Tuesday, January 31, 2017

Guest Post: The Clutter Problem – Tracing The Causes of Falls in the Elderly

By Jessica Hegg

When it comes to accidental falls, you may think that you understand the risk factors that face the elderly as they age-in-place.

You’ve moved your loved one to a home without stairs – or installed a chairlift or other safety apparatus. You’ve installed a raised toilet seat, grab bars, shower stool, and non-slip mats in the bathroom – you’re covered!

After all, a large portion of falls do occur in the bathroom and on stairs – especially if they lack security devices – so you’re probably good to go, right?

Wrong. Although bathroom falls and stair falls compose a large portion of falls in the elderly, they’re not the whole picture. In fact, when data is collated and analyzed, there’s one clear cause of falls that rises above all others: Clutter and disorganization.

Environmental hazards such as loose rugs and poorly secured storage bins are associated with a huge number of “environmental” falls – falls that are directly caused by some object or lack of safety.

Why is Clutter Such a Big Problem?

The best reason we can come up with is simple – it’s unexpected.

Your loved one isn’t expecting their favorite Persian rug to have a corner upturned in the dining room while they’re walking through with a watering can – they’re not expecting their hall closet to have a storage bin on the upper shelf waiting to fall down onto them when they open it to look for their vacuum, and they’re not expecting the toy their grandkid left behind to be sitting in the middle of the hall when they wake up to use the bathroom at night.

However, when using stairs, bathrooms, and other typically “risky” facilities, your aging loved one is typically on a slightly higher level of alertness – they know that what they’re doing could be risky, and take appropriate steps and precautions.

On the other hand, when a hall rug is turned up unexpectedly, your loved one may not even notice, and walk on through like nothing happened.

The fact that these falls and risks are unexpected is the source of their danger – by default, your loved one cannot prepare for a fall caused by these issues, as they’ll likely never see it coming.

So What Can Be Done?

The only real way to minimize environmental, storage and clutter hazards is by taking a close look at commonly trafficked areas and taking appropriate steps to reduce these hazards. For example – take a close look at the kitchen.

That kitchen mat that’s been there for years. Is it secure? Could it be pushed out of place, leaving a corner upturned and hazardous? Is the pantry easily accessible without the use of a step stool or other method of height elevation? Are important pots, pans and implements in areas that are risky to reach?

Or storage closets – look at commonly used storage closets for risky objects – unsecured boxes in high areas can be risky, and should be moved both to be easily accessible, and to pose less of a risk if they get pushed around.

Hallways are actually surprisingly risky environments – for simple reasons. Hallways are often walked through with no problem at all, and though little time is spent in the hallway itself, hallways often are responsible for quite a bit of foot traffic.

Not only that, the hallways isn’t seen as a “risky” area – just a simple corridor with little danger. However, hall rugs and clutter in hallways can be a huge cause of falls in the elderly – especially at night, when the senses are dampened and risky situations are hard to see.

Minimize Clutter, Maximize Safety

Minimizing clutter isn’t a one-time solution – it’s a form of maintenance that must be undergone multiple times, and it’s good to include an aging loved one in the conversation.

Help them understand the risks – rugs, out-of-place storage boxes, clutter like toys or tools left in places they normally aren’t. Help them understand what areas are the most risky – such as hallways and awkward storage closets – and then help them clean these areas of clutter, making a plan to keep them free of clutter as you go.

Taking Steps to Reduce Risk

Clutter is certainly not the only reason that elderly people fall, but minimizing clutter is one of the easiest ways to reduce the risk of an environmental fall – without buying expensive equipment or devices.

Because of this, any comprehensive aging-in-place solution must include a discussion about the risks of clutter, and steps that can be taken not only to minimize it, but to continue upkeep of your loved one’s home so that it remains safe and accessible.

These simple steps can go a long way to keeping your loved one safe and secure as they age, and ensure a worry-free environment.

Jessica Hegg serves as the Content Manager for Vivehealth.com. The company, based in Naples, Florida, provides a wide array of medical supplies, as well as tips for healthy aging.

Friday, January 13, 2017

Guest Post: Caregiver's Guide to Bed Sores

By Jessica Hegg

Pressure ulcers are one of those day-to-day realities many of us face while caregiving. Avoiding pressure ulcers in anyone who is bedridden for an extended period of time – even when you’re vigilant and take precautions, preventative measures, and examine patients early and often, is a difficult task. They’re pernicious that way, so knowing how to recognize and treat every stage of a pressure ulcer is very important.

In this guide, we’ll take you through a step-by-step look at each stage of pressure ulcers, and give you some tips on recognizing them, and knowing what treatment options are available.

Stage I pressure ulcers generally present rather mildly. Skin is discolored, and some tissue has begun to die, indicated by discoloration – purplish, blue, red, and bruise-like in light-skinned patients, and often a whitish discoloration in darker-skinned patients.

An easy way to recognize these pressure ulcers is with a simple fingertip-pressure method. If you think an area may be affected, simply press down on with one finger to check for both discomfort, and skin blanching. If the skin does not blanch (whiten) in response to light pressure, meaning blood does not get pushed away from the area you press, you likely have a stage I pressure ulcer on your hands.

Treatment of these ulcers generally involves moving the patient so that the affected area is under as little pressure as possible, and simply ensuring the wound is clean and dry, allowing dead skin and tissue to slough off naturally and be restored by healthy tissue. However, these ulcers can progress, and become more dangerous.

Stage II ulcers are generally recognized as extant when the skin around the wound is broken, and dead tissue is present around the wound. The area where the skin has broken will be a reddish-pink color, and may blister.

If a stage I ulcer has progressed to where it has broken the skin, it’s stage II. Generally, Stage II ulcers don’t present with pus or drainage – if this is present, the ulcer may have reached into the fatty tissue layers, and already progressed to stage III.

While stage II ulcers are riskier than stage I ulcers, precautions mainly include avoiding infection and allowing the wound to heal by using a light saline rinse to wash away dead slough skin and keep the area clean. They do have a much higher risk of infection, so precautions should be take to avoid contact with infectious substances. They can then progress to Stage III, which presents much higher risks.

Stage III occurs when the ulcer reaches beyond the surface skin, and tissue up to and including the fat layer is necrotizing.

These wounds present with a far larger, “cratered” appearance than Stage II ulcers, and generally have a significant amount of pus, drainage, and slough. Eschar – large scabs of dried and dead skin – may also be present in more advanced stage III wounds They are generally quite painful and uncomfortable, and present a serious risk of infection due to the vulnerability and depth of exposed flesh.

Generally, Stage III and above ulcers are monitored and cared for by medical professionals in a clinical setting, as they are quite dangerous, and have a high risk of becoming infected. Treatments include debridement and removal of necrotized flesh, and dressings and antibiotics to help prevent infection. The ulcer can progress further, though.

Stage IV ulcers present with tissue loss past the fatty layer of the skin, and through muscle, bone, tendons, and joints. Large quantities of eschar and dead tissue are present, and the injury is often deep enough that you can see bone and muscle layer in the wound.

Stage IV is characterized by visibility of bone, muscle fascia, tendons, ligaments, or cartilage in the wound. If any of these are seen, the wound has progressed past the fatty layer, and is classified as a stage IV ulcer.

Emergency treatment by medical professionals is absolutely required for these ulcers. They are an incredible infection risk, and extremely painful and dangerous for anyone afflicted. Debridement and antibacterial treatments are common until the bacterial load has been reduced, at which time surgery, such as flap reconstruction, can take place to help seal and heal the wound.

Surgery is almost always required for advanced stage IV pressure ulcers, and complete excision of the affected area can be required if the injury is serious enough. These wounds always require the constant care and supervision of medical professionals, and can be life-threatening even if they are not infected.

Unstageable pressure ulcers present when the extent of a pressure ulcer’s depth and seriousness is unclear due to the base of the wound being completely covered in eschar – a certain type of hard scab that is made entirely out of dead tissue.

Excision and debridement of the eschar is the first step. After this, the extent of the tissue injury (stage III or IV) will become clear, and treatment will continue as appropriate.


It’s important to remember that pressure ulcers, while a serious problem, are almost always preventable, and 70 to 90 percent of stage I to II pressure ulcers will heal without serious medical intervention. Being able to recognize when an ulcer has progressed to the point of danger is essential when you are caring for a bedridden loved one at home. Please be sure to consult with your doctor to develop a safe and proper bed sore treatment plan.

Jessica Hegg  serves as the Content Manager for Vivehealth.com. The company, based in Naples, Florida, provides a wide array of medical supplies, as well as tips for healthy aging.