Preventing Bedsores: How Patients and Families Can Advocate for Better Care

Ensuring your older loved one has the care needed is a daunting undertaking. So what happens if you discover red marks during a visit? Bedsores can become a critical health problem for people who are not mobile, and older people with other medical issues require immediate medical intervention. Learn more about what you can do as a family member to advocate for better care for loved ones when they are at their most vulnerable.

What Are Bedsores?

Pressure ulcers or bedsores got their name because they most often appear on areas of the body that remain in constant contact with a chair or bed. The tissue under the skin can become damaged from the constant pressure exerted between the body and the bed. Some areas of the body are more prone to bedsores, including the buttocks, heels, shoulder blades, hips, back of the head and behind the knees. These are the most vulnerable because the skin is the thinnest across bony areas.

Cause

When the body remains in a position too long, circulation is cut off impeding vital oxygen and other nutrients that keep skin and tissue healthy. The longer the blood supply remains cut off, the more likely damage is to set in that necessitates acute and sometimes critical care. While immobility is the most common cause of bedsores, shear and friction can also contribute to their development.

Appearance

It does not take long for bedsores to develop. In a matter of hours, discoloration of the skin, (usually red or white), appears in the vulnerable areas of the body. If the area remains in the same position, the discoloration will give way to an open wound as the tissue further deteriorates. It is this progression that makes the condition extremely dangerous, especially in older or medically compromised people.

Health Implications

Why are bedsores dangerous? When the skin opens to the outside world, it allows bacteria to enter the body directly. Not only that, but open bedsores often run extremely deep in the body and can even go all the way down to the bone. Bedsores that run this deep usually require surgical intervention to stop the spread of the infection. Necrosis, a condition that occurs when tissue dies and spreads to surrounding areas and organs, can result in catastrophic tissue loss and spread infection throughout the body.

Common complications of bedsores also include:

• Joint and bone infections
• Cancer
• Cellulitis
• Sepsis

Risk Factors

Some people are more likely than others to develop pressure ulcers at some point. The most vulnerable are those who can not ambulate well or at all. This means that they spend all their time in a bed or chair. People with spinal cord injuries, for instance, are more susceptible to bedsores.

Extended moisture on the skin makes it more fragile and easy to break., so people who have a difficult time controlling their bladders or bowels may wind up having to sit or lie in wet clothes or bedding. Poor nutrition, lack of hydration, nerve damage and blood flow conditions also put some more at risk of bedsore development.

Treatment

One of the most critical parts of treating bedsores is movement to reduce the pressure on the impacted area of the body. Physical therapists may visit to help move unresponsive areas of the body to get blood moving and ensure that every part of the body is receiving the oxygen to keep tissue healthy. Depending on the severity of the sore, wound care specialists may need to wash and dry the area regularly. Finally, in the most severe cases, surgeons will remove affected skin and tissue, and administer medication directly into the wound.

Are Bedsores Preventable?

Those at the highest risk of developing bedsores are often older adults, just like your loved one. Part of this is due to the degradation of mobility and also the natural thinning of the skin that occurs as part of the aging process. Skin in older people can become almost translucent, and thus, is also more easily bruised and injured.

The only surefire prevention of bedsores is movement. Even if your loved one cannot do it themself, there should be caregivers at the facility who will rotate them on a regular basis.

What Can You Do To Advocate for Your Better Care?

You may feel like you have little control over your loved one’s care when they are in a facility since you are not living there to ensure the staff is doing the right thing. It is common to feel helpless in these situations, but you do have options when it comes to advocating for the person you love.

Show Up

Making routine and frequent visits to the care facility is the most important step in overseeing the continued care of your loved one. When you show up, you are more likely to impress upon the staff that you expect that they do whatever it takes to care for your loved one and even more, that you are there to notice anything that may be off. While a schedule of visits is a good idea, you should also drop in from time to time so that you can see the level of care when the staff does not expect you to be there.

Committing to a regular schedule of visits allows you the opportunity to spot signs of bedsores or other changes in your loved one before things can escalate to a critical level. You will notice whether staff comes in to rotate your loved one with any kind of regularity and you can do a personal inspection of the vulnerable parts of the body. The more present you are, the more you will observe.

Remain Diligent

Ask questions about your loved one’s care and the schedule of actions that the staff should take to prevent bedsores, such as regular bathing, changing clothes and bedding and, most importantly, how often the staff moves your loved one’s position so vulnerable parts of the body receive proper circulation. If you have concerns about the level of care your loved one is getting, meet with supervisors immediately. You may want to involve your loved one’s physician in discussions so that the facility has accurate orders for physical therapy, medication, wound care, etc.

One key to making sure your loved one gets the care they need is following up on directives and orders. If you continue to see bedsores or other signs of neglect, such as bruising, or a change in mental health or personality, you may have to contact the director of the facility.

Give Us a Call!

A beloved family member deserves to live in comfort and receive the medical treatment, care and respect they deserve. Bedsores may be a one-off event, or they may recur. When they do return, the facility may not be adhering to the standard of care when it comes to your loved one’s medical condition and needs. If this is the case, you may want to seek the assistance of someone else who can advocate on your behalf. That’s where our team comes in. Contact us to learn more about what we might be able to do to assist your loved one get the quality of care and life they deserve.