Skin Infections in Nursing Home Residents
Skin infections in nursing homes are a common occurrence, both for physiological reasons and the nature of long-term care facilities.
The former cannot be changed, but nursing home negligence and abuse can make easily preventable and treatable infections much worse — up to the point of death.
The elderly are more prone to skin infections like cellulitis, wound infection, conjunctivitis, and necrotizing fasciitis.
They are often more susceptible because of:
- Concurrent diseases like diabetes and heart and lung issues
- Longer healing periods from wounds
- Thinner skin (the source of wrinkles)
- Weaker immune systems
Several factors make skin infections in nursing homes more likely, including:
- A higher presence of invasive medical devices, like catheters and feeding tubes
- A steady stream of outside visitors and staff bringing pathogens into the nursing home
- Close-quarters living with shared property
- Health care workers treating multiple patients
All of these factors combine to make skin infections a serious threat to nursing home residents. One of the most common skin infections is cellulitis, which most frequently forms on the lower legs.
Symptoms of cellulitis include:
- A red area of the skin that expands
If cellulitis is not treated with antibiotics, it can damage the body’s ability to fight further infections and lead to chronic swelling of the limb. Even this is reversible with consistent medical treatment, but an infection of the deep layer of skin tissue can be fatal.
Causes of Skin Infections in Nursing Home Residents
Senior citizens living in nursing homes are at risk of multiple skin infections, with cellulitis at the top of the list. Cellulitis just needs a crack in the skin for bacteria to enter and begin multiplying.
The elderly’s fragile skin provides bacteria a perfect target because it is:
- Broken because of conditions like shingles, athlete’s foot, and eczema
- Naturally dry and cracked
- Thin and easily cut
Another widespread problem is bedsores, also called pressure ulcers. These develop from prolonged pressure on the skin, typically on the bony areas of the body like ankles, heels, and tailbone.
People confined to a bed or a chair, like many elderly living in a nursing home, are most at risk.
Symptoms of bedsores include:
- A patch of skin that is cooler or warmer to the touch
- Change in skin color or texture
- Pus-like discharge
“About 159,000 U.S. nursing home residents (11%) in 2004 had pressure ulcers, or more than 1 in 10.” – Centers for Disease Control
Not only are these bed sores painful, but they are ripe targets for skin infections.
Some of the complications arising from bed sores are:
- A form of squamous cell carcinoma called Marjolin’s ulcers
- Damage to cartilage, tissue, and bone from joint infections
Simply repositioning a patient around every two hours is an easy step toward preventing bedsores, but this can be a challenge if a nursing home is understaffed or overworked.
Other suggested prevention techniques include:
- Frequent skin assessments
- Keeping skin clean and dry
- Protective padding to reduce pressure on the skin
Skin Infection Complications
Skin infections can quickly overwhelm the body and create serious complications if left untreated.
One of these complications is meningitis, which results from skin infections traveling through the bloodstream to the brain and spinal cord. Bacterial meningitis is stronger than its viral counterpart.
Bacterial meningitis can cause:
- Severe, persistent headache
- Stiff neck
If left untreated, meningitis can become very serious and cause seizures, hearing loss, brain damage, shock, and death.
Sepsis is the eventual result of almost all the body’s infections, including those in the skin. It’s the result of the body releasing a flood of chemicals into the bloodstream to fight off the infection. This creates an imbalance that can damage the body’s organs.
Further efforts to fight the infection cause septic shock, which quickly results in death.
Symptoms of sepsis include:
- Change in mental status
- Drop in blood pressure
- More than 22 breaths a minute
Preventing and Treating Skin Infections
A diligent nursing home caretaker can take simple steps like massaging residents with a non-irritating moisturizing lotion to keep them comfortable.
A strong hygiene protocol like hand-washing and equipment sterilization in the nursing home goes a long way to prevent skin infections. Individual hygiene for residents should focus on cleaning skin folds and other crevices, with an emphasis on thorough drying afterward.
This should be standard practice for every nursing home, but it may fall to family members if they suspect staff is falling short.
Treatment of skin infections in nursing homes can range from a course of antibiotics up to surgery and hospital stays. If caught early, topical ointments and frequent, clean bandages can clear up a skin infection in a matter of days.
Some infections like cellulitis can easily reappear, though, and require close monitoring — something that’s difficult to achieve in an understaffed nursing home. Severe cases of skin infections kill the flesh entirely and require surgical removal.
Steps for Family Members
The elderly have a heightened susceptibility to skin infections, but good hygiene practices and diligence can keep a minimized risk.
To help prevent skin infections, family members can:
- Bring red spots and signs of infection to the attention of the nursing home staff
- Ensure your loved ones receive medical treatment
- Monitor the development of any suspicious skin conditions
- Regularly check to make sure your loved one has bathed
Failure to prevent skin infections or provide treatment early can lead to serious and even permanent health consequences.
Legal Options for Skin infections
Skin infections carry long-term, serious risks for the elderly, but they are treatable and preventable.
If a loved one you’ve entrusted to a nursing home has been injured or killed by a skin infection, there are legal options available to cover medical expenses and bring justice.