Author Archives: Adam Peck

Bedsores — also called pressure sores or pressure ulcers — are injuries to skin and underlying tissues that result from prolonged pressure on the skin. Bedsores most often develop on skin that covers bony areas of the body, such as the heel, ankles, hips or buttocks.

People most at risk of bedsores are those with a medical condition that limits their ability to change positions, requires them to use a wheelchair or confines them to a bed for prolonged periods. Many of these people are also dehydrated and malnourished.

Bedsores can develop quickly and are often difficult to treat. Several care strategies can help prevent some bedsores and promote healing.

Bedsores fall into one of four stages based on their severity. The National Pressure Ulcer Advisory Panel, a professional organization that promotes the prevention and treatment of pressure ulcers, has defined each stage as follows.

Stage I Pressure Sores

The beginning stage of a pressure sore has the following characteristics:

• The skin is intact.
• The skin appears red on people with lighter skin color, and the skin doesn’t briefly lighten (blanch) when touched.
• On people with darker skin, there may be no change in the color of the skin, and the skin doesn’t blanch when touched. Or the skin may appear ashen, bluish or purple.
• The site may be painful, firm, soft, warmer or cooler compared with the surrounding skin.

Stage II Pressure Sores

The stage II ulcer is an open wound:

• The outer layer of skin (epidermis) and part of the underlying layer of skin (dermis) is damaged or lost.
• The pressure ulcer may appear as a shallow, pinkish-red, basin-like wound.
• It may also appear as an intact or ruptured fluid-filled blister.

Stage III Pressure Sores

At this stage, the ulcer is a deep wound:

• The loss of skin usually exposes some amount of fat.
• The ulcer has a crater-like appearance.
• The bottom of the wound may have some yellowish dead tissue (slough).
• The damage may extend beyond the primary wound below layers of healthy skin.

Stage IV Pressure Sores

A stage IV ulcer exhibits large-scale loss of tissue:

• The wound may expose muscle, bone and tendons.
• The bottom of the wound likely contains slough or dark, crusty dead tissue (eschar).
• The damage often extends beyond the primary wound below layers of healthy skin.

Common sites of pressure sores

For people who use a wheelchair, pressure sores often occur on skin over the following sites:

• Tailbone or buttocks
• Shoulder blades and spine
• Backs of arms and legs where they rest against the chair

For people who are confined to a bed, common sites include the following:

• Back or sides of the head
• Rim of the ears
• Shoulders or shoulder blades
• Hip, lower back or tailbone
• Heels, ankles and skin behind the knees

The Oregon Senate backed a bill recently that will make major changes to Oregon law with respect to elder abuse, creating critical new protections for Oregon’s most vulnerable seniors. House Bill 4084 integrates several recommendations from a work group on elder abuse created in 2011 including increasing the statute of limitation for crimes against the elderly, modifying records disclosure laws to make sure law enforcement can investigate allegations of abuse, and creating a council to review reporting of abuse to determine root causes of abuse and how abuse can be prevented.

According to the Oregon Department of Human Services, state and local offices investigate more than 11,000 complaints of elder abuse or neglect each year. Oregon’s Elderly Persons and Persons with Disabilities Abuse Prevention Act defines an elderly person as any person 65 years of age or older. Abuse is defined as physical injury not caused by accident, neglect leading to harm, abandonment, willful infliction of physical pain or injury, unwanted sexual contact or the inability to consent to sexual contact, or financial exploitation

Bedsores & pressure sores, or pressure ulcers also known as decubitus ulcers as they are medically termed, are thought to affect over one million patients annually in the United States of America.

Tens of thousands of people die annually because of bedsores or infected wounds costing billions of dollars in unnecessary health care costs.

Bedsores can develop in as little as four hours and even when they don’t kill, they can inflict terrible pain and rob thousands of patients of their mobility and independence.

Bedsores, pressure sores and decubitus ulcers are caused where a patient lies immobile for a period of time, unable to shift their weight or get up and move around. This places pressure on certain areas of the body – often the heel, back and elbows, reducing circulation and cutting the supply of oxygen and vital nutrients. The tissue begins to bruise, and if a patient is not moved or ‘turned’ it dies off. In severe cases, this can leave a gaping hole that is not only extremely painful and distressing, but can prove fatal.

The presence of any bedsore creates a major increase in the possibility of the death of the inflicted individual.

There are four grades or categories of bedsores / pressure ulcers:

• Stage 1 – reddening or bruising of the skin;
• Stage 2 – broken skin and shallow ulceration;
• Stage 3 – large in appearance and deep ulceration
• Stage 4 – deep ulceration revealing skin and muscle that has worn away, revealing bone and sometimes internal organs.

Don’t let your loved one be neglected and become another statistic. Watch what they are doing in these long term care facilities, ask questions, be an advocate for your elder or dependant adult.