Zeitschrift für Allgemeinmedizin

Pressure Ulcers in the Elderly, as a Public Health Problem

Abstract

Efraim Jaul and Jacob Menzel

Pressure ulcers (PU) are a common medical complication in the frail elderly. Due to the increase of the elderly population and accrued accompanying comorbidities, there is a higher prevalence of pressure ulcers. These induce suffering and worsening in quality of life and prolong hospitalization. Pressure ulcers are a burden on the medical services and increase their cost substantially. Systemic factors such as aging of the skin, functional impairment, chronic diseases, malnutrition and infection contribute to the appearance of the ulcers and activate development. Low BMI, anemia, low protein and albumin are predisposing factors, as well as serious complications of pressure ulcers interfere with the cure. Prevention of pressure ulcers should be started by the primary care givers through education of the patient and family concerning the external factors as pressure relieving devices, especially mattresses and cushions, position changes, lubrication of the skin and adequate calorie intake for the patient. Attention becomes directed to changes of the skin especially at the location of bone prominences exposed to pressure. A zero-tolerance policy is necessary by the primary physician and the nurse, concerning pressure ulcers. The treating physician familiar with the diseases of the immobile patients and the systemic factors leading to pressure ulcers should apply all available preventive measures.