Pressure Sores: Risks and Prevention

What is a pressure sore?

A pressure sore, also known as a pressure ulcer or bedsore, is an area of skin that has become irritated and damaged by constant pressure or force. Pressure sores are caused by lack of blood circulation to a certain area of the body, causing it to lose oxygen. Pressure sores have the potential to worsen and become very painful if they go unnoticed. Here are the four stages of pressure sores:

Stage 1 – During stage 1, the skin may be irritated and painful, but is not yet broken. The skin may feel warmer in the area of the sore and feel either softer or harder than the surrounding skin.
Stage 2 – Stage 2 of pressure sores is when the skin begins to open into an open wound. The sore now goes deeper into the skin of the individual, typically causing the sore to become more painful and more noticeable.
Stage 3 – In stage 3, the sore is now in the tissue beneath the skin, likely forming a crater-like wound in the skin. Fat may begin to show.
Stage 4 – In the final stage of pressure sores the wound becomes deep and has gone deep into the tissue, possibly causing damage to muscle and tendons. This stage may not be painful due to nerve and tissue damage but increases the likelihood of infection.

While anyone is susceptible to pressure sores, sores become more common in elderly individuals and people with limited mobility.

Here’s a brief list of individuals who are at high risk of suffering from pressure sores:

Limited Mobility – Individuals that are unable to move about while laying or sitting, or have any other movement restrictions, are more likely to suffer from pressure sores.
Poor Circulation – Poor circulation to certain areas of the body cuts off that areas oxygen and nutrients, increasing the likelihood of bedsores.
Lack of Communication – Pressure sores often occur in areas that are hidden by clothing, or in skin folds, and seniors, especially those suffering from dementia, may not say anything about them.
Incontinence – Incontinence, or inability to control one’s bladder and bowels, creates moisture and areas that are constantly damp are more likely to suffer from pressure sores.

It is crucial for caregivers to know the signs and symptoms of each stage of pressure sores so that they can be on the lookout for the wounds as they help wash, groom and dress the individual they care for.

Certain areas are more prone to pressure sores than others, especially for individuals with limited mobility. For example, if an individual is typically confined to a wheel chair, the most common places for sores to occur are shoulder blades, spine, back of the head or neck and back of the arms and legs. Similarly, those that are typically bed ridden will find that the hips, lower back, back of knees, and the back or sides of the head are the most common places for sores. Despite this, it is important to inspect all parts of the body for pressure sores.

Prevention of Pressure Sores

While pressure sores can be irritating, annoying and really painful at times, these sores are preventable. Here are some tips for ensuring that seniors do not have to suffer from the pain of pressure sores:

Caregivers should make sure the senior is eating a balanced diet, and drinking plenty of water to promote healthy skin.
Caregivers should do their best to ensure the individual is not moist or wet at any time, whether this is from sweating, incontinence, or anything else.
If an individual is in a wheel chair, caregivers should ask them to change position twice an hour, and help the get out of the chair every few hours to stretch and reposition.
If an individual is confined to a bed, caregivers should ensure the individual does not stay in one position for too long.
Avoid tight clothing that can make for damp conditions with a low flow of oxygen.

Pressure sores should be prevented to the best of the senior’s and caregiver’s ability. Although, there are times that the sores will persist, despite the caregiver’s best effort. If a caregiver notices sores on the senior they are caring for, they should contact a physician. Often, if the senior is confined to home, a registered nurse will come look at the sores and assess the best treatment.