Age plays a significant role in the development of bedsores, also known as pressure ulcers or pressure sores. Therefore, many elderly residents of nursing homes are at risk for developing these bedsores due to decreased mobility and placing pressure on one body part for extended periods of time either in a chair or in a bed. Under no circumstances should an elderly resident of a nursing home ever reach the latter stages of bedsores, as it is reasonable to expect nursing home employees to easily and readily prevent and detect bedsores and treat them while still in their earlier stages.
Nursing homes have a responsibility to ensure that they care for their residents in such a way that they never develop any kind of bedsore. The prevention of bedsores helps ensure that these sores or ulcers never result in any long or difficult treatments. The following are some activities that nursing home staff members should engage in to assist in the prevention of serious bedsores in elderly residents.
- Change Positions. Nursing home staff members should make sure that elderly residents change their position frequently. Those residents in wheelchairs or sitting should receive repositioning every 15 minutes, and those residents in bed should receive repositioning at least every two hours. The repositioning of residents will prevent them from placing sustained pressure on one area of the body, such as the hips or legs. Additionally, for those residents that are bedridden, the nursing home should provide special pressure-reducing mattresses.
- Inspect Skin. Nursing home staff members should inspect the skin or elderly residents on a daily basis. This simple inspection can prevent the progression of bedsores in elderly residents. Any sign of skin damage, infection, foul smell, or sensitivity should alert a caregiver to seek medical attention for their resident.
- Nutrition. Nutrition impacts the development of bedsores. Malnutrition can easily lead to bedsores and other medical conditions. Residents of nursing homes should receive proper calories, fat, vitamins, minerals, and protein.
- Exercise. While elderly residents often have challenges with their mobility, the nursing home should provide modified exercise activities to allow residents to increase their blood flow and prevent bedsores.
Bedsores do not occur from one day to the next, but rather there are four stages of bedsores. Since this medical condition does not occur instantaneously, nursing home employees should monitor their elderly residents frequently, and bedsores should never develop into serious and complicated medical issues.
Bedsores begin as a small area of reddish-colored skin. This area may or may not itch, feel warm, spongy, or firm. Those elderly residents with darker skin may have a darker purple or blue color instead of a reddish-color. If an elderly resident has a stage 1 bedsore, simply relieving the pressure will resolve their condition quickly.
Bedsores develop into a more serious condition at stage 2, when some skin loss occurs and bedsores may even be an open wound. Several layers of skin appear removed at this stage, and the bedsore often appears as a blister or some sort of abrasion. Again, the area will contain discoloration as either red, purple, or blue. At this stage, simply relieving the pressure and tending to the wound will resolve an elderly resident’s bedsore quickly.
Stage 3 bedsores present themselves with so many layers of skin missing that the muscle can oftentimes be visible. The tissue in these cases may suffer permanent damage. The wound now appears as a crater (known as a slough), and actual fat may also appear noticeable surrounding the infected area. This stage is quite serious and needs medical attention.
Stage 4 bedsores are serious medical situations. Damage occurs in both the tissue and bone, along with tendons and joints. Massive amounts of tissue are permanently destroyed, and at this point, the wound may never heal properly. In fact, the infections present at this stage can cause death.
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Additional Medical Complications
Along with the bedsore becoming infected, and bone, tissue, tendon and joint damage, bedsores can lead to squamous cell carcinoma, a type of cancer requiring surgery. Additionally, infections of the joint or bone are common as is cellulitis and inflammation of connective tissues. Finally, an untreated bedsore can result in sepsis, a bacterial infection of either the bloodstream or body tissues that often results in death.