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When you’re taking care of an elderly parent or any other beloved senior, you want to give them the best care possible. And it can be a wonderful thing for the caregiver as well – a heartening 88% of family caregivers told Pew Research Center that caring for their elderly loved one was rewarding for them. In the best of worlds, care ramps up slowly as your loved one needs more attention, and there is time to learn what you need to know to make their life more comfortable, including using a medical alert system.
But there can be some difficult issues along the way. One of those issues can come into play if your parent is unable to walk, is using a wheelchair during most hours, or is confined to a bed. When someone is mostly immobile, serious physical problems can arise quickly. This is especially true if you struggle to move them to different positions.
Bedsores, also known as pressure ulcers, can form over a matter of hours and lead to a need for intensive treatment. About 2.5 million people are hospitalized each year in the United States for pressure ulcers, and the complications of bedsores lead to about 60,000 deaths each year[1]. To say that this could be a potentially serious issue is an understatement!
That’s why understanding what bedsores are, how they form, and how to spot and treat them is vitally important for family caregivers. But even more important is prevention – and we’ve got several tips to help you keep this potentially serious problem from occurring at all.
The Basics of Bedsores
Let’s begin with understanding what bedsores are. Pressure ulcers are defined by the Indian Journal of Plastic Surgery as “a type of injury that breaks down the skin and underlying tissue when an area of skin is placed under constant pressure for [a] certain period causing cessation of nutrition and oxygen supply to the tissues and eventually tissue necrosis.”
What does that mean? If someone is in one place for too long, the pressure on certain areas of the body can cause the skin to break down. This often happens on the bony areas of the body, such as the tailbone or the hips, where the bone is closer to the surface of the skin. And it often happens to those of limited mobility – those in a wheelchair or those who are bed-bound and rely on someone else to turn them from one side to the other.
The damage caused by a pressure ulcer can happen within a matter of hours. Initial damage might look like bruising or swelling, with unusual changes in the color of the skin or even the texture of it. The area might be quite tender to the touch. And in some cases, the area of injured skin can be a different temperature than that of healthy skin. As the bedsore gets worse, there might be what looks like a depression in the skin or even an open wound, as well as pus-like drainage. If left untreated, a bedsore can progress to a deep injury that involves muscle and bone – and obviously a great deal of pain[2].
According to WebMD, bedsores for those who are using a wheelchair are more often on the shoulder blade, spine, tailbone, buttocks, and the backs of arms or legs where they press against the wheelchair. Those who are confined to their bed might have pressure ulcers in those areas as well as the back and sides of the head, hip, lower back, heels, ankles, and even the skin behind the knees.
Keep in mind that those who have underlying conditions that affect their blood circulation, such as diabetes or sickle cell anemia, are at greater risk for developing pressure ulcers. Those chronic conditions can also make any injury take longer to heal, so a bedsore can be a problem for weeks or months – and in some cases, even years. Those who are unable to sense pain, such as those who are paralyzed with a spinal injury and have lost all feeling in some parts of their body, are also at higher risk[3].
Other risk factors for developing pressure ulcers include being overweight or underweight or being unable to control bowels or bladder[4].
Someone who is suffering from the discomfort of bedsores will reasonably do whatever they can to alleviate the pain and avoid further damage. If your elderly parent is trying to do this but their mobility is quite limited, they might be in danger of falling from their wheelchair or bed.
Medical alert technology is an important safety net for anyone at risk of falling from a wheelchair or bed. A person who is already of limited mobility will have difficulty reaching a phone or other way to call for help. But an emergency response solution from Alert1 makes it easy to reach out for help – all your parent has to do is press the button on their medical alert pendant, 24/7/365.
Just How Bad is a Bedsore?
There are four main stages of bedsores, according to Johns Hopkins Medicine:
· Stage 1: This is when the area feels warm to the touch. It looks red on those with fair skin, but might look blue or purple on those with darker skin. If your parent can feel the bedsore, they might say it itches, hurts, or burns.
· Stage 2: The discoloration is worse at this point and the skin around it is also discolored, like a deep bruise. It might look like an open sore, a tear in the skin, a scrape, or even a blister. At this point your parent might be feeling significant pain from the pressure ulcer.
· Stage 3: This is when a bedsore begins to look more like a crater in the skin. That’s because the tissue beneath the surface is breaking down due to the constant pressure and untreated injury. As you might imagine, if your parent has feeling in that area, there will be serious pain involved.
· Stage 4: There is severe damage, discoloration, and pain. The bedsore is large and undeniably an open wound. Underneath, the damage can extend to muscles, tendons, joints, and bone. Infection is quite likely.
A mild Stage 1 pressure ulcer might heal on its own by ensuring that no further pressure is applied to the area. The moment you notice an ulcer, keep an eye on it and get in touch with the doctor if it hasn’t improved within 48 hours[5].
Also be on the lookout for symptoms that might not seem related, such as confusion, generalized weakness, a fast heartbeat, or fever and chills. These could be a sign of an infection[6]. In that case, it’s a potential medical emergency – call the doctor right away.
Treatment for Pressure Ulcers
If the ulcer is already rather serious or a mild one hasn’t shown improvement within that 48 hour window, it’s time to get the doctor involved. Home treatment for a pressure ulcer can include repositioning to remove pressure from the area, covering the wound with a dressing and keeping the area very clean.
More serious bedsores might need intensive treatment. This often includes antibiotics to treat an infection that can easily begin as a bedsore gets worse. It might also mean pain relief, as some pressure ulcers can lead to serious discomfort.
A doctor might also need to use negative pressure wound therapy, debridement to remove damaged or dead skin, or even surgery. In the worst cases, skin grafts might be transplanted to the area to aid in closing the wound and allowing it to better heal.
How to Prevent Bedsores
Bedsores can be quite frightening. But the good news is that pressure ulcers can be prevented with proactive care. Here are some comprehensive tips[7].
· Regularly inspect the skin for any signs of redness. Pay special attention to the bony areas of the body. Do this at least once a day.
· Ask your loved one if they are feeling any pain. Ask them to tell you where it hurts. Sometimes the redness can be mild enough that you don’t think it’s an injury; their pain level can tell you otherwise.
· Turn and reposition them every two hours if they are in bed. If they are in a wheelchair, encourage them to shift their position every 15 minutes or so.
· Ensure that their skin is always clean and dry. This might take much more attention if they are incontinent. Clean them up immediately and apply a skin protectant if necessary. Ask their doctor for recommendations.
· Soft padding in the bed and in wheelchairs can help reduce pressure on areas that are tough to position away from; for instance, a person in a wheelchair will likely have consistent pressure on their buttocks, no matter the position. Proper padding can be the best way to reduce that pressure. Natural sheepskin padding is always a good bet. Gel pillows or foam mattresses can help those who spend most of their time in bed.
· Make sure your parent’s nutrition is adequate. Getting enough calories, fluids, protein, vitamins and minerals can help ensure better health. Inadequate nutrition can contribute to slow healing. Speak to their doctor about their nutrition and what needs to be added to their diet. Make sure they stay well-hydrated.
· Know the proper way to clean them. For instance, wash their body with a soft sponge or cloth and never scrub hard. Exfoliating cloths, while they might feel good at first, can lead to faster breakdown of the skin. Use a gentle soap.
· Pay attention to their clothing. Clothes with thick seams that press against the skin can be harmful. Clothes that are too tight or fabrics that are too rough can lead to problems. Try to keep clothing from bunching up underneath the body.
· Learn how to move them. When transferring someone from their wheelchair, make sure not to drag them across the surface. They need to be lifted and then gently placed down on the new surface. The same is true with moving someone in bed – be gentle and don’t drag them. Talk to a physical therapist to learn the proper way to do this (and to help prevent injury to yourself as well).
· Make sure a wheelchair is the right fit for them. A physical therapist or their doctor can assess this. They might need a new wheelchair if they have gained or lost weight or if they are feeling pressure in any particular spot.
· Consider a medical alert pendant or wristband. This is a good idea for your elderly parent to wear at all times.
Take Care of Yourself Too
Family caregivers are under a lot of strain. Taking care of yourself helps you take better care of someone else. If your caregiving requires physical care and lifting, such as moving someone in bed or transferring them from a wheelchair, it’s important to be strong enough to do it properly. To that end, make sure you have adequate nutrition, good exercise, and the help of a physical therapist on learning lifting and moving techniques that can protect you from serious injury.
While it’s a great idea for your parent or other loved one to have a medical alert device, it’s also a good idea for your own peace of mind. A medical alert watch or pendant from Alert1 keeps your elderly parent safer and provides comfort and assurance that if anything happens, a simple press of the button can summon emergency services or other assistance immediately, at any time of the day or night. Take a look at Alert1’s affordable alert systems for seniors and choose the one that’s right for your family.