Bedsores, also called pressure injuries or pressure ulcers, are serious skin problems that can almost always be prevented with proper care. Pressure ulcer occurrence is one of the quality measures that the Center for Medicaid and Medicare Services (CMS) looks at when evaluating a nursing facility. Data revealed that up to 25% of high-risk long-term care patients in Illinois had a pressure ulcer. Pressure injuries can be quite painful, impacting sleep, daily activities, and overall quality of life. With proper care and nutrition, pressure ulcers or bedsores can be healed in a timely fashion to prevent any adverse events from happening to your loved one.
At the Noll Law Office, their Nursing Home Abuse and Neglect Lawyers understand the severe health repercussions bedsores can have on Illinois nursing home residents. Their lawyers will review a client’s medical records, care plan, investigative documents as well as any other relevant paperwork to determine if the pressure ulcer was the result of nursing home abuse or neglect. Furthermore, they will review the nursing home’s response upon discovering the bedsore. This includes making sure the resident obtains the appropriate nutritional care to help aid in the wound’s recovery. If you believe your loved one developed a bedsore due to nursing home abuse and neglect, contact them today at (217) 414-8889.
What Are Pressure Injuries and How Do They Develop?
Pressure injuries occur when there is unrelieved pressure on a certain area of the body over a long period of time. They can also occur when there is a large amount of unrelieved pressure on an area of the body for a short amount of time. They most often occur on the lower back, buttocks, hips, heels, or elbows.
Pressure injuries are typically classified into stages 1-4. In a stage 1 pressure injury, the skin may not yet be broken, and this is the least severe of the four classifications. In a stage 2 wound, there is a breakdown to the first and possibly second layer of the skin, Stage 3 wounds extend through the second layer of the skin and possibly below it into the fat layer under the skin. A stage 4 wound may expose muscle or even bone, being the most severe of the four classifications.
Stage 3 and 4 wounds are at the highest risk of infection and other complications. Nutrition intervention, along with frequent nursing care, is imperative at stages 2 and greater to prevent the area from worsening and promote healing.
Nutrition’s Role in Wound Healing
Older adults may be at risk for undernutrition or malnutrition. Up to 85% of nursing home residents had poor nutrition status. Poor nutrition, also known as undernutrition or malnutrition, is defined as “an imbalance between the nutrients your body needs to function and the nutrients your body gets.” Inadequate food intake along with other vitamin or mineral deficiencies can lead to unintended weight loss, which all make nursing home residents at high risk of developing a pressure sore. If a loved one of yours developed a pressure sore at a nursing home, below are some ways managing nutrition can help with healing.
- Avoid dietary restrictions, if possible, to assure calorie intake is sufficient. Some older adults need to be on a nutrient-controlled diet for medical reasons, such as kidney disease, diabetes, or heart failure, and this should continue to be maintained as needed. Though if someone is not eating well, oftentimes liberalizing the diet can allow for increased calorie intake. Undernutrition or malnutrition can impair the wound-healing process.
- Consume more protein than you normally would, and include protein at each meal and snack. A dietitian can determine the correct amount of protein someone would need on a given day to help with wound healing while still taking medical conditions into account. Oftentimes, at least 1.2 grams per kilogram of body weight is recommended. Some high-protein foods are chicken, eggs, fish, and dairy products. A high-protein and high-calorie oral nutrition supplement high in protein may be considered to help meet daily protein needs. These usually contain vitamins and minerals as well. Protein is important for tissue repair, maintaining muscle mass, and much more. When trying to heal a wound, the body is in a catabolic state, meaning it is using more calories and protein than it would on a normal basis.
- Staying hydrated is important for healing pressure injuries. In Stage 3 or 4 pressure injuries, fluid can be lost through the wound. Maintaining adequate fluid intake is important for skin turgor and replacing lost fluid will assist in wound healing.
- The addition of Vitamin C and Zinc has both been shown to prove effective in healing pressure injuries. This will vary from person to person. Vitamin C is important in collagen synthesis. One review showed up to an 84% reduction in pressure injury size when treated with vitamin C. Zinc is a mineral that is important for cell membrane repair and immune system function. A blood test can be done to check zinc levels and this can be done before starting a zinc supplement. Always check with a provider before starting any supplementation, even vitamins, and minerals, as some may interact with pharmacological medications.
- Eating meals in a communal setting and out of bed, if able. One of the best ways to promote intake in older adults in nursing homes is to provide an environment that allows for autonomy, socialization, and conversation. Half of the older adults in this study preferred to eat in a dining room as it encouraged socialization, and some felt it contributed to overall happiness as well.
- Meal assistance, set up, or providing “finger foods” if someone is having a hard time with utensils. A therapy team, such as an occupational therapist, can help with this as well. Some older adults may need adaptive equipment such as built-up utensils or a special plate to assist in getting food onto the utensils. Also, foods easy to hold and take bites off like sandwiches could be a great option.
- Assure maintenance of oral health. If a loved one has poor dentition, or trouble chewing or swallowing, it may be impacting their eating. This could lead to undernutrition and slower wound healing. The texture of their food may need to be changed to something easier for them to chew and swallow to allow for food intake. A speech-language pathologist can help determine the safest food and drink texture.
Nutrition plays an imperative role in wound healing, but also the collaboration with interdisciplinary team members is just as important. Please speak with the appropriate interdisciplinary team before starting a wound healing regimen. Any underlying health conditions and/or prescription medications should be taken into consideration before adding or taking anything away from the diet.
If you or your loved one has developed a bedsore or pressure ulcer in a nursing home and do not believe the nutritional needs are being met, contact the nursing home abuse and neglect lawyers at the Noll Law Office in Springfield, Illinois for a free initial consultation. They represent nursing home residents throughout the State of Illinois. They can be reached at (217) 414-8889.