Long-Term Care Staff Must Strive to Prevent Pressure Ulcers

The prevalence of chronic wounds located in the lower extremity area is high among older adults.  Not only can they be extremely deleterious and pose major health risks, they also increase socioeconomic burden because of the high expenses of wound care, long duration of healing time, increased complication rate and negative effect on patients’ and loved ones’ quality of life.  Chronic wounds are related to heightened mortality and significant morbidity because of infection, loss of ability to perform daily activities, pain, and psychosocial issues. Health care clinicians must be trained to identify and diagnose wounds, as well as provide proper management of their etiology. The four most common chronic wounds are venous leg ulcers, diabetic foot ulcers, pressure ulcers, and arterial ulcers.  Although there have been recent advances in wound care, care providers are still struggling to provide the best quality of care in this area, especially for elderly people living in nursing homes and assisted living facilities.

Statistics show that chronic wounds affect an approximated 7 million patients every year in the United States alone, burdening the US healthcare system in more than $25 billion annually in costs. Although wound-healing research has made significant strides in recent years, care staff professional training and education is still lacking and chronic wounds are still a major problem among the older adult population.  The prevalence of risk factors for chronic wounds, such as diabetes mellitus, will also continue to contribute to its rise.  It is crucial that nursing homes and assisted living facilities increase their staffing levels and ensure that their clinicians are well-trained in order to combat the increasing number of elderly patients with wounds and issues with wound-healing.

Unlike acute ulcers, which usually heal through a tissue-repair process that is normal, orderly, and timely, chronic ulcers take an abnormally long time to heal back to its original anatomical and functional integrity.  Open wounds increase a patient’s vulnerability to infection, which partly contributes to the increased morbidity and mortality related to chronic diabetic foot ulcers (DFUs) and pressure ulcers (PUs). Furthermore, patients also suffer from increased morbidity from related pain, drainage, and pungent odor, diminished mobility, and pychosocial consequences. Caring for an older adult patient with a chronic wound begins with making a correct diagnosis.

Determining the cause of the chronic wound begins with discerning whether the wound is one of the four common chronic wounds, and wound location is usually very helpful. For example, in regards to chronic leg wounds, the most common type is the venous leg ulcer (VLU).  An estimated 80% of all leg ulcers are VLUs and are commonly suffered by older adults.  The highest incidence of chronic foot wounds is the diabetic foot ulcer.  There are an estimated 30 million people in the United States with diabetes mellitus, and their lifetime risk of developing a foot ulcer is almost 25%.

The most common chronic wound, regardless of location, is the pressure ulcer, which develops primarily in areas that are exposed to high- and prolonged-pressure. Older adults, especially residents of long-term care facilities, are especially prone to suffering from pressure ulcers. It is crucial that staff in these facilities are vigilant in supervising and caring for their patients so as to avoid the development of these deleterious wounds. If you or a loved one has been a victim of neglect or abuse in a nursing home or assisted living facility, such as one in Beverly Hills or Bradbury, California, contact the Law Offices of Ben Yeroushalmi today.