Bruises on forearm

[Loopyloo97]

My mother has vascular dementia and is in a nursing home and I haven’t seen her for two days I was shocked to see this on her forearm this morning , it doesn’t feel smooth the nurse said she scratches but before I jump the gun any ideas plesse ? she is on a cocktail of drugs

Does it disappear when a glass is rolled over it? It could be a rash from something she is allergic to x

Is she on warfarin?

I’d insist they call a GP to have a look at that.just to be sure

No it doesn’t disappear it looks like bruising , she’s on Apixaban

Funny thing is it’s only on one arm I just hope that she hasn’t been restrained in any way

If she is taking blood thinners she will bruise easily. Is she mobile? She could of knocked it on a door frame, bed rail, wheelchair arm etc. It's not necessary suspicious. Have staff recorded it in her notes?

Do they check her blood pressure? A bp cuff can cause this type of bruise.

I think if she had been restrained there would be more individual finger mark type bruises. If she is on blood thinners and repeatedly scratching one area this could cause bruising. It does look quite linear like long scratches. If her finger nails are relatively short she wouldn't necessarily break the skin.

My mum is bed bound these marks are only on one arm , I would hsve thought if it was meds it would be on both
I am worried as it feels rough

Oh the bruising is on her forearm I did mention it to a nurse yesterday but she dismissed it and said my mum scratches which I’ve never seen her do

Could she of bumped it on the sides of the bed? You should check when the bruise was first noticed as all marks on the skin should be clearly recorded and they should be accompanied with a body map. Even if it is unexplained.

The Apixaban will make her bruise incredibly easily, even from a BP cuff, scratching, catching it on a corner, even from washing with a flannel.

Is her skin quite dry? It is in most elderly people. That will cause itching and can be why it's bumpy. Try using an emollient cream on her skin.

It doesn't automatically look like a NAI if that's what you're thinking, as it's linear and doesn't appear like a grab mark. I have patients with skin petechiae like that from scratching, one arm only as for eg they are right handed and scratch the left arm as per your photo.

They also get marks like that on the shins from scratching, as well as the neck and face.

Thankyou Sidge that’s reassuring it looks awful , her skin isn’t really dry but I will put some emollient on it
My mum can’t speak for herself it’s so sad I’m worrying all the time

I understand, it's distressing seeing our loved ones so vulnerable. Dementia is a terrible disease

When you visit you could take some lovely body cream (as rich as possible, not lotions) and give her a hand and arm massage (and legs as well if you like). It can be great for the skin and also touch is very important in people with dementia, well most people really especially the elderly. Older people tend to only be functionally touched (eg lifting, moving, feeding, washing) and many will miss comforting touch.

Thanks again Sidge , I did look up Petechiae and the rash looks like my mums
I’ll be visiting her tomorrow so I’ll take some cream