Bedsores and chronic wounds are common among elderly patients, due to their inability to move as easily as they used to. Elderly patients that have difficulty moving need to be repositioned in bed or transferred between seats to prevent the development of bedsores. If a chronic wound or bedsore does develop, elderly patients will have more trouble healing than younger patients.
Types of Elder Wounds
Examples of wounds that elderly patients may experience include:
– Bedsores or pressure ulcers
– Diabetic ulcers
– Venous and arterial ulcers
– Scrapes or gashes from a falling incident
– Open wounds from a burn incident
– Amputation wounds
– Post operative wounds
– Open wounds from a lack of circulation to a specific area of the body
How Wounds Heal
Wounds go through several natural stages of healing, regardless of age or medical conditions. There are four main phases that a wound progresses through to fully heal. In order, the four stages of a healing wound involve hemostasis, inflammation, proliferation, and remodeling. To successfully heal, the wound must pass through all four stages in the correct sequence and time frame.
For elderly patients, these stages can be interrupted or inhibited for a number of reasons. Elderly patients typically have very thin or fragile skin. This makes elder patients more prone to chronic wound development than young or middle-aged patients. The fragile skin and slower cell regeneration can make it difficult for a wound to heal once it has formed. In addition, certain prescriptions that are commonly taken by elder patients can inhibit the elder’s ability to heal.
Elder Wound Care
Wound care for elders may vary slightly, depending on the cause and severity of the wound. Generally, the medical professional will begin by cleaning the elder’s wound. This may involve surgery. If the elder patient has a large quantity of dead tissue in the wound, the dead tissue must be removed for the wound to heal properly. This is commonly seen with bedsores and pressure ulcers.
In most cases, the doctor will apply a topical antiseptic on the elder patient’s wound. The topic antiseptic helps the elder’s wound heal in two ways. First, it prevents the growth and spread of bacteria within the wound. This helps to prevent infection. Second, a topical antiseptic can help keep the elder’s wound moist. This aids the body during its four natural stages of healing.
The use of bandages varies depending on the nature of the elder patient’s wound. In the case of elder patients living in nursing facilities, wounds are generally kept covered due to the increased abundance of bacteria in the patient’s living environment. For some patients, doctors may suggest to use a radiant bandage to keep the wound warm. This allows the blood vessels to remain dilated, so the patient’s body is better able to heal the elder wound. The use of a radiant bandage helps prevent elder wound infection and ischemia.
Improper Wound Care
In nursing facilities, elderly patients may develop certain types of wounds due to negligence by the nursing home staff. For example, bedsores occur as a result of the elderly patient laying or sitting in the same position for an extended period of time. This immobility prevents adequate circulation and oxygen to the parts of the patient’s body that receive the most pressure in that position. Without adequate circulation or oxygen, the body develops a pressure ulcer because the tissue at that location is dying.
The staff at nursing facilities is supposed to rotate the elder patient through a variety of sitting and laying positions to prevent bedsores. If the elder patient has very poor circulation, fragile skin, or severe incontinence issues, a bedsore may still develop. Once the bedsore or pressure ulcer has developed, the nursing home staff should follow protocol for elder wound care. The patient should also be temporarily kept in positions that allow for the least amount of pressure upon the elder wound. Doughnut or circular pillows should never be used because they may inhibit circulation to the healing elder wound.
Elder Wound Infection
Signs that an elder’s wound is infected include:
– Weakness or confusion
– Fever
– Pus coming from the wound
– Redness or tenderness near the elder wound
– Warm or swollen skin near the elder wound
– A foul odor coming from the wound
When a patient receives improper elder wound care, a wound infection is likely to happen. Elder patients in nursing facilities are exposed to certain types of bacteria due to the nature of their environment. It also takes a longer time for elder patients’ wounds to heal. This is often a result of age, fragile skin, slow cell regeneration, medication, certain diseases, malnutrition, or dehydration. If an elder’s wound is infected, the infection must be treated immediately to prevent amputation or death.
Sources:
Guo, S., and L. DiPietro. United States. National Center for Biotechnology Information. Factors Affecting Wound Healing. Bethesda: National Library of Medicine, 2010. Web. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903966/
United States. National Library of Medicine. Pressure ulcer. Bethesda: Medline Plus, 2013. Web. http://www.nlm.nih.gov/medlineplus/ency/article/007071.htm
“Wound Care.” St. Elias Specialty Hospital: a Providence Partner. BridgeCare Hospitals, n.d. Web. 20 May 2013. http://www.st-eliashospital.com/index.php?option=com_content&view=article&id=83&Itemid=91