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What Are The Risk Factors?

Bedsore Risks to Consider

Nursing home residents and their loved ones should be aware of underlying conditions that may raise their risk for acquiring bedsores.

Residents with the following risk factors should be vigilant with nursing home staff about the need to be timely repositioned and turned. Bedsores are also referred to as pressure injuries, pressure ulcers or decubitis ulcers.

Poor Mobility / Immobility

Residents who are unable to independently change position are at increased risk of developing a bedsore (pressure sore/ulcer), due to pressure exerted over bony prominences which results in reduced blood flow to the tissues and subsequent hypoxia.

Poor Nutrition Status

It is widely accepted that nursing home residents who are compromised nutritionally are at higher risk for the development of bedsores.

Compromised Blood Flow

Whenever there is compromised blood flow to the tissues, there is increased risk of bedsore development. 

Neuropathy / Compromised Sensation

If you cannot feel pain or pressure, you are at higher risk of developing a bedsore. Residents who fit into this category include those with spinal cord damage, stroke, MS, neuropathy and other conditions that compromise one’s ability to perceive pain and/or pressure.

Skin Color Changes

Nursing home residents with darker skin pigmentation may be at risk for bedsores and/or pressure ulcers simply because health care professionals fail to recognize the early signs of pressure damage (i.e. blanching erythema). In addition, patients with conditions that change the normal appearance of the skin are at high risk (e.g. patients with bruising, dermatitis, eczema and other skin diseases).

Support Surfaces

The surface upon which the nursing home resident lies or sits can profoundly influence pressure over bony prominences, as can lying or sitting in the same position for long periods of time, such as in a wheelchair without pressure relief. 

Pain

Pain may prevent nursing home residents from moving, even when they are feeling the unpleasant effects of pressure. Too much pain medication may sedate residents to the point where they don’t change position as often as they should, or at all. 

Age

Elder residents may be at higher risk for the development of bedsores due to inability to move/change position independently. 

Mental Status

Nursing home residents suffering from dementia or other cognitive disorders may be unable to comprehend instructions that could help prevent pressure injuries/bedsores; or residents may fail to recognize discomfort as a signal to change position or to signal for assistance.

Incontinence

Incontinence may cause skin damage that can increase the risk of developing pressure ulcers/bedsores. This skin damage may make it more difficult for health care professionals to recognize the early warning signs of pressure ulcers (i.e. reddened areas of skin that blanch when light pressure is applied).

Sources: https://www.nursingtimes.net/clinical-archive/tissue-viability/pressure-ulcer-risk-assessment-20-01-2012/

https://www.woundsource.com/blog/do-you-know-these-10-risk-factors-pressure-ulcers

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