Aging changes us inside and out. One of the most notable changes can be bruising in elders. Bruising occurs when small blood vessels burst and dark blood collects under the skin. Bruises can be tender or even painful when touched, but most bruises heal on their own.
While bruising is common and not always avoidable, there are steps you can take to reduce the risk and treat bruising in elders. It’s also critical to know when bruising is occurring naturally and when it’s caused by a medical issue or elder abuse.
What Causes Skin Bruising in Seniors
Skin bruising happens more easily in seniors because of the skin changes that happen with age. As we get older, our skin becomes more fragile as it loses its elasticity, retains less moisture and begins to thin. As the skin thins, it loses the layer of fat that typically protects small blood vessels. So, a bump or light impact that would never result in a bruise on younger skin will be much more noticeable on elderly skin. Bruising commonly occurs when elders bump into objects, trip, fall or are otherwise injured due to mobility issues. Medications like blood thinners and supplements like fish oil, garlic, ginkgo and vitamin E can also lead to easy bruising because they prohibit blood clotting.
Ways to Prevent Bruising in the Elderly
While it’s difficult to stop bruising in the elderly entirely, it is possible to reduce the risk through prevention and protection.
Prevention: Creating a safer home environment for the elderly can reduce the risk of falls and bumps that can contribute to bruising.
- Reduce obstacles: Take the time to clear paths through the home by decluttering and rearranging furniture.
- Remove tripping hazards: Look for ways to reduce risk from loose rugs, power cables and other obstacles.
- Improve mobility: Consider providing your senior with a cane, walker, handrails and other types of support.
- Diet: Bruising can be a warning sign for senior malnutrition. Encouraging seniors to eat healthy foods that can keep their weight up will slow the loss of the subcutaneous fat that protects them.
- Exercise: Encourage your senior to get lots of exercise, with a focus on maintaining strength and balance.
Protection: Other factors that can contribute to bruising are vitamin deficiency and overexposure to the sun. Encourage your senior to wear protective clothing and sunscreen when outside and talk to your doctor about vitamins and other supplements that can help.
Assisted living: If you’re concerned that your elder may be at risk of bruising due to their home environment, you may want to consider assisted living. With assisted living, your elder would be in an environment that is easier to navigate and would have more access to caregivers who can identify suspicious bruising.
How to Treat Bruises in Seniors
Usually, the treatment for bruising is minimal and the body will heal on its own. Putting a cold compress on the bruise can reduce the bleeding and reduce swelling. However, you should seek medical attention if an elder:
- Shows signs of severe bruising
- Has bruises appear with no memory of a bump or fall
- Has unusual bleeding or spontaneous bruising
- Bruises more easily after starting a new medication
Bruises from Elder Neglect or Abuse
While bruising may be common in seniors, it can also be a warning sign of elder abuse or neglect. According to the National Center on Elder Abuse (NCEA), elder abuse is defined as a knowing, intentional or negligent act that causes a serious risk of harm to a vulnerable older adult. The organization identifies how bruising can be an indicator of elder abuse:
- Location: Most accidental bruising happens to the arms and legs. Bruising to the neck, torso or head may be a sign of abuse.
- Shape and size: Bruises from abuse may be larger than bruises from falls and bumps. Many adults who have been abused have bruises approximately 2 inches apart, which may be a sign of finger marks.
- Memory: Many seniors, even those with dementia or cognitive impairment, can recall abusive bruising. If they indicate or you suspect abuse, talk to your elder in private.
- Unexpected sources: The source of abuse may not always be obvious. Aging and dementia can lead to severe behavioral changes. The injuries may be coming from a longtime partner, or they may even be self-inflicted.
Protecting Your Elders from Abuse
If you are concerned that an elder is being abused, talk to your doctor. Medical professionals often see examples of elder abuse on a regular basis and may be able to identify signs of abuse.
If an elder is in immediate, life-threatening danger, call the police or 9-1-1 immediately. If the danger is not immediate, but you suspect abuse, talk with local Adult Protective Services (APS), a long-term care ombudsman, or the police. To report a concern, contact the APS agency in the state where the older adult resides. Find the APS reporting number for each state by visiting:
- The State Resources section of the National Center on Elder Abuse website
- The Eldercare Locator website, or calling 800-677-1116
Bruising in elders is a natural part of life and a common sign of aging. However, if you are concerned for an elder’s health and safety, don’t be afraid to take the necessary steps to protect them.