The 2004 death of actor/director, Christopher Reeve, at the age of 52 years from heart failure secondary to an infected pressure ulcer underscores the importance of effective pressure ulcer prevention, treatment, and management strategies. Septic infections are associated with pressure ulcers and age-adjusted mortality rate calculations are 3.79 per 100,000 population (95% confidence interval [CI] 3.77–3.81). The incidence of pressure ulcers vary greatly. In the acute care setting, incidence ranges from 0.4%–38% and in nursing homes prevalence rates range from 2%–23.9%.
Pressure ulcers add significantly to health care costs and patient suffering. Beckrich and Aronovitch estimated that pressure ulcers cost the U.S. health care system $5–$8 billion (1999 dollars). Patients describe, “endless pain,” isolating themselves from others, and fear of odors emanating from pressure ulcers.
More than 95% of pressure ulcers develop on the lower half of the body with the greatest number in the heaviest part, the pelvic girdle. Approximately one quarter of adult Americans have a pressure ulcer at the time of their death. Because of the high prevalence and incidence of pressure ulcers and their complications, costs to the health care system, pain and suffering for affected adults, and caregiver burden, efforts are being made to reduce pressure ulcer rates. One of the goals of Healthy People 2010 is to “reduce the proportion of nursing home residents with current diagnosis of pressure ulcers.”
The purpose of this chapter is to discuss evidence-based literature regarding the prevention and treatment of pressure ulcers in older adults and the need for an interdisciplinary team approach in pressure ulcer care.