It’s that time of year when people are showing more skin thanks to warmer temperatures and outdoor activities. This might also be a time when you as a caregiver to an elder notice some skin bruising that you will need to address.
What Causes Easy Bruising in the Elderly?
Before you panic and alarm the senior in your life with your concern, know that not all bruises are a medical emergency.
There is something called “easy bruising” and it can happen at any age but is primarily associated with elderly people. According to the Mayo Clinic, “most bruises are harmless and go away without treatment.”
However, it’s important to know when it might be something more serious. Experts at the Mayo Clinic explain that “most bruises form when small blood vessels (capillaries) near the skin’s surface are broken by the impact of a blow or injury—often on the arms or legs. When this happens, blood leaks out of the vessels and initially appears as a dark mark.”
These types of bruises, they say, will disappear as the body reabsorbs the blood.
For most people, it takes a significant bump or blow to the body to cause a bruise, but for older women especially, as they age and their skin becomes more thin, they tend to bruise more easily.
One study found that those who need assistance with their Activities of Daily Livings (ADLs), were more likely to bruise than those who did not this assistance.
Why Does Elderly Skin Become Thinner?
The thinning of skin is a natural part of aging, but there are ways to minimize how your body is impacted. The Mayo Clinic suggests these protective measures:
- Avoid long sun exposure and opt for long sleeves, pants, and wide-brimmed hats when outdoors.
- Wear a water-resistant sunscreen with an SPF of at least 30 outside on uncovered areas or when engaged in activity where you cannot be covered up such as swimming. Remember to reapply!
- Maintain a moisturizing routine year-round. Ask your dermatologist for product recommendations that are best for your skin type.
- Talk to your doctor if you are concerned that certain medications, supplements, or dietary changes can be contributing to issues with thinner skin.
Men and women’s skin ages differently due to hormonal changes and therefore bruising is not the same, nor is healing from a bruise.
Purple Patches on Elderly Skin: Is It a Bruise?
You probably haven’t used the term “purpura” but it’s important to know when caregiving for an elderly person who shows a lot of skin splotches. Purpura appear as purple spots on the skin, but may also be brownish-black or reddish-purple on some complexions. The occur when blood is leaking under the skin.
There are many different types of purpura and they will resemble a bruise but, according to Cleveland Clinic, it is not a medical condition in itself but a sign of another causing the bleeding.”
Causes of purpura can include:
- Drug interactions
- Congenital disorders
- Vitamin or nutrient deficiencies
- Blood clotting disorders
- Certain cancers
Unlike a bruise, purpura is not caused by a fall or a blow.
Senile purpura is common in older adults, according to Cleveland Clinic, and can be the result of sun exposure.
Some types of purpura will require immediate medical attention such as Warfarin-induced skin necrosis, Heparin-induced thrombocytopenia, or disseminated intravascular coagulation. Contact a healthcare provider for a diagnosis of the underlying condition causing the purpura.
Fall Risks in the Home and Bruising
The Centers for Disease Control and Prevention (CDC) states that one out of four adults will fall in the United States each year. “Falls are preventable and do not have to be an inevitable part of aging,” they state on their website.
With millions of people being treated in emergency departments for broken bones and head injuries, a bruise from a fall seems like no big deal. However, a caregiver can help to decrease the chances that the next fall could result in injury or death.
Consider these steps to reduce the chances of a fall in the home:
- Engage in a physical activity such as a water workout class or Tai Chi class that can build muscles and help with stabilization in general.
- Declutter the living space to get tripping hazards out of the way such as loose rugs, end tables, cords for lamps or TVs, and more.
- Consult a healthcare provider about any medication side effects that can cause dizziness.
- See an eye doctor to rule out any vision issues contributing to falls.
- Research assistive devices such as canes, walkers, and wheelchairs with a health care provider to see if these can help to prevent the likelihood of a fall.
Other Causes of Elderly Skin Bruising
While a bump or fall are often the most likely causes of a new bruise, there can be other reasons too.
Has this person recently had blood draw or medicine given intravenously?
Being immobile for prolonged periods of time can also cause bruising and bedsores. A caregiver can assist with moving a person more frequently so that they do not develop these conditions.
If there are unexplained or unusual bruises—such as a bruise with swelling, repeat bruises in the same part of the body, large or irregular shaped bruises—contact a doctor for a consultation.
These medical conditions and medications can cause bruising:
- Clotting disorders
- Liver disease
- Common over-the-counter medications such as ibuprofen, aspirin, and asthma medicines can lead to bruising on the skin
- Blood thinners and other anticoagulants
Elder Abuse and Bruising
The study, “Bruising in the Geriatric Population” from the Irvine College of Medicine noted that, “With the increased awareness of the estimated 1 - 2 million cases of elder abuse, adult protective services is…looking to geriatricians and the medical community for input in elder mistreatment cases involving clients with extensive bruising.”
If you suspect that an elder is being abused, contact a trusted healthcare provider and also the National Center on Elder Abuse for support. Talk to your loved one calmly and privately about your concerns.
The location of the bruise can be an indicator of whether the cause was intentional or accidental. For example, the majority of accidental bruises occur on the extremities, rarely on the neck, face, or trunk of the body.
While an older adult may be receiving care for dementia, sometimes their behavior changes can accidentally cause injuries to themselves or others who are living with them or caring for them. A caregiver or family member can discreetly ask about any physical altercations that may have occurred. However, someone who is living with dementia may not remember how they got a bruise so observation may be necessary to understand the cause of a bruise.
Treating Elderly Skin Bruising on Arms and Legs
Once the cause of the bruise has been determined and possibly addressed if there is an underlying medical condition, the tender area can be treated.
If tolerated, try icing and elevating the affected area. Alternate the cold with a warm compress. Keep in mind though that thinner skin will be more sensitive to temperatures.
The important thing is to prevent elderly skin bruising in the first place, if possible, and to take measures to determine the cause of a bruise. A typically caused bruise does heal on its own in just a few weeks.