Preventing Pressure Sores: Ways to Enhance Quality of Life for Seniors in Wheelchair
Seeing your loved one lose their mobility is one of the most difficult challenges families face as parents or other older relatives age. You may start by helping them around the house, ensuring they don't trip or fall, but as their mobility worsens, you might find yourself becoming their primary caregiver.
You may have already experienced this problem until it became overwhelming for you and your siblings. Professional caregivers or adult day care centers are often used to maintain a better quality of life. Sometimes, professional long-term care costs too much since a loved one didn't purchase a Long-Term Care Insurance policy when they were younger and healthier.
No matter the situation, you and your family are in crisis mode, and watching them transition to using a wheelchair can be emotional and overwhelming. Not only does it mark a significant change in their independence, but it also brings new health concerns, one of the most prominent being pressure sores.
Wheelchairs and Pressure Sores
Pressure sores, also known as bedsores or pressure ulcers, develop when prolonged pressure reduces blood flow to the skin and underlying tissues, often resulting in painful, sometimes dangerous, wounds. For older adults in wheelchairs, these sores are a serious concern due to the combination of limited mobility, thinner skin, and age-related health issues. If left untreated, pressure sores can lead to infections, hospitalization, or worse.
Preventing pressure ulcers has long been a critical concern in nursing. Florence Nightingale highlighted the importance of nursing care in this regard, stating in 1859, "If he has a bedsore, it's generally not the fault of the disease, but of the nursing."
As a caregiver or family member, it's crucial to understand how to prevent pressure sores and ensure your loved one receives the best care possible. Even if you have professional caregivers in their home, or they are living in assisted living or a nursing home, ensuring the caregivers are taking the appropriate care to avoid complications, like pressure sores, is vital to maintaining a better quality of life.
But before diving into prevention, it's essential to explore why so many older adults end up relying on wheelchairs in the first place and the long-term care challenges associated with mobility loss.
Common Reasons Older Adults Require Wheelchairs
As we age, various health conditions can lead to significant mobility issues, eventually requiring a wheelchair. The most common reasons include:
- Stroke: One of the leading causes of long-term disability in older adults, strokes can severely impact mobility, particularly if paralysis occurs on one side of the body. Post-stroke, many individuals may lose their ability to walk independently.
- Multiple Sclerosis (MS): This progressive neurological disease affects the central nervous system, leading to muscle weakness, coordination problems, and, eventually, the need for a wheelchair.
- Severe Arthritis: Osteoarthritis and rheumatoid arthritis can cause debilitating joint pain, stiffness, and inflammation, making walking painful or impossible.
- Parkinson's Disease: This neurological disorder affects movement, balance, and coordination. As the disease progresses, individuals may rely more on wheelchairs to maintain mobility.
- Injury or Surgery: Some older adults may require temporary or permanent use of a wheelchair due to accidents, such as hip fractures, or surgeries like knee or hip replacements.
- Dementia and Cognitive Decline: Though primarily known for its impact on memory and thinking, advanced stages of dementia can also affect an individual's physical abilities, necessitating a wheelchair for safety and mobility.
With these conditions come new challenges—both for the individual and their caregivers. Mobility loss often means relying more on long-term care, which can include home caregivers, assisted living facilities, or nursing homes. But no matter the setting, ensuring proper care includes being proactive about potential complications like pressure sores.
Understanding the Risks of Pressure Sores
Pressure sores develop when prolonged pressure on the skin cuts off circulation, usually over bony areas like the tailbone, hips, heels, and elbows. For wheelchair users, sitting for long periods without shifting weight can quickly lead to these sores.
The National Pressure Injury Advisory Panel (NPIAP) has adopted the term "pressure injury" as the updated clinical terminology for what was formerly known as pressure ulcers, pressure sores, or bedsores. A pressure injury describes damage to the skin or soft tissue in areas subjected to consistent force and friction from surfaces like beds or chairs.
"Pressure sores are more than skin deep. They signal a deeper health crisis, a warning sign of immobility and compromised circulation. Untreated, they can open a gateway to severe infections that threaten not just the skin, but the body's very foundation."
Leisel Villafania is the lead wound care physical therapist at Chapman Global Medical Center in Orange County, California.
"The NPIAP changed the terminology years ago from pressure ulcers to pressure injuries because not all are open or ulcerated."
Older adults are at an increased risk due to their thinner skin and slower healing processes. Even small wounds can become significant medical problems if not treated properly. For those already dealing with chronic illnesses like diabetes, the risks are even higher, as poor circulation further complicates healing.
Practical Tips to Prevent Pressure Sores
Thankfully, pressure sores can be prevented with diligent care and attention. Here are several practical tips for caregivers and loved ones:
1. Regular Position Shifts
Encourage your loved one to shift their weight every 15 to 30 minutes to relieve pressure on vulnerable areas. If they are unable to do this on their own, help them change positions regularly. Doctors say frequent repositioning is one of the easiest ways to prevent pressure sores. Repositioning helps restore blood flow and reduces the risk of tissue damage.
2. Use Pressure-Relieving Cushions and Mattresses
Specialized cushions and mattresses are designed to distribute weight evenly and reduce pressure on high-risk areas. Wheelchair cushions can help prevent pressure sores by distributing weight evenly and reducing stress on vulnerable areas. Look for gel, air, or foam cushions that offer excellent support and comfort. Consult a healthcare provider to find the best cushion for your loved one's needs.
Pressure-relieving mattresses or overlays are also beneficial for those who spend long periods in bed.
3. Maintain Skin Hygiene and Moisture Balance
Keeping the skin clean and moisturized is essential. Dry skin is more prone to cracking, leading to sores, while overly moist skin can break down quickly, especially in areas prone to sweating.
"Caregivers should ensure daily gentle cleaning of the skin and regular use of moisturizers to maintain the skin's integrity."
4. Monitor Nutrition and Hydration
Good nutrition is critical in skin health and the body's ability to heal. Ensure your loved one eats a balanced diet of protein, vitamins, and minerals. Hydration is equally important, as dehydration can cause the skin to become fragile. Studies show that proper nutrition can improve wound healing by up to 50% in older adults.
5. Exercise and Stretching
Even those in wheelchairs can benefit from gentle exercises or stretches to improve circulation and muscle strength. Simple leg lifts or arm movements can help maintain blood flow and reduce the risk of sores. Regular physical activity also boosts mood and mental well-being.
6. Conduct Regular Skin Inspections
Caregivers should perform daily checks on vulnerable areas to catch early signs of pressure sores, such as redness, warmth, or swelling. Early intervention can prevent more severe sores from developing.
"If you notice any redness on the skin that doesn't fade away after relieving pressure, it could be a warning sign of a developing pressure sore."
Impact of Pressure Sores on Long-Term Care
For families and caregivers, managing the health of a loved one in a wheelchair can be daunting. Pressure sores, in particular, can lead to long-term care complications, increased medical costs, and emotional strain.
In severe cases, pressure sores can result in hospitalization or even the need for surgical intervention. According to the National Pressure Injury Advisory Panel (NPIAP), advanced pressure sores can take weeks or even months to heal, significantly impacting an older adult's quality of life and independence.
Preventing pressure sores protects the individual's health and reduces the overall burden on caregivers and healthcare systems. In assisted living facilities, caregivers are trained to monitor residents' skin health, reposition them regularly, and provide access to pressure-relieving aids.
Professional monitoring and staff training are essential factors in ensuring a high-quality experience at long-term care facilities. These elements play a crucial role in maintaining your loved one's well-being and overall quality of life.
You can use the LTC News Caregiver Directory to search for professional caregivers and long-term care facilities that best fit the needs of someone you love. You can search from over 80,000 providers nationwide. Plus, the search is free to use.
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However, family members who provide care at home must also be proactive in learning these techniques to ensure their loved ones' safety and comfort.
The Role of Assisted Living in Preventing Pressure Sores
For many families, transitioning an older loved one into an assisted living facility is a difficult decision. However, these communities offer essential resources and care that can greatly reduce the risk of pressure sores and other complications related to immobility.
· The Top Assisted Living Facility Providers in the U.S.
Assisted living facilities often have trained staff who understand the nuances of skin care and pressure sore prevention. These professionals regularly monitor residents, ensure they change positions, and provide pressure-relieving equipment.
In addition, assisted living facilities typically offer physical therapy programs designed to keep residents as active and mobile as possible, further reducing the risk of pressure sores.
For couples, many assisted living facilities offer a solution where a healthy spouse can live alongside their partner who requires more care. This arrangement provides peace of mind, knowing that the loved one who needs help is receiving professional care while both partners can continue to enjoy life together.
Be Proactive with Older Family Members
Caring for an older loved one who uses a wheelchair requires diligence and a proactive approach, especially when it comes to preventing pressure sores. While pressure sores are a common risk for wheelchair users, they are preventable with regular care, proper equipment, and attention to skin health.
Whether providing care at home or considering an assisted living facility, understanding the importance of mobility, skincare, and nutrition can greatly improve your loved one's quality of life. With their trained staff and specialized programs, assisted living communities can offer an extra layer of support, ensuring that older adults remain comfortable, healthy, and well-cared for.
As you see your loved one's age, it is the best time for you to consider your own aging and the impact it will have on your family and finances. Nobody, including yourself, is immune to aging and the need for long-term care. Quality long-term care services are costly, and those costs are increasing rapidly nationwide.
Adding a Long-Term Care Insurance policy will help ensure you have access to quality long-term care services, including at home, protecting your finances, and reducing the burdens otherwise placed on someone you love.
· How To Apply For Long-Term Care Insurance
You can use the resources available on LTC News to learn about LTC Insurance and how it works - Plan Like a Long-Term Care Insurance Expert.
According to experts, the ideal time to consider LTC Insurance is in your 40s or 50s, but if you enjoy fairly good health, you can find affordable options in your 60s and older, depending on your health.