Pressure sores are also known as decubitus
ulcers and occur in patients who have little or
no mobility allowing them to change positions
and relieve the pressure on the body.
Sores can develop over time and may be diagnosed
in “grades” of progression. Prevention is
the best method of dealing with anything that
compromises our health, but bedsores can be
alleviated efficiently when they are addressed
in early stages.
Muscles and fat pad the body, distributing
pressure in a more even fashion. Our
natural fidgeting from one side of the body to
another helps also. In folks who have
little or no “natural” padding, and who are
paralyzed or bedridden, the pressure is more
direct and wears away at the skin. Skin
can also become very strained when the bone
moves one way and the fleshy portion moves in
As we age, skin becomes thinner and prone to
breakage. If there is prolonged pressure
on an area, when the individual changes
position, the skin may “slip” and a small tear
Nerve impairment makes for diminished sensation,
and the individual may have difficulty assessing
whether a given area is more sensitive than
another. Over time, skin breakdown occurs,
unless someone is checking the skin at regular
Bedsores don’t just develop from the outside
route, although that is the main contributor.
External pressure that is consistent will leave
anyone with soreness, and even a mark. But
there is activity going on under the skin, too.
Circulation changes when pressure is applied,
which hampers the ability of the body’s tissues
to “bounce back” both literally and
If your loved one is less than mobile, or must
be in bed full time, you can monitor their skin
integrity. This will help in identifying
possible areas of skin breakdown, as well as
areas that have already become sensitive.
Your loved one may have at-home nursing care,
but if you are around for bath time, both you
and the home health aide should check together.
If your loved one is in a rehab facility or
nursing home, they will probably check for
bedsores on admission. This eliminates
their liability, and more importantly, allows
for aggressive treatment to reverse the
progression of the bedsore.
Keeping skin clean and dry is a “common sense”
option that may be difficult to do if your loved
one has any degree of incontinence.
Sanitary pants that wick away moisture can help,
as well as any prescribed medication that will
control incontinence that is due to muscle
spasms. The physician has to evaluate the
degree of incontinence before prescribing any
Staying mobile can be impossible for someone who
is confined to a wheelchair or bed, and that’s
where a trip to the medical supply store may be
in order. Caregivers can research for
products online that will offer physical support
with less pressure exerted on a single area.
Wheelchairs have come a long way since their
creation, and the options for seating are
numerous. Your loved one may have a
“basic” wheelchair for transportation, but you
can still look into possible additions that can
be purchased over the counter.
Again, prevention is always easier than
correction where health is concerned.
Proper nutrition which may include vitamin
supplements is also helpful. The body’s
ability to repair itself requires adequate food
and water. Individuals who don’t receive
proper nutrition can have problems with healing.
If your loved one has trouble getting the
correct amounts of food into them, look into
liquid vitamin supplementation, or ask the
doctor for a prescription for supplements.
Enzyme supplements help the body absorb what it
takes in, and may be useful also.
Position And Location
Bedsores can occur in a variety of points on the
body, most often where bone and muscle create
higher pressure “hot spots.” The hips and
spine are the two most mentioned areas, but the
back of the head, knees, ankles and heels are
other locations that are sensitive.
Areas of sensitivity vary with the areas of the
body that have pressure exerted on them, even
when “resting.” Padding the area can help,
whether this is with “homemade” solutions like
blankets or pillows, or with professionally made
Your loved one may need some guidance in
positioning themselves correctly. We all
have habits of sitting and lying down, and they
can be hard to break. As their caregiver,
you can utilize some psychology to assist them.
If you are incorporating a new item to help
support them, remind them that it is to help
them feel more comfortable. Work with them
to find the optimal position that relieves
pressure on an area, but still allows them to
relax in that position. Some of us are
used to “sitting sloppy,” or lying down with
arms and legs akimbo. Support behind the
knees or ankles may take getting used to, but be
comfortable in the long run. The medical
supply company, doctor and physical therapist
can help in educating you on the ideal
Individuals who are in wheelchairs often go to
regular clinic appointments to evaluate the
chair and pressure points. Make sure your
loved one attends regularly, if this is
Less “Pressure” For Caregivers
Bedsores can begin as areas of skin that are
warmer or more discolored compared to the skin
around it. No panic is necessary when you
see these, but action in the form of position
changing and addressing any core issues (like
incontinence) is required.
It’s true that bedsores can progress quickly and
become ulcerated, where the skin is very damaged
and may have to be surgically removed.
However, they need not get that way with
attention and intervention.
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