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.
To start assisting those in your care, you first need to learn what causes bruising in elderly people. Let’s dive deeper into the many factors that can lead to easier bruising on elderly skin.
How Bruises Form
Bruises form when an impact causes the small blood vessels near the surface of your skin to rupture, leaking blood. In most cases, the bruise starts as a dark mark and fades as the body reabsorbs blood.
Before you panic and alarm the senior in your life with your concern, know that not all bruises are a medical emergency. According to the Mayo Clinic, “most bruises are harmless and go away without treatment.”
So, Why Do the Elderly Bruise Easily?
There is something called “easy bruising.” It can happen at any age, but it’s particularly common to see the elderly bruising easily.
For most people, it takes a significant bump or blow to the body to cause a bruise. So why do older people bruise so easily? As people age (especially women), their skin becomes thinner, and they tend to bruise after relatively minor impacts.
What Causes Thin Skin in Elderly People?
The thinning of the skin is a natural part of aging and can be made worse by sun exposure and genetic factors. With proper care and preparation, there are ways to minimize how your body is impacted. The Mayo Clinic suggests these skin protection 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 when engaged in an 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 could be contributing to issues with thinner skin.
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.
Falls can do so much more than bruise, often leading to serious injury in elderly patients and sometimes even to death. Consider these steps to reduce the chances of a fall in the home:
- Engage the person in a physical activity that builds muscle and improves stabilization, such as a water workout or Tai Chi class.
- Declutter the living space to eliminate tripping hazards, 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.
- Recommend the person see an eye doctor to rule out any vision issues contributing to falls.
- Ask your loved one’s health care provider to see if assistive devices such as canes, walkers, and wheelchairs can reduce 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? Needle sticks can lead to bruising. Being immobile for prolonged periods of time can also cause bruising and bedsores. A caregiver can assist with repositioning a person frequently so that they do not develop these conditions.
Many medical conditions and medications can cause bruising, such as:
- Anemia
- Clotting disorders
- Liver disease
- Diabetes
- Common over-the-counter medications such as ibuprofen, aspirin, and asthma medicines
- Blood thinners and other anticoagulants
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.
Purple Patches on Elderly Skin: Is It a Bruise?
These purple splotches are called “purpura,” and like bruises, they’re caused by blood leaking under the skin. According to the Cleveland Clinic, purpura “isn’t a medical condition but a sign of another condition causing the bleeding.” Purpura appear as purple spots on the skin, but may also be brownish-black or reddish-purple, especially on darker complexions.
Causes of purpura can include:
- Drug interactions
- Congenital disorders
- Vitamin or nutrient deficiencies
- Blood clotting disorders
- Certain cancers
- 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.
Elder Abuse and Bruising
If you can’t figure out what causes the bruising on an elderly patient, there is a possibility it’s the result of elder abuse.
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 the National Center on Elder Abuse for support.
Talk to the person calmly and privately about your concerns. 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.
The location of the bruise can be an indicator of whether the cause was intentional or accidental. For example, most accidental bruises occur on the extremities, rarely on the neck, face, or trunk of the body.
Treating Elderly Skin Bruising on Arms and Legs
Once the cause of the bruise has been determined and 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 that thinner skin will be more sensitive to these extreme temperatures.
Preventing Elderly Skin Bruising
Now that you know what causes elderly skin bruising, the important thing is to prevent it in the first place. If you can’t prevent elderly skin bruising the first time, take measures to determine the cause of a bruise to prevent it in the future.
Some elders require dedicated care to avoid injury. Our elder care services provide the support loved ones need to recover from falls, notice and treat minor injuries quickly, and avoid future bruising through preventative measures.
Contact your local Homewatch CareGivers to schedule in-home support that’s tailored to your elderly loved one’s unique needs.
