Everyone gets a cut or scrape once in a while, but in the senior population, wounds are much more serious. Blood does not flow as easily as it used to, and minor injuries can become major if not properly treated. A caregiver needs to know some basic prevention and also treatments for their loved one.
Wound prevention
The first place to assist with a loved one’s wound care is in preventative measures. The skin is the biggest organ of the body and, often, the most neglected. Every day a person’s skin is exposed to irritant chemicals and also prone to injury. As people age, the skin becomes drier, especially with those who are dehydrated—a category where many seniors find themselves.
Increasing water intake, as well as using a multivitamin designed for skin preservation, can help prevent dryness and further skin deterioration. A caregiver should invest in an intense moisturizing lotion, avoiding those with scents.
A caregiver must keep a watchful eye on the integrity of a loved one’s skin. Check at least once a day for changes in color or temperature, as well as rashes, sores, or painful areas.
When washing, a mild soap is recommended—one without the “antimicrobial” and “antibacterial” properties. Use warm water and pat dry; don’t rub skin that is thin and at risk of tearing easily.
Long sleeves and pants offer an extra layer of protection against skin problems. A caregiver should encourage a loved one to be aware of what they wear and how using an extra pillow or blanket can help avoid friction and prevent skin tears.
Finally, establish a schedule. This can be for toileting, body rotation, and, if possible, exercise. Changing position and moving around keeps the skin stronger and less likely to develop serious issues.
Prevent Three Different Types Of New Wounds From Forming
1) Pressure Ulcers
When resting in a bed: If you’re providing at-home wound care for someone who has trouble moving on their own, help them change position at least every two hours they are in bed. To maximize bed sores prevention, make sure they are using a commercially available pressure-reducing mattress, but avoid those that resemble egg crate foam. Place a pillow under their calves to prevent their heels from touching the bed, and use pillows and foam wedges to keep their ankles and knees apart.
When resting in a chair: If you’re assisting someone who has difficulty getting around on their own, help them reposition at least once every hour when they are sitting. If you notice your loved one sitting with their legs crossed, encourage them to shift to a new position since crossed legs can reduce blood flow and put pressure on their nerves and blood vessels.
Skin tears and seniors: Are you providing in-home wound care for an older adult? Take extra care to be gentle when helping them move during routine activities to avoid causing any unnecessary friction when shifting in a chair or rolling over in a bed because these actions can result in skin tears. If damage does occur, aid the healing process by dressing the new, minor wound with a protective, non-adherent dressing. Monitor all skin tears, and seek professional medical help ASAP for your loved one if you see any signs of infection.
2) Diabetic Foot Ulcers
People who have diabetes don’t always notice when they have pain in their feet because of nerve damage, which causes a loss of feeling.
3) Venous Ulcers
If you’re helping provide in-home wound care to a patient who has (or has had) venous ulcers, monitor them closely and do what you can to help prevent disability and amputation by helping your loved one lose weight. Work with them to create a plan that promotes getting in some daily exercise (via an activity like walking) to increase blood flow to their legs, which may also result in the benefit of reducing their healing time and helping to prevent future venous ulcers.
Because the home environment may lack all the resources you need, remembering everything you need to do before you leave the patient’s home may be challenging.
- To help keep things on track, develop a checklist of reminders that covers these points:
- Have necessary medical appointments been arranged?
- Does the patient have transportation to appointments?
- Are there sufficient supplies in the home?
- Is there enough medicine? If not, who will pick up the medicine?
- Are consults needed, such as a social worker or physical therapist?
- Who will help with any activities of daily living that the patient is unable to do?
- Does the patient with diabetes have a glucometer?
- Are you trained to communicate with the home health agency through telemedicine channels? Are they HIPAA compliant?
- Non-healing wounds
- Wounds that haven’t improved over two weeks
- Wounds that have worsened, and you need a new treatment plan
- Complex wound care needs
- Special catheters
- Complicated treatment orders
- New Stage III and IV pressure ulcers
- Needs for preventative skin measures (e.g., appropriate support surface, moisture management)
- Conditions that make wound care a challenge, including diabetes and heart disease
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