With the people we support at The Arc of Monroe getting older and having more medical complexities, one of the most important things we can do is protect their skin. Pressure ulcers (AKA “bedsores”) are a dangerous type of skin breakdown that can lead to infection, pain, or even death. They are caused by pressure on an area of skin that interferes with blood flow to the area causing the skin and underlying tissues to break down. A mild pressure ulcer may just look like redness or discoloration on the skin, but if left untreated, it can progress through the layers of tissue exposing fat, muscle, and even bone.

Pressure ulcers are most commonly found in people who do not move well independently. Aging, incontinence, sensory problems, diabetes, vascular disease, and poor nutrition can also increase a person’s risk of developing pressure ulcers. They occur most often in areas where bones are close to the skin surface such as toes, heels, ankles, knees, hips, elbows, shoulders, spine (especially tailbone/sacrum), ears, cheeks, collarbone, and back of the head. They can also develop where areas of the body rub together and moisture collects, such as under breasts, between abdominal folds, between the crease of buttocks, and between the thighs.

The best way to treat skin breakdown is preventing it from happening in the first place; the good news is that it’s ALWAYS preventable. Here are 7 things you can do to help protect the people we support:

1. Keep skin clean and dry. Ensure people are changed out of wet or soiled briefs and clothing promptly to prevent moisture from sitting on skin. Encourage regular bathing and ensure that the skin is completely dry afterward (pay special attention to under skin folds).
2. Frequent repositioning. If a person is unable to make large positional changes on their own, ensure they are being repositioned at least every 2 hours. A pillow under a hip is a great way to help relieve pressure on the tailbone. Ask your medical team for other ideas specific to the people you work with.
3. Make sure clothing, shoes, and medical devices (braces, orthotics, oxygen tubing etc.) are well fitting and don’t rub anywhere. Things that are too tight can put pressure on the skin and can cause a pressure ulcer.
4. Encourage good nutrition and adequate fluid intake (per individual guidelines). This helps keep the skin healthy and can reduce the risk of skin breakdown.
5. Be careful during transfers; do not pull on the person being moved or create a shearing force.
6. Keep nails short and clean and take off any jewelry that can cut or scratch a person supported.
7. Check skin regularly and inform your RN if you notice any redness or open areas. This can be done easily during bathing and dressing. Pay special attention to under skin folds and other areas at high risk of skin breakdown (see above). Also be sure to check noses and behind the ears in people who use oxygen or wear glasses.

 

Margaret Wallace is an RN at The Arc of Monroe. To connect with Margaret, email her at mwallace@arcmonroe.org. 

We hope this blog is helpful to you! Our Health Services team at The Arc of Monroe is a wealth of information. Our staff is made up of experienced professionals who primarily support people with disabilities. To learn more about who they are, visit our Health Services page. If you’re interested in working with us at The Arc of Monroe, visit our careers page. If you’d like to give and help make valuable resources like this possible, you can give online.