Skin tears might seem like minor injuries at first glance, but for older adults living in nursing homes, they can be a big deal. These wounds are caused by friction, shear, or even the removal of medical tape. They can lead to infections, pain, reduced mobility, and other health complications.
Skin tears are more common than you might think and are often the result of nursing home neglect. Now, thanks to a new study, we’re starting to understand which residents are most at risk and how we might stop these injuries before they happen.
Why are skin tears such a concern in nursing homes?
As people age, their skin naturally becomes thinner, drier, and more fragile. This makes it easier to tear and harder to heal. Add in chronic conditions, cognitive impairments, or the need for help with everyday tasks, and it’s clear why skin tears are so common.
These injuries happen most often on the arms, especially the forearms, and they’re not just uncomfortable. They can lead to serious infections, chronic wounds, or hospitalization. On top of that, they require time-consuming wound care. Plus, they can limit a resident’s ability to move or participate in activities.
What did the new study find out?
A team of researchers in Berlin, Germany, wanted to get a clearer picture of what causes skin tears in nursing home residents. They looked at data from 101 residents aged 65 and older. That included tracking their health and care needs over a 12-week period. Nearly 19% of them developed at least one skin tear during that time.
The researchers weren’t just interested in counting injuries. They wanted to understand why these tears happened and who was most at risk. So, they examined several factors such as medication use, skin conditions, and mobility levels. The ultimate goal was to build a model that could help predict who might be in danger of developing a skin tear so caregivers could take action early.
What risk factors stood out the most?
After analyzing the data, the study highlighted four key risk factors that made residents more likely to develop skin tears:
- Low body mass index (BMI): Residents with a lower BMI were more likely to experience skin tears. That’s likely because thinner individuals have less fat and muscle to cushion the skin, making it more prone to injury.
- Corticosteroid use: Regular use of corticosteroid medications was also linked to a higher risk. These drugs can weaken the skin over time, making it more fragile and slower to heal.
- Lower functional independence: Residents with lower scores on the Barthel Index—a tool that measures how much help someone needs with daily activities—were at greater risk. This makes sense: people who need more assistance are often moved, lifted, or repositioned more often, increasing the chance of friction and shear injuries.
- Dry skin on the legs (xerosis cutis): Dry, flaky skin lacks the elasticity and moisture needed to resist tearing. Residents with noticeable dryness on their legs were more vulnerable to skin tears during routine care like bathing or dressing.
Other research has flagged additional concerns, such as a history of previous skin tears, frequent falls, bruising from sun-damaged skin (known as senile purpura), and taking multiple medications (polypharmacy). The researchers noted that they didn’t have access to every possible data point, so there may be other important clues that future studies can build on.
How reliable is the predictive model from the study?
The model developed in this study showed strong performance in identifying at-risk residents. It had a solid balance of sensitivity (how well it caught true cases) and specificity (how well it avoided false alarms). In technical terms, the model had an area under the curve (AUC) score of 0.823, which is considered good.
Of course, like any model, it isn’t perfect. It still needs to be tested in other settings and with larger groups of residents. But as a starting point, it’s a valuable tool for helping nursing homes focus their prevention efforts where they’re needed most.
What can nursing homes do to prevent skin tears?
The good news is that some of the biggest risk factors identified in the study are manageable or even preventable. Here’s how nursing homes can turn this research into better care:
- Moisturize: Daily use of emollients on dry legs can help maintain skin integrity and reduce the risk of tears. This is a low-cost, high-impact intervention.
- Review medications: Residents taking corticosteroids should be closely monitored. If possible, care teams could consider alternatives or added skin care precautions.
- Monitor underweight residents: Nutritional support could help raise BMI and improve overall health, which in turn may protect skin from injury.
- Use gentle handling techniques: For residents with limited mobility or low Barthel Index scores, caregivers should be trained in low-friction transfer methods and use equipment like slide sheets to reduce trauma.
When skin tears point to neglect, not just risk factors
While research helps identify who’s most at risk, the root problem in many nursing home cases isn’t just fragile skin — it’s a failure to provide appropriate care. When staff ignore obvious warning signs, skip skin checks, rush through hygiene routines, or fail to follow basic protocols like moisturizing and safe handling, that’s not an accident. It’s neglect.
Facilities have a duty to adjust care based on known risk factors. If a resident is underweight, immobile, or on medications that weaken skin, the nursing home must act accordingly. Skin tears may start as preventable injuries, but when they’re ignored or allowed to worsen, they can become a clear sign of systemic failure — one that leaves residents in pain and families demanding accountability.
Our Chicago lawyers fight for families when care facilities fail in their duty
If your loved one was neglected in a nursing home, you don’t have time to wait, and neither do they. The Chicago nursing home abuse and neglect lawyers at Ferrell Young, LLC, understand how heartbreaking it is to discover that the people entrusted with your family member’s care failed in their most basic duty. Don’t let the facility sweep it under the rug. You have the right to demand answers, accountability, and justice.
Our legal team has stood up to negligent nursing homes across Chicago and beyond. We know their tactics, and we know how to fight back. With decades of experience handling elder neglect cases, we’ll dig deep, build a strong case, and push for the compensation your family deserves. Most importantly, we’ll give your loved one a voice and the respect they were denied.
Contact us today for a free, confidential case evaluation. There’s no pressure and no obligation to hire us; just straight answers from a legal team that puts families first.
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