Pressure ulcers or bed sores can affect bed-bound people of any age, but they’re more commonly associated with the elderly. If you spot pressure sores on the hips, shoulder blades, lower back or ankles of your family member, how concerned should you be? It’s not like bed sores are fatal, right?
Although bedsores themselves will not lead to death, complications from bedsores such as bone infections, myonecrosis, necrotizing fasciitis, or cancer can be deadly. Even if they aren’t, some of these complications can require amputation.
If you have never seen a bedsore or pressure ulcer, they can be horrific. I worked in a nursing home as a physical therapy aide one summer where more than one nursing home resident had these ulcers – some the size of the bottom of a soda can!
They formed despite the person laying on special mattresses and being shifted by the staff on a regular basis. Often the person had at least one deep wound that had caused extensive damage to the skin, putting them at an increased risk of infection or possibly death.
In this article, I’ll tell you everything you need to know about bedsores, including their causes, more on the above complications, and how to get rid of bedsores.
Whether this is the first bedsore you’ve spotted on your senior or the seventh, you’ll certainly want to keep reading!
What Causes Bed Sores?
Decubitus ulcers or bedsores are open wound skin injuries that can sometimes affect the tissue as well.
The most common areas for bedsores are the tailbone, hips, ankles, and heels. If your senior has bedsores, these don’t usually appear overnight, but rather, over hours, days, or even weeks.
So what causes bedsores? It’s actually a combination of three factors, which are shearing, friction, and pressure.
Shearing refers to what happens when surfaces move in opposing directions. By adjusting a senior’s bed so they’re sitting up, for example, their tailbone is angled down but the skin is not. This pulls on the skin, creating the potential for shearing.
Friction is any type of heat or rubbing between two surfaces, such as bedding and skin or even a senior’s pajamas or clothing rubbing against their skin.
Constant pressure can limit the blood flow to the area. When the tissue and/or skin cannot receive enough nutrients and oxygen from the blood supply, they die. We’ll talk more about this in the next section.
Risk factors for pressure injuries include (from the Mayo Clinic ):
- Immobility – This is usually the main cause of pressure ulcers. Lack of movement can be due to many factors – hospitalization due to severe infections, neurological problems from a stroke, paralysis from injury to the spinal cord, poor health, etc.
- Incontinence – many elderly patients have problems with incontinence. When the skin is exposed to urine and feces for periods of time, it can cause it to become more vulnerable. This can a big problem for nursing home residents because these facilities are often underserved. Overworked nursing home staff may be so busy they don’t realize their immobile patients haven’t been shifted or their diapers and clothing changed frequently enough.
- Lack of sensory perception – many conditions can cause the inability to feel a certain part of your body. These include paralysis or neurological damage. Even some medical conditions, such as diabetes, can certainly contribute. If you don’t feel discomfort or pain, it probably wouldn’t occure to you to shift your body.
- Medical conditions – there are certain medical problems that can certainly make someone more prone to bed sores such as diabetes and vascular disease.
- Poor nutrition – oftentimes, an ill person who is on bed rest doesn’t eat well (if at all), so they don’t get enough vitamins or hydration. A lack of nutrients can only make someone more ill than they already are.
Be on the watch for bedsores if the person you are caring for experiences the following symptoms:
- tenderness in certain areas, especially if it is near a bony area
- The surrounding skin of the affected tissue feels warm or cold compared to adjacent areas
- Pus leakage and a foul odor
- Skin texture and/or color changes
What Can Bedsores Lead To?
Bedsores themselves cannot kill a person, but the resulting complications of untreated bedsores certainly can. Here is what can result if older adults don’t get the proper care or medical treatment for bedsores in the early stages of a pressure injury:
Bedsores are like any other skin breaks. The wound requires disinfecting and bandaging to staunch the bleeding and stop it from worsening. Yet bed-bound seniors might not even realize that they have bedsores – or they may, but lack the mobility to do anything about it.
Leaving bedsores untreated can cause infections. If caught by a health care provider when showing the first signs of infection, they can treat the pressure ulcer with little to no threat to the senior’s life.
Serious infections, however, put the person at high risk of complications.
In the advanced stages, a doctor might recommend emergency surgery to amputate the affected limb. Keeping the limb attached to the body could allow the infection to spread, often fatally.
Gas gangrene or myonecrosis is also referred to as clostridial myonecrosis. Although it’s considered a rare complication, that doesn’t mean it couldn’t happen to the senior in your life. This infection is caused by Clostridium perfringens, a species of bacteria.
In this type of infection, the affected muscle tissue can die, which will lead to shock and/or toxemia (toxemia is bacterial-induced blood poisoning). While the muscle tissue dies, the sores that form will be very big and then turn black.
The necrotic tissue releases gas during myonecrosis, which makes a noticeable sound. This side effect is called crepitus.
Other symptoms of myonecrosis that can occur before muscle tissue death include jaundice or yellowing, swelling, blisters, numbness, and lightheadedness. Your senior might report a heart rate that’s faster than usual and they could have a fever as well.
One of the scariest complications of bedsores is necrotizing fasciitis, which is a flesh-eating bacterium.
Any skin breakages are openings for the bacteria to get into. These include surgical wounds, puncture wounds, insect bites, burns, scrapes, cuts, and bed sores.
The symptoms of necrotizing fasciitis can come on incredibly fast. They include fever, pain in the infected area, swelling, redness, and warmth.
As necrotizing fasciitis progresses, the symptoms advance in severity, but still not enough that you might think something is seriously wrong.
A senior might experience exhaustion, wooziness, pus leakage, skin discoloration, blisters or ulcers, and black spots on the infected area(s).
Even if these symptoms altogether don’t seem serious, you should still take your senior to a doctor for an emergency appointment.
The doctor might recommend surgery if the necrotizing fasciitis is advanced. Antibiotics may be able to lessen the symptoms in mild cases.
In very severe instances, such as with continually neglected bedsores, infections can worsen to the point where they travel beyond the skin and tissue and nestle into the bones.
A severe infection will begin breaking down cartilage in the bones, which can lead to significant damage the limbs that requires amputation.
Bone and joint infections neeed immediate treatment, as without medical intervention, nothing will stop the infection from spreading to all the bones and joints.
If the infection reaches crucial parts of the body like the heart, then a bone infection can be deadly. That’s also true if the infection spreads to the entire body.
Unaddressed, recurrent wounds could become squamous cell carcinoma, which is yet another complication to look out for.
This form of cancer can be cured if detected early enough. Like the other complications of bed sores, by ignoring squamous cell carcinoma for too long, it can become fatal.
The treatments include topical medications, photodynamic therapy, radiation, laser surgery, electrosurgery or curettage, cryosurgery, and excisional surgery.
Can Bedsores Turn Into Sepsis?
Sepsis is an infection complication that can be deadly without treatment. When a senior has sepsis, their bloodstream chemicals trigger bodily inflammation. This sudden reaction can cause the organs to shut down, and death soon follows.
Can sepsis occur from bedsores? Considering that infections are a frequent complication of untreated bedsores, the answer is yes, absolutely, bedsores can turn into sepsis.
Seniors are already more likely to develop sepsis since it more frequently affects those with preexisting medical conditions and/or weakened immunity.
The symptoms include elevated respiration (more than 22 breaths per minute), low systolic blood pressure, and mental and/or behavioral changes. These symptoms must be accompanied by an infection.
If sepsis progresses to septic shock, lactic acid levels will rise in the blood. This indicates that the cells either aren’t receiving enough oxygen or aren’t using what they have. A senior’s systolic blood pressure can drop even further. Sepsis shock is often fatal.
What Is The Fastest Way To Get Rid Of Bedsores?
Now that you’ve realized your senior’s body is riddled in bed sores, you have to do something for them immediately. I’d recommend an appointment with their primary care physician, who can look over the state of the bed sores and let you know whether any are infected.
Then you should start bed sore treatment with the approval of your senior’s doctor. Here are some methods that can get rid of bed sores fast.
Limit Pressure On The Affected Area
Since pressure is one of the three factors that can lead to the development of bedsores, it’s important to reduce pressure on the body going forward.
Your senior shouldn’t spend all day in bed or sitting in one spot. Encourage them to get up, take a walk, or step outside for a few minutes.
Even moving your senior from their bed to a wheelchair is enough to alleviate the pressure, so immobile seniors don’t have to live with beds ores either.
You can also ask your senior’s doctor about debridement, a medical process in which they’ll scrape away any infected or dead tissue so the rest of the tissue can heal unobstructed.
NOTE: This is not something you should do at home! Please let your senior’s doctor take care of it.
Clean The Affected Area
Once your senior is back home or at the nursing facility, you need to keep treating their bedsores until they heal. Every day, clean the wound using a povidone-iodine or saline water solution.
Make sure that whatever product you use is sterile. Besides keeping your senior’s wounds clean, these solutions might also prevent new bed sores from forming.
Bandage The Affected Area
Covering bedsores will keep them from rubbing against the senior’s clothing or bedding. Medicated gauze is good to use here, as it will continue healing the wound long after you apply the povidone-iodine or saline water.
Do make sure that you replace the bandaging daily.
Improve The Senior’s Diet
What does your senior eat? A diet that’s deficient in vitamin C and protein can impede wound healing speed.
Whether your senior needs supplements to get their minerals and vitamins or they begin eating more healthful meals, their bedsores should start healing faster.
Bed sores might not seem serious at first glance, but these wounds can become infected quickly, leading to deadly complications such as sepsis or necrotizing fasciitis.
If you see bed sores on your senior parent’s body, schedule an appointment with their doctor as soon as possible. You’ll not only help to ease their suffering, you just might safe their life!