Seniors are at risk for a variety of health problems, ranging from physical health deterioration to cognitive decline. While the risk factors for these conditions differ, nearly all seniors are at risk for pressure sores. These sores develop when pressure builds in a specific area of the body over time, and repeated pressure exposure on the same area will result in the degradation of the skin’s integrity, literally opening the skin up to infection.
Beginning October 2017, the Centers for Medicare and Medicaid Services (CMS) will begin requiring all health facilities to track and report data reflecting pressure sore development on all clients, and by October 2018, financial penalties will be assessed to health facilities that do not meet these requirements. However, senior caregivers can work to reduce pressure sores among seniors, as well as ailing people of any age, by following these seven steps.
1. Get Seniors Moving
Exercise, ambulation and range of motion exercises promote circulation, and circulation actually helps to prevent the formation of pressure sores, explains the U.S. National Library of Medicine. This is much more than simply getting out of bed and into a wheelchair too. Pressure sores may develop on the tailbone, hip, shoulders or heels from prolonged sitting in a wheelchair, so variety in movement is key.
Use wheelchairs when necessary, but offer to help seniors get into recliners or other more-cushioned chairs. Also, avoid leaving seniors in one position in any location for an extended period of time. This includes repositioning seniors while laying down or while awake during the day.
2. Check the Skin for Signs of Developing Pressure Sores Often
The skin should be checked frequently for the signs of developing pressure sores. A pressure sore may develop in less than a few hours.
For example, have you ever experienced increased soreness and redness on your buttocks while driving for more than an hour or two? If so, you developed a Stage I pressure sore, but your ability to move allowed you to recognize the pain and adjust your position to prevent it from progressing.
For some seniors, you must be the one to check and recognize the signs of a pressure sore’s development when performing perineal care, providing showers or performing other assessments of skin integrity. All such checks should be documented as well.
3. Use Specialty Bedding or Materials to Reduce Pressure
Depending on the needs of each senior, specialty beds, such as water or air mattress toppers, or special, cushioned padding, such as heel protectors, may be needed to reduce the amount of pressure placed on sensitive areas of the body. These additional materials should not be limited to mattresses or modifications to footwear. Instead, keep the options open for what may and may not be the most comfortable and beneficial to the needs of seniors.
For example, a memory-foam pillow is great, but it does little good if it is always placed in the same position. Furthermore, soft, pillow-like wedges may be used to help seniors remain on their sides while lying in bed between repositioning times.
Some newer beds may suggest automatic turning is available for use. However, these systems do not completely reposition a person. As a result, it is best to use these systems in conjunction with manually reposition of a person.
4. Keep the Skin Dry and Clean
Incontinence is one of the biggest factors associated with the development of pressure sores. When bowel movement or urine stays in contact with the skin, acids and enzymes in them will begin to cause excoriation and degradation of the skin faster than usual. When combined with limited ability to reposition oneself, a senior may develop a pressure sore in the perineal area faster.
If the area appears to become reddened, the senior may have developed a Stage I pressure sore. When this occurs, it is best to assume the area has been subject to more intense pressures and proceed with an appropriate treatment, such as the use of a barrier cream to help prevent further excoriation due to bodily substances. However, the use of a barrier cream does not negate the need for continued repositioning and movement to help prevent worsening of the area.
5. Encourage Seniors to Maintain a Healthy Diet
The benefits of a well-functioning circulatory system are only as good as the nutrients it delivers. Seniors should strive to eat a well-balanced, healthy diet, explains Medscape. In fact, optimizing the nutritional status of a senior living with a pressure sore is key to ensuring successful treatment. For seniors living with metabolic disorders, such as diabetes, a healthy diet can go much further than simply preventing or encouraging the healing of pressure sores.
6. Manage Chronic Health Conditions Effectively.
Chronic health conditions may also impact risk for developing pressure sores. Any condition that affects the function of the cardiovascular system may result in poor circulation and greater risk for pressure sores, asserts Healthline. As a result, the effective management of these conditions remains critical, in addition to all aforementioned steps, to preventing the development or worsening of pressure sores.
This may include monitoring fluid intake for those with heart failure, maintaining dietary restrictions for seniors with kidney disease or ensuring medication interactions do not result in poor circulatory function.
7. Create an Incentive-Based Program for Senior Caregivers
Senior caregivers play major roles in preventing the development of pressure sores, so consider implementing an incentive-based program. This program can utilize data from your pressure sore tracking measures to provide a “reward or recognition” to caregivers that maintain repositioning and actively work to reduce the prevalence of pressure sores among those in your care.
Put These Steps Into Action Today
There are many different paths you can take to reducing pressure sores in your facility, and even if seniors in your care receive services at home, every step can be implemented in different types of care settings. Since it is in the best interest of your organization and the seniors you serve, start using these seven steps today, and be creative if you run out of other ideas. You could even have a brainstorming session with caregivers about the best ways to “knock out” pressure sores for your specific clients too.