The very mention of a bruise might make us cringe, so it’s no surprise that catching a glimpse of an unsightly one on the hand or arm of an elderly loved one may cause us a bit of concern. At the Bronx Center for Rehabilitation and Nursing, we do all that we can to avoid and account for bruising on our residents, but the truth is that nature and time are against us. Unlike with younger people, it doesn’t take much force to break a blood vessel under the skin of an aging person, and the results are often much more visible when it happens. We find that better understanding the reasons for this often puts our minds more at ease.

As people age, the cells in their skin divide more slowly, and the skin begins to thin. It also retains less moisture, and both of these factors result in less protection from external force for the fragile blood vessels underneath. Routine bumps and pressures that we may not even register in our younger daily lives may now become causes of bruising. While we’re careful to be extra vigilant toward dangers to the aging, anyone is capable of accidentally bumping an arm or hand against a hard surface from time to time.

Bruising on the elderly frequently looks more severe than what we’re used to seeing in younger people. Thinned, drier skin is more translucent, giving us a better glimpse of what’s going on below the surface. Medications may complicate the issue by thinning the blood, which allows for increased bleeding and causes bruises to look larger and darker. Blood that does clot or partially clot may result in a hematoma.

While ideally it would be nice to avoid all bruising entirely, the more realistic approach is to accept that a small amount of bruising may occasionally occur and to try to avoid it whenever possible. Warm, soft clothing can be protective for aging skin, and proper positioning can help decrease pressure-related bruises. The greatest prevention measures are planning and caution. Try to devise mobility strategies for avoiding falls, and be wary of activities that involve even small amounts of impact.