The number of people at risk from pressure ulcers is increasing due to an aging population and a growing prevalence of long-term chronic conditions. Older adults who have functional limitations and immobility issues are especially at risk for developing bed sores. Bed sores, also called pressure ulcers or decubitus ulcers can result due to a combination of prolonged pressure on the skin in combination with friction and/or shearing forces. Shearing is the force exerted on the skin when the person is pulled up or moved in bed and friction is the skin rubbing against the linens. Immobility and nutritional deficiencies can cause someone to be more at risk for developing a bed sore. Changes in the skin with aging can make older adults especially at risk.
- Ensure your loved one has adequate nutrition and hydration. This may mean adding a nutritional supplement such as Ensure or Boost health shakes to provide additional protein, arginine, zinc, vitamin C, and other micronutrients.
- Provide daily hygiene skin care and look at your loved ones skin regularly- all of it, paying special attention to problematic areas like the tailbone (coccyx), hips, and bottoms of heels. Look for redness or discoloration that does not go away when pressure is relieved, or any open blisters. Talk to your health care provider about any abnormalities you find.
- Assist with repositioning frequently at least every 2 hours when lying in bed, as 2 hours of uninterrupted pressure has proven to cause tissue damage. When sitting in a chair or wheelchair, position shifting should be happening at least 3 times an hour.
- Use pillows, towels, washcloths, or blankets to position body so that pressure is off bony prominences.
- Laying on one’s side and then switching to the other side, or stomach lying (prone) can be helpful to someone who is generally bedridden.
- Someone who is generally chair bound can use special gel cushions or pads on the seat to relieve pressure. These can be purchased online or at most medical supplies stores.
- Special alternating pressure air mattresses and foam mattresses should be considered for someone who is bedridden to prevent bed sores.
- Use a barrier cream or ointment to protect skin that may be exposed to moisture, as in incontinence.
Treatment of Bed Sores
Caring for and treating bed sores is not an easy task and requires a team effort. Talk to your healthcare provider about the use of special creams, ointments, gels, and dressings, which will vary based on the type, severity, and wound characteristics. Click here to read about the staging of pressure ulcers. General wound care goals are to keep the wound clean and free from infection, and absorb drainage. At times, a healthcare provider may need to remove dead tissue on the wound, called debridement. Specific types of wound dressings your health care provider may prescribe to treat pressure ulcers include hydrocolloid, hydrogel, alginate, or collagen dressings. For more severe wounds that are not healing, a special device like a wound vacuum may be applied.
With any treatment, it is essential to make sure your healthcare provider can properly evaluate whether the treatment is working or not, so follow up care is important. Pain can be expected and should be discussed with your healthcare provider. Turning and repositioning frequently is especially important to promote wound healing. Having a pressure ulcer puts you considerably at risk for developing more, so make sure nutrition is adequate and consider special pads and air mattresses to relieve pressure.