Bed sores prevention and treatment

Key points:

There are four stages of pressure ulcer severity, with the condition becoming progressively harder to treat
Older people are more likely to develop bed sores, as a result of frailty, mobility issues and a higher rate of contributing lifestyle factors
Stage four bed surgeries may result in death

This edition of Aged Care Guide will cover contributing factors, causes, treatments and outcomes for the development of pressure ulcers. Pressure ulcers develop when blood cannot circulate to areas of the body, with the lower back, back of head and inner thighs most commonly affected.

Although pressure ulcers are commonly called ‘bed sores,’ the condition is not necessarily caused by or related to lying in bed. Instead, any sedentary lifestyle or mobility condition which impairs movement may lead to its development. The rate of hospital-acquired pressure injuries in Australia was 9.7 injuries per 10,000 hospitalisations in 2015 –16.

Contributing factors and causes

Contributing factors for the development of bed sores, include:

Smoking
Obesity
Malnutrition
Circulatory system disorders
Paralysis or mobility impairment
Incontinence

Essentially, anything which may expose skin to bacteria, impact the flow of blood to skin or indicate a lack of physical activity may cause bed sores over time. Think of it like a large weight falling on your back and crushing you — if you move it, you’ll be able to breathe normally, but without a change, you may die — your skin is the same.

Pressure ulcers are categorised based on the severity of damage:

Stage one — bruising or discolouration
Stage two — noticeable skin loss or damage
Stage three — the skin begins to visibly die or is dead [necrosis]
Stage four — the death of the skin begins to impact underlying tendons, muscle and organs

It’s always a good idea to wash your hands after you use the bathroom or if you hurt yourself in the kitchen, but the same goes for all skin — if bed sores lead to skin loss, the blister or wound is vulnerable to infection. In serious instances, bed sores may be fatal.

Treatment for bed sores

Treating bed sores is difficult and only gets harder as the condition worsens, so prevention is important. You can prevent the onset of pressure ulcers through going for a walk, getting up off the couch, eating a balanced diet and bathing regularly.

Depending on any existing impairments, doctors may suggest a change in diet, weight loss methods and plans (such as orlistat and phentermine or liposuction), directed activity management or getting retro with a waterbed to ease pressure.

As with any open wound, minor skin loss should be sanitised, dressed and applied bandaging should be regularly changed to prevent infection. In addition, please refer to your local doctor for guidance as to the progression of bed sores, with a range of telehealth options available for those with a mobility impairment. In severe cases of necrosis, invasive surgery and skin grafting may be required in order to assist with the recovery of open wounds or the removal of dead skin.

If you or someone you love receives support from a facility or carer, check regularly for signs of pressure ulcers, as they can be a sign of abuse/neglect. Reports of bed sores are generally indicative of the level of care a provider is offering clients, as vulnerable people are likely to develop signs of the condition and carers are supposed to offset development/progression.

Mental health services for older people in aged care

Allied health to assist with the ageing experience