Bruising in Elderly

Bruising:

Bruising on the skin occurs after an injury where deeply located blood vessels are microscopically torn, causing them to leak their fluids toward the surface of the skin. The collection of blood results in discoloration of the skin producing blue and black marks (Jaliman et al.,2019).

Characteristics of a bruise:

Initially, a bruise may be painful, but pain will disappear as the color fades.

A fresh bruise may be reddish. It will then change into light purple or dark purple color after few hours, and finally it will transition into a green or yellow hue after a few days as the bruise heals.

There is no risk of infection provided that the skin is not cracked or broken in a bruise (Jaliman et al.,2019).

Causes of a bruise:

Bruises form when something bumps into the individual or vice versa; elderly patients, however, may be more prone to bruising. Elderly patients experience physical changes inside and out. As the skin ages, it becomes increasingly sensitive, resulting in frequent bruising (Samuels, 2020). Here, we list some of the most common reasons for bruising in the elderly community:

Fragile skin:

In the elderly community, the first and the most important factor for bruising is fragile skin. In older adults, skin cells divide at a slower rate decreasing its capability to repair itself and therefore causing wounds to heal very slowly. The fragility of elderly skin is also due to the decreases in subcutaneous fat which typically protects and cushions the blood vessels and the loss of of elasticity (Samuels,2020). Genetics, sun exposure, and aging also play a role in the thinning of the skin (Samuels,2020).

Mechanical and nonmechanical bruising:

Bumping into the bedpost or any other object can result in unexplained bruises on the thigh or elsewhere on the skin. Sometimes individual may fail to recall the injury, this is very prevalent in the elderly. Additionally, bruising may not be a result of a mechanical injury; a minor burst of blood vessels upon a handshake or assistance with activities of daily living (ADLs) can leave noticeable marks on the elderly due to their fragile skin (Samuels,2020).

Bleeding disorders:

A patient may have a bleeding disorder if bruising is accompanied by persistent bleeding of gums or nose and unexplained bruises occur due to no specific reason (Jaliman et al.,2019).

Vigorous exercises:

When weightlifters and athletes exercise vigorously, microscopic, or small tears occur in the blood vessels under the skin resulting in a bruise. Similarly, the elderly can also result in bruising while exercising even if it is just a little (Jaliman et al.,2019).

Immobilization:

Lastly, immobilization is also a frequent cause of bruising in patients that are bedridden. When a patient is bedridden, there is a fair amount of pressure applied to a certain region of the patient’s body. As a result, pressure and inactivity cause the skin tissue to bruise and breakdown; resulting in what is known as bedsore (Samuels,2020).

Conclusion:

Bruising is a condition that results upon damage to the skin and its blood vessels, leading to discoloration of the skin. The Elderly are more prone to bruising due to their fragile skin and often, their inability to take care of their bodies on their own. Although bruising may be inevitable, it is important to acknowledge common causes for bruising in the senior community.

References

Jaliman, D. (2019). An Overview of Bruises. Retrieved 6 June 2021, from https://www.webmd.com/skin-problems-and-treatments/guide/bruises-article#:~:text=Bruises%20in%20elderly%20people%20frequently,medicine%20to%20thin%20the%20blood

Samuels, C. (2021). Elderly Skin Bruising: Causes & Prevention. Retrieved 6 June 2021, from https://www.aplaceformom.com/caregiver-resources/articles/elderly-bruising

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