Bruising both arms symetrically

[Palerider]

I just want to ask if anyone has experienced bruising on both arms at the same level symmetrically plus a hand injury that can't be explained???

I'm asking because after nearly 30 years in the NHS myself I would be suspiciious of carer abuse, especially as I had to ask one of them to leave immediately.

Mum has revealed a thumb print bruise on both of her arms at the same level and a swollen painful knuckle in her left hand which is all new.

Can anyone offer a rational explanation before I feel obliged to report it???

 

[nitram]

I can't comment on carer abuse and knuckle/hand injuries

I can say that anytime my wife had BP measurement(s) any bruising on her arm(s) had to be recorded and explained.

 

[Palerider]

I can't comment on carer abuse and knuckle/hand injuries

I can say that anytime my wife had BP measurement(s) any bruising on her arm(s) had to be recorded and explained.

Thanks Nitram


Its very difficult. I wasn't happy when I was home with a visit over a week ago which is why I asked that particular carer to leave. She was on the verge of C&R, which is not permitted in someones own home and to be fair was completely unwarranted in any event. It could be a self injury, but I have only seen single sided bruising in self injury +/- same sided hand injury with falls

 

[LadyA]

Can't comment on abuse either, but I know that my late husband often bruised on both his upper arms, just from the slight pressure of me holding him to lift him out of chairs, bed etc. I also saw a horrendous bruise appear instantly on his hand one time, when a Care Assistant was gently washing his hands. She literally just gently wiped the back of his hand, and this huge black bruise just followed the cloth! She and I looked at each other open mouthed, and my husband looked at his hand and said "oopsies!". It hadn't hurt him at all. He wasn't on aspirin or blood thinners. It is just common in the elderly.

 

[Palerider]

I've been mulling it over, I won't act but I will take mum to the GP, we have to go anyway to check on the progess of her cellulitis, I'll point it out there on Tuesday. Having seen some hideous acts against the vulnerable as a nurse my mind does get carried away with itself....mum can't currently express any immediate concerns so we'll wait and see the GP

 

[Lawson58]

I am wondering if your mum is taking medication such as warfarin, though I am sure with your experience you have taken that into consideration.

My husband often has bleeds and bruises on his arms and hands and this is from years of taking blood thinners.
He has had massive nose bleeds and an internal bleed over the course of the last few years. He brushed against a brick wall and lifted an area of about three square inches of skin. He was always itchy and often marked his own skin with his constant scratching.

However, he has been having UV light treatment for the last three months and there has been a marked lessening of the bleeds and bruises on his arms.

But if you have concerns it needs to be followed through.

 

[Dunroamin]

Difficult to say as the elderly bruise easily often from compassionate handling. However discuss your concerns with the gp. Getting the bruising documented will help if anything untoward happens in the future. Make sure you keep a photograph fro your own records.

 

[Palerider]

Thanks everyone

I am reassured by all of your responses. This is one side of caring for your own as a professional that can be difficult...is ignorance bliss?

Anyway, we have seen the GP today she has explained the swollen knuckle which is in keeping with infective OA so again mum is on Abx. She could not explain the bilateral bruising on each arm at the same point and same size on each forearm (mum is not on blood thinners). Each bruise was consistent with a thumb print and we both couldn't understand how these were anterior (upward most) on her arms if she had knocked them or in some way caught them.

I agree it may be from friendly persuasion, though I have never heard of anyone grasping arms to 'friendly persaude' and neither has the GP. I feel that this is likely an oversight, having seen all of the carers they all good and I am generally impressed apart from one who is now no longer allowed to visit mum, I made sure of that.

I'll keep an eye, and hopefully there won't be a repeat

 

[Shedrech]

hi @Palerider
it's good that you have had a chat with your mum's GP
personally, I would also have a chat with your mum's carers ... you have noticed something and you are concerned, so why not discuss this with them ... it's not necessary to 'report' or 'complain' (unless you so choose) simply ask what/if they noticed and if they have any idea as to what has happened and when ... keep the chat calm and friendly, 'we're all looking after her together' style ... that way you may get an explanation that satisfies you, or one that worries you, and the carers know you are keeping an eye out but are also willing to discuss issues openly not merely seeking to 'blame'

you have some doubts, it would be sad to let them fester

 

[Spamar]

OH got the same marks and I took photos of them. When I came in that day, about 11:00, he had no sandels or socks on and his feet were blue! I ...er... made waves amongst all the staff and management - it never happened again.
Unfortunately lost the photos, accidentally dropped the camera overboard on a boat ride, but on the whole I’m glad those photos are not around for me to look at! I was absolutely livid, cos he was very compliant.

 

[Palerider]

hi @Palerider
it's good that you have had a chat with your mum's GP
personally, I would also have a chat with your mum's carers ... you have noticed something and you are concerned, so why not discuss this with them ... it's not necessary to 'report' or 'complain' (unless you so choose) simply ask what/if they noticed and if they have any idea as to what has happened and when ... keep the chat calm and friendly, 'we're all looking after her together' style ... that way you may get an explanation that satisfies you, or one that worries you, and the carers know you are keeping an eye out but are also willing to discuss issues openly not merely seeking to 'blame'
you have some doubts, it would be sad to let them fester

Hi Shedrech

I agree with your advice, and it has already taken place. I was very calm about it and I think there has been some 'reflective management' of the problem. I can understand this situation, these carers are not trained specifically in dementia and it can be hard to walk away without trying to help, I don't have a problem with that. I do however have a problem with mum who rarely bruises and when she does its one arm or one leg having knocked it. It would be very difficult to explain this as a self injury on both arms unless she somehow walked into something with her arms anterioly positioned (both) and also slouching slighlty so as to knock or bang her arms (both) on something that made those bruises on both arms the same size at the same level. To me and the GP agreeing, it is consistent with someone holding both arms, the pressure applied by thumbs. If the carer concerned had documented this in the care plan I would have been more willing to be more understanding, however she had not. What adds to my concern (not blame) is the fact that the week before I asked her myself to leave over concerns.

 

[Palerider]

OH got the same marks and I took photos of them. When I came in that day, about 11:00, he had no sandels or socks on and his feet were blue! I ...er... made waves amongst all the staff and management - it never happened again.
Unfortunately lost the photos, accidentally dropped the camera overboard on a boat ride, but on the whole I’m glad those photos are not around for me to look at! I was absolutely livid, cos he was very compliant.

I haven't made waves and I'm not sure your quite grasping the point. I don't worry if mum doesn't have her compression stockings on or socks on thats fine pwd do that. I don't worry about a single bruise on one side that is ill defined -means she's knocked herself against something and in general I don't have a problem with the carers at all or mums care -just one carer and one or two episodes of that particular persons attempt to try and help

 

[Spamar]

He had symmetrical bruising on both arms. He was also prone to cold because of poor circulation, especially to his legs, even after femoral stents and a femoral popliteal vein graft. All this was made perfectly clear to the home before he went in.

 

[canary]

It sounds like you have sorted out the problem @Palerider
Lets hope it doesnt happen again

 

[Palerider]

It sounds like you have sorted out the problem @Palerider
Lets hope it doesnt happen again

I think it won't. Hopefully lessons learned.

 

[Palerider]

He had symmetrical bruising on both arms. He was also prone to cold because of poor circulation, especially to his legs, even after femoral stents and a femoral popliteal vein graft. All this was made perfectly clear to the home before he went in.

I see your point, its difficult I know