The Skin You’re In: Preventing Pressure Ulcers

Good skin health is important to living a full and active lifestyle

By Corrie Dinwiddie, RN
Oxford HealthCare Wound Coordinator

The skin is the largest organ of the human body. According to the online journal LiveScience.com, the average person’s skin counts for 16 percent of their total weight, and spans a surface area of 22 square feet. It is also one of the most important organs for our general health, helping to:

  • Maintain your body temperature
  • Protect you from germs
  • Gather information for your nervous system
  • Assess and react to your surroundings (e.g. heat, cold, pain, sensory touch)

To function properly, your skin needs adequate attention and proper care. A break-down in your overall skin health can put you at risk for injury and disease.

Possible Skin Problems

Even if you have healthy skin, problems may occur if you are immobile for long periods of time, especially in a lying or sitting position. When this happens, pressure from your body weight on the bed or chair surface cuts off the blood supply to skin. As a result, those skin cells don’t get the oxygen and nutrients they need to survive, and a pressure ulcer may result.

Pressure ulcers occur from prolonged sitting or laying

The condition mainly occurs on skin areas that cover a bone or bulge, such as heels, shoulders, hips, and upper buttocks. Pressure ulcers have many names, including:

  • Bedsore Decubitus (de-KU-bi-tus) ulcers
  • Dermal wounds
  • Pressure sores

Risk Factors for a Pressure Ulcer

You may be at risk for a pressure ulcer if you are experiencing:

  • Limited activity or confined to bed
  • Reduced tactile sensation (sense of touch)
  • Chronic, complicated medical problems such as diabetes, obesity, smoking, poor circulation, and spinal cord injury
  • Increased skin moisture from bladder or bowel control issues
  • Poor diet or nutrition Low protein intake, especially if nutrition is already poor

Older adults are more at risk for a pressure ulcer, as are patients who slide down in the bed. Sliding down can cause friction that may tear delicate or already damaged skin.

Symptoms of a Pressure Ulcer

If you have a pressure ulcer, you may have burning, aching, or itching at the site. The injured skin may be red or bruised, or have a purplish discoloration that continues even after you shift position. People with darker skin tones may not show redness or discoloration, and some may need to compare the injured area with uninjured skin tissue.

A pressure ulcer may feel firm or mushy, and may be warm to the touch. Swelling and tenderness are common, and a blister or shallow sore may develop. Sometimes a clear or blood-tinged fluid may drain from the ulcer area. If un-noticed or un-treated, the wound may deepen and extend into the fat layer or adipose (ADD-ih-pose) tissue, or even down to the bone. Pressure ulcers are sometimes categorized in stages (Stage I, Stage II, etc.), based on how deeply the tissue is injured.

Stages of bedsores and pressure ulcers

What Can You Do to Help Prevent a Pressure Ulcer?

You and your family members are important to the prevention and care of a pressure ulcer. Your skin health can be improved when general steps are taken, including:

  • Not smoking
  • Daily exercise (even bedridden patients need activity)
  • Good nutrition
  • Maintaining a healthy weight
  • Adequate hygiene
  • Moving and turning
  • Asking your family or caregiver to help you move and turn if you are confined to a bed or chair

How Do Hospitals and Nursing Homes Prevent Pressure Ulcers?

Your nurses and doctors will begin a plan of care to help keep your skin healthy. If you are not able to move yourself, the hospital or nursing home staff will help you move and turn. They may use special skin care products to protect your skin, and connect you with a dietitian to help you improve your diet. If your nurse or doctor suspects an ulcer, he or she will work to relieve pressure on the area. In some cases, a special mattress or bed may be used to help redistribute pressure.

Even though your skin is one of the most complex and important organs in your body, caring for it is not complicated. Follow these simple steps, and ask your doctor if you have further concerns about potential pressure ulcers.

February is American Heart Month!

by Pam Gennings, Executive Director Special Projects

Heart disease prevention is important year-round.

Knowing the causes, symptoms and preventions of Heart Disease is important year-round.

February brings Valentine’s Day and heart-shaped boxes of candy, but it’s also American Heart Month. First declared by President Lyndon Johnson in 1964, it was designed to bring awareness to the symptoms, causes and preventions of Heart Disease, which at that time was responsible for more than half of all deaths in this country.

Awareness and prevention have greatly increased in the half-century since the first Heart Month. As a result, heart disease has steadily declined since 1968, with fewer than 400,000 actual deaths in 2010, according to the National Heart, Lung and Blood Institute (NHLBI). The institute estimates that if 20th-century heart disease trends had continued unchecked, it would have been the cause of nearly five times as many deaths – more than 1.8 million – in 2010.

However, heart disease is still the current leading cause of death in both women and men in this country, responsible for one in four deaths in the United States. Though a heart attack is the most-often associated health risk, other serious types of heart disease include coronary artery disease (the most common), heart arrhythmias (irregular heartbeat), cardiomyopathy (diseased heart muscle), atrial fibrillation (a type of arrhythmia), and congenital heart defects.

Risk Factors for Heart Disease

According to the Centers for Disease Control (CDC), there are numerous hereditary and environmental factors that determine an individual’s risk for heart disease. They include;

  • High Blood Pressure
  • High Cholesterol
  • Diabetes
  • Age/Family History/Race or ethnicity
  • Lifestyle choices such as:

->  Unhealthy Diet
->  Physical Inactivity
->  Obesity
->  Too Much Alcohol
->  Tobacco Use

Symptoms of a Heart Attack

The National Heart Attack Alert Program notes these major signs of a heart attack:

  • Chest pain or discomfort. Most heart attacks involve discomfort in the center or left side of the chest that lasts for more than a few minutes, or that goes away and returns. It may feel like uncomfortable pressure, squeezing, fullness, or pain.
  • Discomfort in other areas of the upper body. Can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
  • Shortness of breath. This can often accompany chest discomfort, but can also occur before any other signs are noticeable.
  • Other symptoms. This includes breaking out in a cold sweat, nausea, or light-headedness.

If you think that you or someone you know is having a heart attack, you should call 911 immediately.

Preventing Heart Disease

While the effects of heart disease are serious, the good news is there are many common-sense steps that you can take to limit your risk factors, according to the CDC. Some of them include;

1.     Live a healthy lifestyle – Healthy behaviors can lower your risk for heart disease, which include;

  • Eat a healthy diet
  • Maintain a healthy weight
  • Get enough physical activity
  • Limit alcohol use
  • Don’t smoke or use other forms of tobacco

2.     Check your cholesterol – Your health care provider should check your cholesterol at least once every five years. If you have already been diagnosed or have a family history of heart disease, your cholesterol should be checked more frequently. If you have high cholesterol, lifestyle changes or prescribed medication may help reduce your risk of heart disease.

3.     Control your blood pressure – High blood pressure usually has no symptoms, and is important to have yours checked on a regular basis.  If you are diagnosed with high blood pressure, your health care provider might recommend that you lower the sodium in your diet, prescribe medication to lower your blood pressure, and make some lifestyle changes.

4.     Manage diabetes – If your health care provider identifies symptoms of diabetes, they may recommend that you get tested. If diagnosed, it’s important for you to monitor and control your blood sugar levels. Lifestyle changes can help keep your blood sugar under control, and reduce your risk for heart disease or other diabetic complications.

5.     Take your medicine – If you take medication to treat high cholesterol, high blood pressure or diabetes, follow your doctor’s instructions. NEVER stop taking your medication without talking to your doctor, nurse or pharmacist.

6.     Talk with your healthcare provider – Work with your medical team to prevent or treat medical conditions that can potentially lead to heart disease.

How We Can Help

If you or a loved one is diagnosed with heart disease, Oxford Healthcare has numerous Home Care programs that can help. Contact us to find out about our cardiovascular, telemonitoring, and specialty services designed to help more people with heart disease stay healthy, and stay home.


About the Author
Pam Gennings has a Bachelor of Arts and has worked in the field of Geriatric Social Work and Care Coordination for more than 30 years. She started working for Oxford HealthCare in 1993. During the course of her career she has helped thousands of people find resources to remain in their homes, as well as providing guidance to families that were facing difficulties with their aging loved ones.

Fall Prevention: Simple Tips To Prevent Falls

Trip hazards can cause falls around the home.

By Jan Untz, RN, BSN, Oxford Orthopedic Coordinator

Falls can put you at risk of serious injury. Fall prevention may not seem like a lively topic, but it is quite important. Physical changes and health concerns—and sometimes the medications used to treat those conditions—can make falls more likely.

Fact: Falls are a leading cause of injury among older adults.

Help prevent falls with these simple fall-prevention measures, from reviewing your medications to hazard-proofing your home.

Talk to Your Doctor

Make an appointment with your doctor to begin your fall prevention plan.

Be prepared to answer questions such as:

  • What medications are you taking? Make a list of your prescription and over-the-counter medications and supplements, or bring your medications to the appointment.
    Your doctor can review your medications for side effects and interactions that may increase your risk of falling. To help with fall prevention, the doctor may consider weaning you off certain medications—such as sedatives and some types of antidepressants.
  • Have you fallen before? Be prepared to discuss instances when you fell and give detailed information about when, where, and how you fell. You also need to be prepared to discuss instances when you almost fell but were caught by someone or managed to grab hold of something just in time. Details such as these may help your doctor identify specific fall-prevention strategies.
  • Could your health conditions cause a fall? Certain eye and ear disorders may increase your risk of falls. Be prepared to discuss health conditions and how comfortable you are when you walk—do you feel any dizziness, joint pain, numbness or shortness of breath when you walk? Your doctor may evaluate muscle strength, balance and gait as well.

Keep Moving

Physical activity can go a long way toward fall prevention. If approved by your doctor, you may want to consider activities to reduce the risk of falls and improve your strength, balance, coordination and flexibility such as walking, water workouts or tai chi.

If you avoid physical activity because you’re afraid it will make a fall more likely, talk about it plainly. Your doctor may recommend carefully monitored exercise programs or may refer you to a physical therapist, who can create a custom exercise program to improve balance, flexibility, muscle strength and gait.

Wear Sensible Shoes

Consider changing your footwear as part of your fall-prevention plan. High heels, floppy slippers and shoes with slick soles can make you slip, stumble and fall. People at risk for falls should wear properly fitting, sturdy shoes with nonskid soles.

Remove Home Hazards

Take a look around your home. The living room, kitchen, bedroom, bathroom, hallways and stairways may be filled with hazards.

To make your home safer:

  • Remove boxes, newspapers, electrical cords and phone cords from walkways.
  • Move coffee tables, magazine racks and plant stands from high-traffic areas.
  • Secure loose rugs with double-faced tape, tacks or a slip-resistant backing—or remove loose rugs entirely.
  • Repair loose floorboards and carpeting right away.
  • Store clothing, dishes, food and other necessities within easy reach.
  • Immediately clean spilled liquids, grease or food.
  • Use nonslip mats in the bathtub and shower.

Light Up Your Living Space

Keep your home brightly lit to avoid tripping on objects that are hard to see.

You can also:

  • Place night lights in the bedroom, bathroom and hallways.
  • Place a lamp within reach of the bed for middle-of-the-night needs.
  • Make clear paths to light switches that aren’t near room entrances.
  • Consider trading traditional switches for glow-in-the-dark or illuminated switches.
  • Turn on the lights before going up or down stairs.
  • Store flashlights in easy-to-find places in case of power outages.

Use Assistive Devices

Your doctor might recommend using a cane or walker to keep you steady. Other assistive devices can help, too.

For example:

  • Hand rails for both sides of stairways
  • Nonslip treads for bare-wood steps
  • A raised toilet seat, or one with armrests
  • Grab bars for the shower or tub
  • A sturdy plastic seat for the shower or tub plus a hand-held shower nozzle for bathing while sitting down

If you or someone you know could be at risk for falls and would like to learn more about Oxford’s Lifeline Personal Emergency Response System click here.

Hypertension: High Blood Pressure

Checking BP for signs of hypertension

By Crystal Maggard, RN Oxford Cardiopulmonary Coordinator

Have you checked your blood pressure lately??

Did you know that long-term elevated blood pressure is called “the silent killer?”

High blood pressure is a common condition in many people, many of whom often are not even aware they have it. Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance in your arteries—the more blood your heart pumps and the narrower your arteries, the higher your blood pressure.

Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke. You can have high blood pressure for years without any symptoms or any problems. However, damage to blood vessels and your heart can develop and cause life threatening problems.

Fortunately, high blood pressure can be easily detected and controlled with the help of your physician. The first step is simply becoming aware of your elevated blood pressure.

Symptoms

Even if blood pressure readings reach dangerously high levels, most people with high blood pressure have no signs or symptoms, thus, the name “the silent killer.”

Some people may have:

  • Headaches
  • Shortness of breath
  • Nosebleeds

However, these symptoms aren’t specific, and they usually don’t occur until high BP has reached a life-threatening level.

Causes

There are two types of high blood pressure.

Primary (Essential) Hypertension

For most adults, there’s no identifiable cause of high BP. This type of high BP, called primary (essential) hypertension, tends to develop gradually over many years.

Secondary Hypertension

Some people have high BP caused by an underlying condition. This type of BP, called secondary hypertension, tends to appear suddenly and cause higher BP than primary hypertension. Various conditions and medications can lead to secondary hypertension, including:

  • Obstructive sleep apnea
  • Kidney problems
  • Adrenal gland tumors
  • Thyroid problems
  • Certain defects in blood vessels you’re born with (congenital)
  • Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs
  • Illegal drugs, such as cocaine and amphetamines
  • Alcohol abuse or chronic alcohol use

Risk Factors

High blood pressure has many risk factors, including:

  • Through early middle age, or about age 45, high blood pressure is more common in men. Women are more likely to develop high blood pressure after age 65.
  • High blood pressure is particularly common among African Americans, often developing at an earlier age than others.
  • Family history
  • Being overweight or obese
  • Not being physically active
  • Using tobacco
  • Too much salt (sodium) in your diet
  • Too little potassium in your diet
  • Too little vitamin D in your diet
  • Drinking too much alcohol
  • Stress
  • Certain chronic conditions. Kidney disease, diabetes and sleep apnea, among others, can be a risk factor.

Complications

Uncontrolled high blood pressure can lead to:

  • Heart attack or stroke
  • Aneurysm
  • Heart failure
  • Weakened and narrowed blood vessels in your kidneys
  • Thickened, narrowed or torn blood vessels in the eyes
  • Metabolic syndrome
  • Trouble with memory or comprehension

What You Can Do

Talk with your doctor.

You should have your physician obtain a BP reading at least every two years starting at age 18. If you’re 40 or older—or you’re age 18-39 with a high risk of high blood pressure—ask for a yearly BP reading with an appropriate-sized arm cuff. Your doctor will likely recommend more frequent readings if you’ve already been diagnosed with high BP or have other risk factors for cardiovascular disease.

Children age 3 and older will usually have BP checked as a part of their yearly exam.

Blood pressure measurements fall into four general categories:

  • Normal blood pressure – Below 120/80 mm Hg.
  • Prehypertension – Systolic pressure ranging from 120 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg. Prehypertension tends to get worse over time.
  • Stage 1 hypertension – Systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg.
  • Stage 2 hypertension – Systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher.

If you fall into the pre-hypertension or hypertension categories, it is important to talk to your physician about getting your BP under control.

Don’t Get Scammed by Home Repair Schemes

By Pam Gennings, Executive Director Special Projects*

Just like migrating birds arrive as the weather warms, so do the scammers. Home repair con artists are out in force this time of year—“flocking” to your neighborhood. These scammers are looking to make a quick buck; and unfortunately, older adults are most vulnerable.

 

According to the National Consumer League, the most common types of home repair scams are:

  • Duct cleaning
  • Driveway sealant
  • Leaky foundations
  • Landscaping
  • Furnace and roof repair

Don’t be a victim—know the signs!

  1. A contractor shows up uninvited, or will call or email out of the blue.
  2. The contractor tells you he/she is in the neighborhood and has “extra material” left over.
  3. The person pressures you to make a decision today because the “special offer” is for today only.
  4. The contractor points out a “problem” or offers a “free” inspection. Some scammers have been known to break something on purpose so they can be paid to “fix” the problem.
  5. The person demands full payment up front and usually wants cash.
  6. The individual has no identification or permits from the county or city.
  7. You are offered a discount so your home may be used as a “model”.
  8. The contractor wants to show you the “damage”, while an associate steals valuables from your home.

 

Tips to avoid being scammed by home repair con artists:

  1. Don’t allow yourself to be pressured. You have the right to say NO!
  2. Get several estimates on any home repair job.
  3. Check references including checking with the Better Business Bureau.
  4. Never pay in full up front, especially if paying by cash.
  5. It is very important that the contractor is insured and bonded—ask to see proof.
  6. Make sure everything is put in writing. Carefully read all the contracts and be sure you fully understand the scope of the work to be done, cost and time necessary to complete the job. Have in writing how payment will be handled. Make sure you understand the contract cancellation and refund terms.
  7. Ask for advice from a trusted friend or family member, especially if you are feeling pressured or have questions and concerns.

If you suspect you have been the victim of a scam, don’t be afraid or embarrassed to tell someone you trust. You can turn to the police, go to your bank if money has been taken from your account or seek help from adult protective services. In Missouri the adult protective service toll free number is 1-800-392-0210. To find the adult protective service contact information in other states, call the Eldercare Locator, a government sponsored resource line, at 1-800-677-1116 or at www.eldercare.gov.

 

Excerpts from National Council on Aging and National Consumer League

 

*Pam Gennings has a Bachelor’s of Arts and has worked in the field of Geriatric Social Work and Care Coordination for more than 30 years. She started working for Oxford HealthCare in 1993. During the course of her career she has helped thousands of people find resources to remain in their homes as well as provided guidance to families that were facing difficulties with their aging loved ones.

 

MAY IS NATIONAL STROKE AWARENESS MONTH

By Pam Gennings, Executive Director Special Projects*

Every 40 seconds someone in the United States has a stroke. A stroke occurs when a blockage stops the flow of blood to the brain or when a blood vessel in or around the brain bursts. Strokes are the leading cause of long-term disability in the U.S. and according to the CDC (Centers for Disease Control and Prevention) it is the fourth leading cause of death. A stroke can strike people of all ages, in fact the CDC reports that nearly a quarter of all strokes occur in people younger than 65.
Strokes are largely PREVENTABLE.
• According to the American Stroke Association, one in three Americans has high blood pressure, which is the number one controllable risk factor for stroke. It is important to keep your blood pressure under control.
• Cigarette smoking contributes to one in every five strokes in the country. Exposure to second hand smoke can also contribute to a higher stroke risk.
• Exercise regularly. To help lower or control blood pressure, get 40 minutes of moderate to vigorous physical activity three to four times a week.
• Prevent or control diabetes.
• Get your cholesterol checked regularly and manage it with diet/physical activity or medication if needed.
• Eat a healthy diet. Watch your sodium intake.
• Limit your alcohol intake.
• Ask your doctor if taking aspirin is right for you.
Strokes are TREATABLE, but every second counts. The sooner a patient receives medical treatment, the lower the risk of death or disability.

As an easy way to remember the sudden signs of stroke, the American Stroke Association wants everyone to learn F.A.S.T. When you spot the signs you will know to call 9-1-1 immediately.

F = Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
A = Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downwards?
S = Speech Difficulty – Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is the sentence repeated correctly?
T= Time to call 9-1-1 – If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you will know when the first symptoms appeared.

Beyond F.A.S.T., other warning signs include:
• Sudden numbness or weakness of face, arm, or leg.
• Sudden confusion
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden severe headaches with no known cause

Remember getting immediate medical attention for stroke is crucial to prevent disability and death.
For more information go to www.strokeassociation.org

*Pam Gennings has a Bachelor’s of Arts and has worked in the field of Geriatric Social Work and Care Coordination for more than 30 years. She started working for Oxford HealthCare in 1993. During the course of her career she has helped thousands of people find resources to remain in their homes as well as provided guidance to families that were facing difficulties with their aging loved ones.