Pressure sores are not a new thing and have been around since ancient times. There is evidence that Egyptians suffered from bed sores when their scars have been found on the mummified remains (Source: Feinstein, ed 1996). If you have never been stuck in bed or in a chair for any length of time without being able to change position, you may not understand the pressure sore. However, if you have ever sat still for a very long lecture, funeral or presentation and then felt the sore spot, you might have a small concept. Now think of that same pressure, day after day for hours and you see how a bed sore or pressure sore may begin (The pressure sore is commonly called a “bed sore” but it does not always happen just in bed and really has little to do with the bed itself).
The Reality of Pressure Sores
Pressure sores are not just the bane of the elderly although they are the ones that get these sores most often. Elderly women as well as those who have heart disease or diabetes are the most vulnerable to bed sores (Source: MacLean, 1993) There are some places on the body that are more prone to bed sores than others and there are some factors that encourage their development. While smaller, thinner people are more likely to develop a bed sore, the main reason that they begin and worsen is poor nutrition. Those who are prone to bed sores or who are recovering from one, should make certain adjustments to their diet first and foremost, as well as making some simple adjustments.
The more seriously malnourished a person is, the more serious the pressure ulcer will be. Doctors rate a pressure sore by the degree of tunneling, meaning how deep the damage goes into the skin. A pressure sore may start as a simple reddened spot in the beginning but will start going deeper and deeper. The skin will crack open and may go through the layers of the skin, to the muscles and in some cases, all the way to the bone. Once the red areas are noticed, it may already be too late, however, there are some times that the area will not be noticed at all- especially in those who have reduced sensitivity and commonly in the case of diabetics who may not feel any pain that would move them to investigate.
Pressure sores start in the areas that have the least amount of tissue, fat and muscles, the so called bony prominences: the elbows, the knees, the buttocks and the spinal column. They do not only start because of the time in the bed, they can also develop for people who spend a lot of time sitting down as well (Pressure sores for those who are stuck in chairs or wheelchairs are typically found on the base of the spine and the buttocks as well as the heels).
There are three ways to prevent and to deal with pressure sores: careful investigation and monitoring, proper nutrition and proper treatment. People who have bed sores should be under a doctor’s care, especially those who have diabetes, kidney disease, immunity suppressing diseases or heart disease. People who are older than sixty years old or older should also be especially vigilant.
Careful Investigation and Monitoring
Those people that are most prone to bed sores are also those who are probably least able to care for themselves properly. For those who are living in a nursing home or extended care facilities, the skin should be monitored during each bath or linen change. For those who are confined to bed or wheel chair, there should be constant position changes and preventative measures should also be taken for proper care. While the entire body should be looked over carefully, special attention should be paid to the areas of the most pressure- especially in those who are severely underweight or poorly nourished. It is a myth that pressure sores only happen to thin or slim people. There have been cases of people who weigh over 400 pounds who have developed pressure sores because they are not mobile at all and not being cared for properly.
The areas that should be looked at include: the elbows, the heels, the tail bone and the spine. The spine is most likely to develop pressure sores in the areas where it makes the most contact with the bed or the chair. For instance, in someone with a humped back, the middle spine area may be the spot that has the most pressure.
Any spot that is noted to be red should be carefully monitored. Once the pressure is removed, give the area fifteen to twenty minutes and then recheck. If the redness continues, consider the area to be a beginning stage pressure sore and seek medical assistance and advice.
Elderly women are the group most likely to get a bed sore, along with those with Alzheimer’s disease and other dementias, those with diabetes and those who have been paralyzed by any condition or disease. Sadly, these groups are also the same people most likely to have poor diet and poor appetites. It is important to note that despite suggestions of eating better, these people may not be interested or may be unable to eat very well. Using a protein supplement may be a good suggestion, especially in light of the fact that the protein needs for those who have bed sores is highly increased over the normal needs.
The average, healthy person needs around.8 grams of protein per kilogram of body weight, however, an older person may need slightly more (even while healthy). For the person who is prone to bed sores or is trying to heal one, the protein needs are increased. It may be difficult to get more protein into a diet that is limited and largely ignored as it is. Using protein supplements can make sure that the patient is getting enough protein plus other vitamins and minerals. There are several types of protein supplements to choose from, each with different pros and cons.
Protein supplements include: protein shakes, powders, bars and supplement shots. Protein shakes are pre-made and convenient but may be too much to deal with. Protein bars may not be a good choice for those who are not eating very well to begin with and may not be able to be chewed by some patients. A protein supplement shot is a good idea because it is small and packs a huge amount of protein. Profect, by Protica is small (it is less than three fluid ounces) but has 25 grams of protein, a day’s worth of Vitamin C and 10% of the daily supply of the Vitamin Bs.