In particular, physically disabled patients must be turned on regular basis to avoid unrelieved pressure from developing. Similarly, caregivers must be diligent when caring for physically disabled patients who are incontinent to avoid protracted skin contact with urine and feces– known caustic agents that may speed skin breakdown.

In patients who are paralyzed due to a stroke or traumatic event, staff need to regularly check the patients entire body for the early signs of bed sores– discoloration of the skin.

According to the National Spinal Cord Injury Association:

• More than one-third of people living with spinal cord injuries living in the United States are battling a bed sore of some type
• Bed sores are responsible for causing the death of 8% of spinal cord patients
• When bed sore advance and the person develops sepsis, there is a 50% mortality rate
• Bed sores heal slower in patients with spinal cord injuries– frequently they require more than a one-year hospitalization

Caregivers for disabled patients should be aware that the individuals they are responsible for caring for are at heightened risk for developing bed sores.  Consequently, they may wish to implement some of the following preventative measures:

• Use specialized beds and other medical equipment to minimize the direct pressure on particularly susceptible areas of the body such as the heels, back, buttocks and head.
• Provide proper nutrition and supplements
• Get the person out of bed as often as feasible
• Keep a chart to help track different rotation positions
• Notify doctors immediately if the patients condition changes or bed sores develop

Related:

Settlement For Neglected MS Patient With Bedsores

A Graphic Example Of Nursing Home Negligence: Amputation Of A Leg Due To Untreated Bed Sores

As the largest organ of the body, the skin is one of the first places where the consequences of malnutrition may be visible in the form of a bed sores (similarly described as pressure sores, pressure ulcers, or decubitus ulcers).  There are various medical explanations why malnourished individuals are more susceptible to develop bed sores, but most experts uniformly agree that there are two primary reasons:

1) Malnourished people have less energy and consequently are unable to move on their own– resulting in a more time spent in one position.

2)  A long-term consequence of malnourishment is loss of fat, muscle and tissue– that provide necessary padding particularly in bed-bound patients, the less padding the more pressure that is put directly on the body– thereby resulting in increased rate of bed sores.

Another component of malnourishment and bed sores involves the essential nutrition for the healing process.  Patients with bed sores require an extraordinary amount of energy and nutrients, such as proteins and vitamins B and C, in order to heal advanced bed sores.  Without adequate nutrition, bed sores will not heal and frequently may worsen.

The following are common symptoms of malnutrition:

• Diarrhea
• Disorientation
• Goiter (enlarged thyroid gland)
• Loss of reflexes and lack of coordination
• Muscle twitches
• Scaling and cracking of the lips and mouth
• Drastic weight loss

Related:

Extra Calories Essential For Pressure Sore Patients To Heal Wounds

Grim Detail Emerge Regarding Malnutrition In Kentucky Nursing Home

Are individuals with poor nutrition susceptible to bed sores?

In addition to unrelieved pressure, other factors can contribute to the development of bed sores (or decubitus ulcers, pressure ulcer or pressure sores).  Facilities need to pay special attention to people in the following demographics who are at a heightened risk of developing bed sores.

Aggravating Factors:

Age: If you are over 70, you are at an increased risk for development of bedsores.  Older adults tend to have thinner skin than their younger peers, making them more susceptible to damage from minor pressure. Older people also more likely to be underweight and have less natural cushioning over their bones. Even with optimum nutrition and good overall health, wounds tend to heal slower as you age, because the repair rate of your cells declines.

Living In A Nursing Home:  In general, nursing home residents have higher rates of bedsores than do people who are hospitalized or cared for at home, in part because nursing home residents may be especially frail or immobilized.

Another reason why nursing home patients tend to develop bed sores more frequently, is because some facilities are under-staffed.  One of the most important steps to prevent bed sores is to rotate patients on a regular schedule.  Patients at facilities that are under-staffed may simply be left unattended for long periods.

Lack of Pain Perception: Loss of sensation is usually due to spinal cord injuries or disease. An inability to feel pain means you’re not aware when you’re uncomfortable and need to change your position or that a bedsore is forming.

You Are Skinny:  You often lose weight when you’re sick or hospitalized, and muscle atrophy and wasting are common in people living with paralysis. In either case, you lose fat and muscle that help cushion your bones. Some experts say the best way to prevent skin breakdown is to have at least 2 inches of muscle over bony areas.

Malnutrition: You’re more likely to develop pressure sores if you have a poor diet, especially one deficient in protein, zinc and vitamin C. You’re also more likely to have recurrent pressure sores, more severe infections and slower healing wounds than are people with healthier diets.

Urinary or fecal incontinence: Problems with bladder control can greatly increase your risk of pressure sores because your skin stays moist, making it more likely to break down. The caustic nature of urine and feces also contributes to the rate of skin breakdown.  When incontinent patients are left in their own feces, bacteria can enter the wounds causing serious local infections and life-threatening systemic complications such as sepsis, gangrene and,  necrotizing fasciitis, a severe and rapidly spreading infection.

Diabetes: Because certain health problems such as diabetes and vascular disease affect circulation, parts of your body may not receive adequate blood flow, increasing your risk of tissue damage. And if you have muscle spasms (spastic paralysis) or contracted joints, you’re subject to repeated trauma from friction and shear forces.

Smoking: Smokers have a higher incidence of pressure sores than nonsmokers do. They also tend to develop more severe wounds and to heal more slowly, mainly because nicotine impairs circulation and reduces the amount of oxygen in your blood. The risk increases with the number of years and cigarettes smoked.

Staff in nursing homes and hospitals must be vigilant to monitor all patients (irrespective of age or contributing factors) on a daily basis to prevent bedsore development.  Further, staff need to be trained to identify bedsores at their early stages to prevent them from advancing.