by Mary Keen
According to the National Institutes of Health, 6.5 million people in the U.S. suffer from chronic wounds. A large amount of those people are elderly. For example, 70% of all pressure ulcers (bed sores) occur in the geriatric population. The elderly are much more likely to have chronic wounds because, as they age, they develop conditions that cause wounds, such as diabetes, poor circulation, poor nutrition, or immobility. Wounds in the elderly can take up to four times longer to heal than they would in younger persons. Why is wound care so much more intense for the elderly? An elderly person’s skin can be as much as 20% thinner. This means that a cut may often slice deeper than it would in younger skin. Elderly skin is also less supple due to a lack of moisture, which makes it more vulnerable to dryness and cracking. Also, advancing age is believed to change one’s immune response, causing increased susceptibility to infection. Hard-to-heal wounds also cause pain, emotional problems and social isolation. Studies have proven that, the longer a wound takes to heal, the more it impacts the patient’s and the family’s quality of life. Failure to control issues like pain, excessive drainage and odor can have an extreme psychological impact on the patient and caregivers.
Each day, thousands of patients are discharged from a hospital stay with slow-healing surgical wounds, injuries from falls, and more. To prevent infections and other serious complications like bleeding and wound separation, getting proper wound care is essential. With this critical need for wound care in mind, CJE’s Lieberman Center for Health and Rehabilitation recently inaugurated a multi-faceted Wound Care Service. According to Raymond Pryor III, M.D., C.W.S., a board-certified wound care specialist (consulted through Vohra Wound Physicians) and Director of the new Wound Care Service: “In working with CJE the past team, capable of handling even the most challenging and complex wounds. This is through teamwork, communication and recognizing the need for an all encompassing wound care program that treats all aspects of the body to heal a wound.”
A multidisciplinary team cares for the patient’s nutrition, hygiene and emotional state along with localized wound care to heal or manage a wound. Joining Dr. Pryor on this team are Dr. Jason Gruss, a physiatrist; Dr. Jeffrey Rager, a podiatrist; nurse managers stationed on each Lieberman floor; advanced care nurses; and physical therapists. While specific treatments vary by patient, Lieberman’s wound care team treats three years, I have had the benefit of helping mold their wound care service into an upper echelon both new wounds and wounds that have previously resisted traditional treatment. These can include: pressure ulcers; orthopedic joint replacement wounds; infectious wounds; lower extremity wounds; surgical wounds; reconstructive surgery wounds; and lymphedema (a build-up of fluid caused by the lymphatic system).
At Lieberman Center, staff monitors patients to prevent wounds, or if they have wounds, to make sure they heal as quickly as possible. The first step of the main protocol is communication between nursing staff and the rest of the team. When a problem with a wound is detected, the nursing staff consults the wound care specialist. An assessment is made of the patient’s ability to function, and then an evaluation of the wound takes place to determine cause, acuteness and other factors. The team then works out an individualized treatment program tailored to the needs and abilities of the patient. Finally, ongoing care is coordinated with the patient’s primary healthcare provider. The nurses and physical therapists also spend a great deal of time educating caregivers about care of wounds and coping with wounds.
Whether using the most current wound dressings or traditional methods, Lieberman’s goal is to decrease wound progression and promote healing. We strive for best outcomes so that people can make a successful transition back home. Establishing the Wound Care Service is another example of how CJE is at the forefront of developing innovative healthcare solutions to address the complex needs of an aging population.
This article originally appeared in the Spring 2013 issue of LIFE, CJE SeniorLife's quarterly magazine.