helpful before or after repositioning, debridement procedures and dressing changes. Topical pain medications also may be used during debridement and dressing changes.
• Antibiotics
  Infected pressure sores that aren’t responding to other interventions may be treated with topical or oral antibiotics.
• A Healthy Diet
  To promote wound healing, a doctor or dietitian may recommend an increase in calories and fluids, a high-protein diet, and an increase in foods rich in vitamins and minerals. The afflicted senior may be advised to take dietary supplements, such as vitamin C and zinc.
• Management of incontinence
  Urinary or bowel incontinence may cause excess moisture and bacteria on the skin, increasing the risk of infection. Managing incontinence may help improve healing. Strategies include frequently scheduled help with urinating, frequent diaper changes, protective lotions on healthy skin, and urinary catheters or rectal tubes.
• Muscle Spasm Relief
  Spasm-related friction or shearing can cause or worsen bedsores. Muscle relaxants — such as diazepam (Valium), tizanidine (Zanaflex), dantrolene (Dantrium) and baclofen (Gablofen, Lioresal) — may inhibit muscle spasms and help sores heal.
• Negative Pressure Therapy (vacuum-assisted closure, or VAC
  This therapy uses a device that applies suction to a clean wound. It may help healing in some types of pressure sores.
• Surgery
  A pressure sore that fails to heal may require surgery. The goals of surgery include improving the hygiene and appearance of the sore, preventing or treating infection, reducing fluid loss through the wound, and lowering the risk of cancer

If you’re caring for a family member who is confined to a bed or chair, inspect their skin each day for early signs of bedsores. If you find a suspicious area of redness or blistering, this is a warning signal to take immediate preventive action. Call your doctor promptly or discuss the problem with your home care nurse.

 

BLOG Date: Tuesday, October 6, 2015
Writer:Ryan Allen