Bedbugs - A Health Issue For The Elderly

The existence of bedbugs can be traced back to bats who inhabited the caves of the Middle East. When man began to inhabit the caves, the parasites moved from the bats to the human hosts and hence began the bedbug problem.

Colonists coming to the new world brought bedbugs with them where they thrived in the close quarters and straw bedding. Early 18th century writings tell of bedbug infestations in Canadian and English settlements. There are also shipping logs that speak of bedbug infestations inside ships that were so horrific sailors refused to sleep below deck.

By the beginning of the 20th century, most Americans had seen bedbugs or been bitten by one. These creatures were considered one of the top three pests that invaded homes and businesses at the time – trailing only rats and cockroaches.

Then by the early 1940s, their numbers began to diminish and just ten years later, scientists had a difficult time finding any thriving populations to continue research.

Entomologists theorized that the chemical DDT, which was being used to kill cockroaches, termites and other insects, had actually killed off America’s bedbugs.

Then in 1972, DDT was banned due to a number of health concerns however the bugs were still difficult to find and this country’s top health officials felt this parasite had been eliminated. But things changed in the 1990s.

First appearing in the “gateway” cities of Miami, New York, San Francisco and Los Angeles, bedbugs began to appear in large numbers once again. By the late 1990s, these cities experienced extreme infestations, first in motels and rooming houses and then expanding into the densely populated inner-city housing developments. From there, they began to show up in premium hotels, hospitals, and nursing homes. Today, these insects have reached levels of infestation never before seen in any culture.

Social scientists and entomologists have several theories for this resurgence including mass immigration, less use of pesticides and even the bedbug’s development of a resistance to the current crop of pesticides being used to control them. Whatever the cause, bed bugs are now found in nearly every setting from homeless shelters to five-star hotels and present a major health hazard for everyone but especially for America’s seniors.

The bedbug itself varies in size, and in color, from a red-brown to a light brown. Adult bed bugs are 1/4 inch, or about the width of a pencil and they move quickly. Bed bugs are active at night and have been shown to be able to travel over 100 feet in a night but tend to live within 8 feet of where people sleep.

When checking an area for bedbugs, bedsheets and mattresses often have small spots which resemble human blood. Although human blood may be present from the scratching of the skin due to the bedbug’s bite, the small spots are actually the fecal material of the parasites.

They also can be detected by smell. They secrete odors with the smell characteristics of over-ripe raspberries, almonds or the herbs coriander and cilantro. Pest control companies in larger cities have trained dogs to detect these smells when trying to pinpoint large infestations. Remarkably, the animals are said to have a 97.5% accuracy rate in tracking down the bugs.

Bed bugs feed by biting the skin of its host for a blood meal. After feeding, they can increase in size by nearly half and double in weight. Living nearly a year, these insects can lie dormant for months without a meal while awaiting the next victim to come along.

These insects are also quite prolific as the female bedbug has the ability to lay 200-500 eggs within two months of birth. The females lay eggs in the seams of mattresses, box springs, bed frames, headboards, dresser tables, inside cracks or crevices, behind wallpaper, or any other clutter or objects around a bed. The eggs appear tiny, white and are hard to see without a magnifying glass.

The bite of a bedbug can cause many health symptoms including skin rashes, pruritic papules, and nodules associated with allergic reactions. Research has also found that bed bugs carry multiple bacterium, viruses, protozoa and parasitic worms. The bedbug has also been found to harbor Hepatitis B and even HIV within their digestive tracts for several days but these pathogens have not been detected in their feces and there exists no hard evidence of any transmission of these viruses due to the insect’s bite.

Those who experienced frequent bites may also develop physiological changes including disturbances of the lymphatic system and in some cases, enlargement of the spleen. Extended exposure for both small children and the elderly can result in major blood loss and anemia.

Many I have spoken with about this issue were surprised to learn that cleanliness is not a preventative against these insects. These bugs can find their way into the cleanest home on the pants or socks of a person who could pick them up while riding a bus, cab or even waiting in a doctor’s office.

Most people never feel the bite of a bed bug, which can take as long as 10 minutes per occurrence. To make matters worse, a variety of studies indicate that not every person has the same reaction to bed bug bites. For some, the bite wound occurs quickly. Some people will experience itching within a few days. Some people may not begin to itch until two weeks later. Some people will not suffer any itching or subsequent swelling which is one of the reasons that bed bugs are able to spread like wild-fire.

Studies have shown that elderly people often do not react to the bite of bed bugs. There is no clear answer as to why this is the case but it is suspected that medications that seniors take, such as corticosteroids, may suppress their body's response to allergens making their immune systems less responsive than someone younger.

Although a bed bug bite may not directly kill an elderly person, a case in Pennsylvania last year raised awareness of the threat bedbugs pose to the elderly.

A 96-year-old Hanover Pennsylvania woman named Mary Stoner died last February from sepsis, a blood infection caused by untreated wounds. Her caretaker, Deborah Butler, was charged with manslaughter in Ms. Stoner’s death.

Butler once ran a licensed home care facility where Stoner lived that subsequently went out of business. When this happened, Butler took over the care of Stoner and another woman in her home. Within months, Stoner’s family noticed that her health was rapidly declining and took her to an emergency room for treatment. While there, ER doctors found numerous sores on her skin, a bad rash covering about half of her body, and a skin infection that was determined to be caused by bed bug bites.

She was discharged a week later, according to the local newspaper the York Dispatch, and readmitted with pneumonia and eventually died. She had been in Butler’s care for more than ten years prior to her death.

What exactly makes seniors especially vulnerable to bedbug infestations? Here are a few things to consider:

  • Studies show that as many as one-third of people show no reaction to the bite of the bug even when repeatedly bitten. This number is much higher among seniors making it much easier for the infestation to occur therefore a lack of bite trauma is not an indication that bedbugs do not exist. And for some seniors, even though they see these bugs at night, they become apathetic given a lack of any physical signs.

  • Apathy may not be the reason for all cases of ignoring the presence of these parasites. When some enter old age, they become less caring about their appearance and tend to ignore cuts, scrapes and skin lesions. They simply stop caring. So, if you have an elderly family member, check them on a regular basis.

  • On the opposite side of the spectrum, some seniors are quite embarrassed by knowing there are bedbugs in their living situation. When the bite marks appear, the become quite concerned about what people will think of them. Unfortunately, there does exist a stigma that bedbugs only happen to dirty people and dirty homes. If you notice that an elderly loved one has welts on their skin, look into this.

  • While bedbugs don't solely occur in those homes that are dirty, there is a connection between clutter and bedbugs. These creatures have a much easier time infesting a home that is cluttered especially if the items are around a couch or a bed. People who have lived a full life often have accumulations of personal items that can make them susceptible to bedbug infestations.

  • Temperatures also play a role in bedbug infestations. The elderly often keep their homes warm, often warmer than younger people feel is comfortable. These high temperatures speed up bed bug life cycles and can result in higher bed bug populations. Higher temperatures also increase the potency of insecticides, causing them to break down faster and reducing the length of time they remain effective.

And one other thing to mention, bedbug infestations can also occur due to stubborn pride. Our elders come from a time that highly valued independence and self-sufficiency. Although they may know a problem exists, they will refuse to talk about it or reject help for fear of losing their freedom.

Earlier in this blog, I mentioned that bedbugs have been found in all facilities including hospitals, nursing homes, and senior centers. I want to stress that the cleanest facility is subject to bed bugs despite the overwhelming precautions they take against them. The staff at these facilities have no idea what the next ambulance may be bringing to them.

I spoke with an administrator of several treatment programs on the Southcoast of Massachusetts and at a hospital in Boston where bedbugs found their way in despite an abundance of precautions being taken.

In one case, he told me of a program where bedbugs were found in mattresses and wooden headboards. At a cost of tens of thousands of dollars, all bedding was replaced as well as carpeting, cabinets and bedside furniture. The building was also treated by a professional company. After moving the patients back in, they were being bitten again within weeks. After evacuating the building, a closer inspection found that these creatures had found their way behind wall panels and when these panels were removed, tens of thousands of bugs were found. Eventually, the building was treated and no additional problems were reported.

While working at a hospital in Boston, he reported that a very strict bedbug protocol was in place. All patients entering the facility were placed in a hospital gown immediately and received a close medical evaluation. All clothing was removed and immediately placed into plastic bags for treatment. Despite these precautions, bedbugs still found their way into the building and upon investigation in one case, it was found that a patient who came in with a portable oxygen machine brought the parasites with her inside the device. He also stated that bedbugs were found inside the spines of books, in purses and behind photos in frames that sat by a bed or couch.

Unfortunately, it is impossible to provide 100% protection against bedbugs given that we live in an area of the country where bedbug infestations are out of control. Orkin, an insect treatment company, points out that the Northeast corridor of our country is in the midst of a major bedbug outbreak with the cities of Boston and Hartford-New Haven in the top fifty of nationwide cities with serious bedbug problems and infestations.

I want to reassure families that the overwhelming majority of hospitals, nursing homes, assisted living residences, senior centers, and senior housing programs are clean, sanitary and meet or exceed state requirements. However, their control over the bedbug issue is limited as visitors, vendors and new patients can bring them in at any time. So, if you hear that a bedbug problem has been found, don’t judge the facility based on this, evaluate them on their response to the problem.

In cases where you find bedbugs in the home, it is recommended that you hire a professional pest control firm to address the issue. They know where to look and what to look for and will use approved pesticide to treat the location. Infected items like mattresses or upholstered furniture must be discarded or treated.

Some of the methods used by professionals include:

  • Heat and/or cold treatments for the entire residence or a single room

  • Steaming or using high-powered vacuums on mattresses, beds and other surfaces

  • Closing off spaces/cracks and other hiding places with a silicon-based sealant

  • To protect yourself from bedbugs returning it is suggested that you

  • Use plastic covers on mattresses and pillows

  • Wash clothing, sheets in hot water and detergent

Above all, do not try to treat bedbugs yourself. Seniors are more likely to have medical problems that make them more susceptible to the effects of insecticides such as bronchitis and emphysema. Those with breathing problems are more affected by airborne irritants such as certain pesticides and the additives used in pesticide products.

I hope this blog provides some insight into the issue of bedbugs and seniors. If you are a senior, be aware of bites or signs of infections on parts of your body. If you have a loved one in care and are concerned about signs you are seeing, speak up and let the floor staff or the administration know and in the overwhelming majority of the cases, they will respond quickly and professionally to correct the situation.

In situations where you suspect senior abuse or neglect is occurring and not being addressed appropriately, Connelly Law Offices can help. Contact us at 401-724-9400.

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