It started as a small sore on Dad's leg. At first, the family thought it would heal in a few days.
But several weeks later, the wound is still there. The skin looks irritated, the dressing needs changing, and everyone is beginning to worry.
Why isn't it healing? Could it become infected? Does someone need to check it?
For many older adults, even a small wound can become a serious concern.
A wound that is not healing, is getting larger, or is becoming more painful should be evaluated by a healthcare professional.
Why Can Wounds Take Longer to Heal After 65?
Our skin changes as we age. It becomes thinner, more fragile, and sometimes less able to recover quickly from injury.
However, age is only one factor. Several medical conditions and everyday challenges can interfere with wound healing.
1. Diabetes and High Blood Sugar
Diabetes can affect circulation, nerves, and the body's ability to fight infection.
Some people with diabetes may not feel a sore developing on their foot because of reduced sensation.
This is why regular foot checks and appropriate medical care are important.
2. Poor Circulation
Wounds need oxygen and nutrients delivered through the bloodstream to heal.
When circulation is reduced, especially in the lower legs and feet, healing may become difficult.
A wound on the foot or lower leg that is not improving may require an evaluation of blood flow.
3. Swelling in the Legs
Persistent leg swelling can place pressure on the skin and contribute to skin breakdown.
Some older adults develop wounds near their ankles or lower legs because of problems with the veins.
These wounds may require specialized treatment based on the underlying cause.
4. Limited Movement or Too Much Pressure
Older adults who spend long periods in bed or sitting in one position may develop pressure injuries.
These commonly occur over bony areas, including the heels, hips, and tailbone.
Regular repositioning and appropriate pressure-relieving equipment may be recommended by the healthcare team.
5. Poor Nutrition or Other Medical Conditions
The body needs adequate calories, protein, vitamins, and fluids for healing.
Poor appetite, certain illnesses, and some medications may interfere with recovery.
A healthcare professional can assess whether nutrition or another medical condition is contributing to delayed healing.
Five Warning Signs Families Should Never Ignore
Check for these changes:
Increasing redness or warmth: The skin around the wound becomes more inflamed.
New or worsening pain: The wound becomes increasingly uncomfortable.
Unusual drainage or odor: There is pus, increased drainage, or a new unpleasant smell.
A wound that grows larger: The affected area expands instead of improving.
Fever or changes in alertness: Your loved one develops fever, chills, or unusual confusion.
Contact a healthcare provider promptly if these symptoms develop. Rapidly spreading redness, severe pain, fever with significant illness, or sudden confusion requires urgent medical attention.
What Should Families Do at Home?
Follow the wound care instructions. Use the dressings and cleaning methods recommended by the treating healthcare professional.
Keep the wound protected. Avoid unnecessary touching, rubbing, or pressure on the injured area.
Do not experiment with home remedies. Products such as alcohol, hydrogen peroxide, or unprescribed creams may irritate tissue or interfere with healing.
Pay attention to changes. Note whether the wound is getting larger, producing more drainage, or becoming painful.
Ask about nutrition. If your loved one is eating poorly or losing weight, discuss this with the healthcare provider.
Avoid treating every wound the same way. A pressure injury, diabetic foot ulcer, surgical wound, and venous leg ulcer may require different approaches.
How Can a Home Health Nurse Help With Wound Care?
For eligible patients, skilled home health nursing may be appropriate when wound care requires professional assessment or treatment.
Depending on the patient's condition and ordered care plan, a home health nurse may:
Assess the wound's appearance, size, drainage, and surrounding skin.
Perform prescribed dressing changes and skilled wound treatments.
Monitor for signs of infection or deterioration.
Teach patients and caregivers how to protect the wound.
Communicate changes to the treating healthcare provider.
Reinforce education about skin protection, nutrition, and pressure relief.
Some wounds require evaluation by a wound specialist or other healthcare professional. Home health nursing works within the patient's broader medical care plan.
Does Medicare Cover Wound Care at Home?
Medicare may cover medically necessary skilled wound care through a Medicare-certified home health agency when eligibility requirements are met.
These generally include homebound status, a qualifying skilled need, and an appropriate provider-ordered plan of care.
Not every wound requires skilled nursing, and coverage is not guaranteed.
Don't Wait for a Small Wound to Become a Bigger Problem
A wound that is not healing deserves attention, especially in an older adult with diabetes, poor circulation, swelling, or limited mobility.
Recognizing changes and seeking appropriate care can help families address problems before they become more serious.
Need Skilled Nursing or Wound Care nurse at Home?
Project Health Corp is a Medicare-certified, CHAP-accredited home health agency serving Northern Virginia.
Our skilled nursing team provides ordered wound care and other nursing services for eligible patients in the comfort of their homes.
Call 703-899-4109 to learn more about our services.
Visit www.projecthealth.us
Project Health Corp — Helping older adults stay safe, strong, and independent at home.