Bedsores 101

bedsores 101

Bedsores, also called pressure ulcers, are created when continuous pressure in one or more body areas restricts healthy blood flow and tissue function. It’s most common in individuals who spend most of their time in chairs or beds, particularly if they are left in one or two primary positions for most of the day. 

In addition to being painful and requiring wound care, bedsores can cause long-term and irreparable damage. They also leave the individual at risk for infection and illness. If you care for a loved one or client who is bed- or chairbound, Bedsores 101 is an essential guide to protect the wellbeing of the one you care for.

If your loved one lives alone and you notice any bedsore warning signs, it’s time to get them outside support to ensure they can continue aging safely in place.

Bedsore Prevention, Warning Signs, and Treatment

Bedsore prevention and management is a primary topic in the healthcare arena when discussing patient care and risk management. The evolution of bedsores can begin a downward spiral, so bedsore prevention is the first and most critical step. However, for some patients, bedsores may be inevitable, requiring expert attention and care to prevent them from worsening.

STEP ONE: Bedsore Prevention

Bedsores are most common in areas of the body that experience constant pressure from stagnant positions. These are typically the areas on the skin where the bones are closest, without fat or muscle tissue to act as a cushion. We call these areas “bony prominences.” 

As a result, bedsores typically develop on:

  • Buttocks/tailbone
  • Ankles
  • Hips
  • Knees (for those who spend their time on their sides)
  • Knobs of the spine

While continuous pressure is the primary cause of bedsores, there are secondary factors as well. These include poor health, malnutrition, and dehydration. A holistic approach to bedsore prevention is the best way forward. 

Healthy diet

Maintaining a healthy diet is essential for us all and is certainly the first line of defense from developing bedsores. A well-nourished body is better able to heal itself, which can help reduce the risk of bedsores and help them heal faster. Also, don’t forget that hydration is a part of nutrition.

EXCEPTION: There is one exception to this rule: when a person is dying. A decline in appetite is completely normal and should be respected in patients who are in the last months of their life. When a person begins declining food, it’s typically a sign their body cannot process food in a healthy way. If you don’t have a supportive hospice team on board, this is a good time to connect with hospice agencies in your area to learn more about the natural dying process. Watch Babara Karnes’s (hospice R.N. and end-of-life expert), video on how not eating is a normal part of the dying process.

Exercise and regular movement

Just because you spend the majority of the day in a chair or bed doesn’t mean you can’t exercise. If your loved one can move, implement relevant movement into their day. Speak to their healthcare provider about exercises for homebound seniors and see if any work for you. If not, your physician can recommend a physical or occupational therapy session to teach you ways to manipulate limbs in healthy ways to promote healthy circulation.

Regular position changes

Position changes are essential to prevent that continuous, extended pressure that causes bedsores in the first place. You can do this manually, supporting loved ones as they move from side to side or from elevated torso to lying with elevated legs, etc. It’s also wise to invest in pressure mattresses or pads that use airflow or fluid flow to change the bed’s pressure points. If you can’t afford them, speak to the healthcare provider to find free or low-cost resources.

Provide extra (clean) padding in key locations

You can also provide extra padding, using pillows or thin memory foam sections, to cushion areas that are at risk or showing the first stages of bedsores. For example, ensure the shoulders and the areas between the knees are padded and protected for those sleeping or lying on their sides.

STEP TWO: Recognizing The Warning Signs: Stages Of Bedsores

Bedsores do not develop overnight. There are clear warning signs, so paying attention and recognizing when they’re erupting is essential to preventing more severe occurrences. 

IF YOUR LOVED ONE LIVES IN A FACILITY: If your bed- or chairbound loved one lives in a facility and you aren’t able to check in at least once per week, we highly recommend hiring a caregiver to become their companion and wellness checker. The CDC cites that at least 10% of nursing home residents have bedsores. Personal caregivers are the best way to ensure your loved one isn’t overlooked or neglected.

Stage 1: Warm, firm, and/or red skin at key pressure points

Keep a constant and vigilant eye on the areas most likely to develop bedsores. These checks should be done daily. If you are caring for a spouse or family member, consider enlisting the help of a licensed caregiver who can support you with personal tasks, especially those that involve heavy lifting, position changes, incontinence care, and bedsore checks.

During the first stage, irritated tissue at key pressure points becomes red, warm, more firm, or softer to the touch than the surrounding skin. During the first stage, the skin is not broken. Taking action now is key to stopping ulcers from growing worse.

Stage 2: Open sore (broken skin)

During Stage 2, the affected deep tissue is so damaged that it erodes away, causing the exterior skin layers to break open. These wounds need immediate care and are also a red flag that other areas may soon be affected. Let your healthcare provider know ASAP to receive proper instructions for care and treatment.

Stage 3: Full-thickness skin loss and deep wounds

At this point, the breakdown of tissue and fat/muscle tissue is so great that you can see deeper into the ulcer.

Stage 4: Full-thickness skin and tissue loss

At this final stage, the wounds are so deep that connective and bone tissue are also involved. You can see exposed muscles, tendons, ligaments, or bones.

STEP THREE: Wound Care For Bedsores

Again, bedsores that are in stages 2, 3, or 4 should be assessed by a professional healthcare provider. In most cases, treatment involves routine cleaning and dressing of the wounds with simultaneous attention to regular position changes and proper cushioning. 

In some cases, the removal of damaged tissue is required. Your physician can prescribe a wound care team to provide regular support until the bedsores are improved enough that you can continue with wound care management and prevention strategies.

Can We Be Of Service?

HomeAide Home Care provides licensed home care to our client’s homes and senior facilities throughout the Bay Area. Our caregivers are here to provide support as you work to prevent and manage bedsores. Contact us to schedule a free, in-home assessment.

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