The Silent Threat to Seniors' Health

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(ARA) - Most folks have heard about bedsores or "pressure ulcers." But it wasn't until the recent death of actor Christopher Reeves that we became more aware of the vast dangers associated with them. As our population ages -- Census Bureau projections indicate that by 2030 one in five Americans will be age 65 or older -- this is one health problem that we all need to understand.

The reason is simple. Most bedsores are preventable, yet studies estimate that more than 1 million patients each year develop pressure ulcers. According to the U.S. Department of Health and Human Services, about 9 percent of all hospital patients and 23 percent of all nursing home patients will develop a bedsore. Bedsores can be extremely painful, debilitating and can be a breeding ground for infection that can lead to serious medical problems and even death.

A bedsore develops when pressure to the skin deprives the tissue of an adequate blood supply and oxygen. Areas of the body that are most prone to bedsores are sites that have a "bony prominence" such as the elbow, hip, shoulder bone, heel, and tail bone. Patients at risk for these sores include immobile or paralyzed patients, obese or very thin patients, incontinent patients and patients with diseases that affect blood flow such as diabetes and vascular disease.

"There is so much that can be done to prevent pressure ulcers from developing from maintaining proper nutrition, to nourishing the skin, to providing proper support, movement and pressure relief," said Cynthia Fleck, RN, ET/WOCN, a certified wound care specialist, and secretary of the American Academy of Wound Management. "Once all these preventative measures are in place, the majority of bedsores can be prevented. And there are some phenomenal products out there to help patients realize these goals."

The first line of defense is proper nutrition. Studies have directly linked malnutrition to pressure ulcers. Patients should be assessed to be sure that their diets have the right amounts of protein and nutrients to support healing. The Department of Health and Human Services recommends that at risk patients have a nutritional screening every three months. Often, vitamin and mineral supplements are necessary to maintain proper nutrition.

Poor diet and other health problems can also lead to breakdown in the skin. Healthy skin is a critical factor in preventing bedsores. Some skin care lines now available actually deliver nutrients to the skin and help prevent its breakdown. Remedy, distributed by Illinois-based medical products company Medline Industries, Inc., is one of the trailblazers in this area. "Our skin is our greatest barrier to infection. Remedy is flying off the shelves because health care practitioners realize its advantage in protecting the skin and actually improving the skin's health," said Jonathan Primer, president, Dermal Management Systems, Medline.

The company also points out the importance of support surfaces that relieve pressure. Patients who are immobile need to be repositioned at minimum when sitting, every 15 minutes and when lying down, every two hours. There are numerous support devices to help a patient alleviate pressure such as wheelchair cushions and special beds that circulate air and help to shift and redistribute a patient's weight. An important advancement in this area is "visco elastic foam." This special foam actually conforms to the whole body, cradling it -- thus more evenly distributing the weight and pressure.

Fortunately for patients, wound treatment technology has also made remarkable progress. Ionic silver seems to be leading the charge. Though known for centuries for its antimicrobial properties, silver in many forms is unstable. But technological advances have now stabilized ionic silver. Newer products use the latest slow releasing silver technology that will provide safe and uniform delivery to a wound. There is even ionic silver in gel form, Silvasorb, which can thoroughly reach into deep and odd-shaped wounds. In addition, unlike many antibiotics, there are no known medically significant bacteria that are resistant to ionic silver. So while silver's antimicrobial properties are highly toxic for microorganisms like staphyloccus aureus (more commonly known as the bacteria that causes "staph" infections), silver released in Silvasorb form is very safe for human tissue cells.

"Ionic silver dressings provide a safe, non-toxic, broad-spectrum antimicrobial without known resistance. This is a perfect alternative to antibiotics, which can contribute to the current drug-resistant bacteria crisis. Gone are the days of using old therapies such as triple antibiotic ointment or bacitracin, which can cause problems. A good place to start is the most versatile of all silver dressings, silver hydrogels," said Fleck.

The nation is taking interest and supporting the reduction of pressure ulcers in residents in nursing homes in the U.S. Department of Health's "Healthy People 2010" initiative. This will help increase the awareness of this national crisis and focus on prevention measures. Bedsores may be commonplace now. But they don't need to be. Education can help health care providers, patients and their families recognize the critical importance of prevention and early treatment.


Factors that increase the risk for bedsores

* Being elderly

* Immobility of certain body parts

* Malnourishment

* Being bedridden or restricted to a wheelchair

* Urinary or bowel incontinence

* Fragile skin

* Certain diseases such as diabetes, heart, lung and vascular problems, cancer and its radiation treatments

Prevention Methods

* Proper nutrition, nutritional supplements

* Skin care -- moisturizing and delivering nutrients to dry skin and preventing "over-moisture"

* Support surfaces (special mattresses, overlays and cushions) and devices that relieve pressure

* Repositioning every 15 minutes in a chair and every 2 hours in bed

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