How Bedsores Begin
Immobile nursing home residents will likely develop bedsores if those charged with their care do not take consistent measures to reposition the resident and relieve the pressure.
Bedsores develop on the bony prominences of the body when there is continuous pressure on that area. Areas most at risk for pressure injuries include the coccyx, hips, and heels, although other areas with unrelieved pressure are at risk as well.
Cleanliness is also a key factor in preventing and healing pressure injuries. When a resident is forced to lie in their own waste for hours, the acidity of the output tends to break down the skin. This breakdown can lead to the development of a bedsore or worsen an existing pressure injury. If a nursing home resident with one or more bedsores is forced to lie in their own urine or feces for hours on end (which, sadly, is a common event at nursing homes), there is the added danger of infection. Once a bedsore becomes infected, the resident is in grave danger of developing a systemic infection throughout their body known as sepsis. Sepsis is difficult to treat and often results in death.
Another key factor in the prevention and healing of pressures injuries is hydration and nutrition. When a nursing home is understaffed or the staff is poorly trained, some of the most basic necessities of life are overlooked. For example, many immobile residents rely entirely upon the nursing home staff for the most basic of care, including giving them a drink of water or assisting with meals. When those basic staples are not accomplished, residents are at risk of becoming dehydrated and malnourished. The loss of fluids and body weight lead to the deterioration of the skin and can cause bedsores.
Dehydration and malnourishment weaken the body. When a person is dehydrated, their skin becomes less supple and more brittle, making it more prone to the development of bedsores. A person who is malnourished has less fat and muscle, making it easier for bedsores to develop and to worsen at a faster rate.
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