People at the greatest risk of developing pressure ulcers are those who are immobile. Once a person losses the ability to move and becomes inactive, the risk of developing a bedsore increases.
Patients who have experienced loss of sensation as the result of spinal cord injury or neurological disease have an increased risk of developing pressure ulcers. A person without sensory loss can feel pain and will generally feel uncomfortable after spending a lot of time in one position. When sensory loss occurs, a person may not feel uncomfortable or the need to be repositioned.
Changes in Mental Status
Likewise, a person with an altered level of consciousness may not feel discomfort or may not be awake enough to physically reposition themselves if they do.
Shear is the rubbing of skin and fatty tissues across bones, and it is caused by the combination of gravity and friction. Shear most commonly occurs when a patient is lying with the head of the bed raised. The person’s skeleton may slide down in the bed while the skin and fatty tissues stay in place. This type of force causes damage to the underlying blood vessels, resulting in ulcers with a large area of internal tissue damage and less noticeable damage at the surface of the skin.
Friction occurs when two surfaces move across one another. Friction decreases the skins tolerance to pressure by causing abrasions and compounds the effect of shear. This can happen when a patient slides down in bed or is repositioned in bed the wrong way.
Moisture is a common problem in people who have become incontinent of urine or stool and have to wear diapers. Moisture from sweat can also be a problem. Moisture removes oils from the skin that normally act to protect it and softens the skin’s connective tissues, making the effects of shear and friction more damaging.
As above, incontinence of bowel movements and urine create moisture on the skin and increase the risk of breakdown. Fecal incontinence has the added risk of damage to the skin from bacteria and enzymes in the stool and also increases the risk of infection and the healing of the bed sores, pressure sores or decubitus ulcers.
Poor nutrition can lead to weight loss which can then increase the pressure on bony areas of the body. Proper nutrition is also important to the healing of bed sores, pressure sores or decubitus ulcers.
As a person ages, the skin becomes thinner and more fragile, increasing the risk of skin breakdown.
If your loved one has any of these risk factors, it’s important for you to take steps to prevent a bed sores, pressure sores or decubitus ulcers from developing.
About the Author
Attorney Steven Peck has been practicing law since 1981. A former successful business owner, Mr. Peck initially focused his legal career on business law. Within the first three years, after some colleagues and friend’s parents endured nursing home neglect and elder abuse, he continued his education to begin practicing elder law and nursing home abuse law.