If you are a senior who has noticed yourself bruising more easily, or if you’re caring for a senior who seems to bruise more easily than they used to, it’s common to be concerned. First and foremost, you likely want to know: Why do older people bruise easily? You may also be wondering if this increased bruising is normal or something serious to worry about.
“Caregivers and older adults often worry when they see bruises,” says Jung Baccam, board-certified family nurse practitioner at Atlas Ketamine. Besides the concerns about whether the bruising might indicate something more serious, there’s also the emotional side, Baccam adds. “Bruises are visible reminders of aging or vulnerability, and that can be upsetting.”
Thankfully, most of the time, increased bruising is nothing to worry about, and it primarily occurs because of changes that happen to the skin during aging, according to Baccam. Still, there are some instances where bruising is cause for concern. Here’s what to look for and how to prevent serious bruising as well as other injuries in seniors.
“As people age, the adipose tissue (fat layer) under the skin gets thinner, reducing the cushion that protects the body from bumps.”
— Jennifer Conlan, registered nurse and regional director of resident care, Waltonwood Senior Living
Why do older people bruise easily?
The number one reason why seniors bruise more easily is because of changes in skin, fat tissue and other bodily systems, says Jennifer Conlan, a registered nurse and Waltonwood Senior Living’s regional director of resident care.
“As people age, the adipose tissue (fat layer) under the skin gets thinner, reducing the cushion that protects the body from bumps,” Conlan explains. Additionally, as we get older, we produce less collagen and fewer blood vessels. “All of this combined makes the skin very thin and fragile, causing even the slightest bump to cause a bruise when in the past it may not have.”
It’s not just bruising that becomes more common as we age. Thinning skin can also lead to skin tears and other injuries. “Skin impairments heal much slower in elderly skin than in youthful skin because the regenerative processes in the skin, such as cell turnover and collagen production, slow down with age,” Conlan describes. Lastly, tears in the skin can be infected if left untreated, and seniors are more prone to these infections.
Causes of age-related bruising
Age-related bruising has several causes. Let’s look at the most common causes of bruising in older adults.
Medications
The medications seniors take may make them more susceptible to bruising, says Dr. Taher Saifullah, pain management specialist and founder of Spine & Pain Institute Los Angeles.
In particular, blood thinners like aspirin and warfarin may increase instances of bruising. “These drugs help prevent blood clots, but they also make it harder for the blood to clot when a blood vessel is injured,” Saifullah explains. “As a result, seniors on blood thinners often bruise more easily.”
Medical conditions
Certain medical conditions can affect your body’s ability to heal after even a minor injury, says Baccam. “For instance, diabetes can impair circulation, meaning injuries take longer to heal,” she explains. Additionally, liver problems can impact clotting factor production.
“For older adults, these health issues often come together, making them more prone to bruising with everyday activities,” Baccam describes.
Changes in mobility
Changes in mobility as we age can cause us to become injured more easily, leading to increased instances of bruising, Conlan shares. As we age, we may not move as easily as we once did and we may become unbalanced more often, she says. “It is common to lose balance or ‘furniture walk’ — leaning on furniture for balance or stability — which makes it easy to bump into door frames, walls or furniture.”
Factors like increased falling also contribute to more frequent bruising. Finally, learning to use new equipment — like walkers and wheelchairs — can lead to more injuries, as seniors may be less aware of the boundaries of their bodies, Conlan explains.
Accidental vs. intentional bruising: How to spot the difference
While increased bruising in seniors can be normal due to bumps or minor accidents, it’s common to wonder when bruising may be a sign of something more serious, such as intentional bruising or elder abuse.
Accidental bruises
“Accidental bruises are usually found on bony areas — arms, legs or knees — where bumps or falls are more likely to happen,” says Baccam. “They’re often irregular in shape and spread out over time as they heal.”
In most cases, you can determine the cause of accidental bruising by reviewing the senior’s daily habits, says Conlan. “For example, if they propel themselves with a wheelchair, bruising on the hands and arms is very common as they may bump them when going through doorways,” she describes. “If the wheelchair has foot pedals, bruising on the lower legs is common as they bump the footrests while propelling.” You can remove the rests if they are not being used or if the person uses their feet to propel themselves, Conlan advises.
Intentional bruises
Intentional bruises typically look different than accidental bruises, says Baccam. For instance, they may show patterns like handprints, finger marks or the outline of an object like a belt. Additionally, you will usually find these bruises in unexpected places, like the neck, back or inner thighs.
“Spotting elder abuse can be heart-wrenching, but it’s so important to stay vigilant,” Baccam shares, emphasizing that you should do some investigation if you see unusual bruises. As yourself questions like:
- Is the senior suddenly more fearful or withdrawn?
- Do they seem hesitant to speak when certain people are around?
- Does the caregiver’s story match the injury?
- Have the injuries happened repeatedly?
If you notice any red flags, you should take action right away, Baccam says. “It’s OK to trust your instincts and ask questions,” she says. In some cases, you may need to remove your loved one from this caretaker’s care. You can call your local adult protective services line or 911 to report suspected abuse.
Ways to prevent elderly skin bruising
There are several key methods for preventing bruising — and injuries overall — in seniors. Here’s what to know.
Fall and accident prevention
Preventing bruises and other injuries begins by creating a safe environment. “Fall-proof the home by removing loose rugs, adding non-slip mats in the bathroom and making sure there’s plenty of lighting,” Baccam suggests. Handrails and grab bars in places like bathrooms can make a difference for stability.
Finally, “encourage gentle activities like yoga or tai chi to build balance and muscle tone, which can prevent falls altogether,” Baccam recommends.
Dietary tips
“A healthy diet can strengthen the skin and blood vessels,” says Saifullah. Here are his recommendations of nutrients to increase in your diet:
- Vitamin C: from foods like citrus fruits, strawberries and bell peppers. It aids in collagen production, which can help strengthen skin.
- Vitamin K: from foods like leafy greens. It helps support blood clotting, which may help reduce bruising.
- Iron: from foods like spinach, beans and red meat. It may help you heal faster from bruises.
Review medications
Baccam suggests going over any medications you take with a healthcare provider. “Sometimes, adjusting dosages or switching medications can reduce bruising risks,” she says. In particular, blood thinners may make you more susceptible to bruising.
“If a bruise is unusually large, painful or appears without any clear reason, it could signal something more serious, like a clotting problem or even a side effect of medication.”
— Jung Baccam, family nurse practitioner, Atlas Ketamine
When to see a doctor about age-related bruising
Again, bruising in seniors is common, and most of the time, the bruises are harmless. Still, there are times when it makes sense to contact your medical provider.
“If a bruise is unusually large, painful or appears without any clear reason, it could signal something more serious, like a clotting problem or even a side effect of medication,” says Baccam. “If bruises are accompanied by other symptoms — like fatigue, unexplained weight loss or frequent nosebleeds — it’s worth getting checked out.”
If you have any concerns about bruising, you shouldn’t hesitate to reach out to your provider. And of course, if there’s ever a concern about elder abuse or unexplained injuries, you should seek expert care right away.
The bottom line
Dealing with health concerns can be stressful, especially for seniors. But simply being aware of these concerns and searching for solutions shows that you care.
“Caring for older adults requires a mix of compassion, vigilance and education,” says Baccam. “While bruising can seem like a small issue, it’s often an opportunity to have deeper conversations about health, safety and well-being.”
If you are ever unsure or have concerns about your own health or the health and well-being of a senior you love, you shouldn’t hesitate to reach out for help, Baccam emphasizes.
