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How to Detect and Prevent Bedsores

Bedsores are also called pressure ulcers and decubitus ulcers. They are injuries to the skin, and the tissue under the skin, caused by prolonged pressure on an area of the body.

Who Is at Risk for Bedsores?

Seniors (and younger disabled people) are at risk for bedsores if they spend most of their time in a bed or chair, particularly if they are limited in their ability to change positions. Wheelchair users are also at risk of bedsores.

Increased risk can also be caused by:

  • Incontinence, in areas where skin might be exposed to urine and/or stool.
  • Lack of sensory perception, such as in individuals with a spinal cord injury.
  • Poor nutrition and hydration.
  • Medical conditions, such as diabetes and vascular diseases, that can affect blood flow.

Bedsores can be caused by friction or shear as well as pressure, such as the skin rubbing against clothing or bedding, or sliding downwards in an adjustable bed.

Where Are Bedsores Most Commonly Found?

People most commonly get bedsores in areas of the body affected more by pressure and where the skin is tighter over the bone. This might include the hips, lower backs and tailbone, back or sides of the head, heels, ankles, shoulder blades, and skin behind the knees. If checking somebody for bedsores, prioritize these problem areas.


Bedsores generally pass through four stages. This means that untreated bedsores will generally progress. The symptoms at each stage are:

  1. Stage 1. Pain, burning, or itching. An area that feels firmer, softer, or a different temperature from surrounding skin. The skin may be red, although that can be harder to see on dark skin. If unsure, press on the spot. If it does not get lighter when you press on it, it's probably a bedsore.
  2. Stage 2. Broken skin that looks like a large blister. The area is warm, swollen, and/or red. The sore is typically painful and may produce pus or clear fluid.
  3. Stage 3. The sore looks like a crater and may smell bad. The edges may be red and the sore likely oozes pus or drainage. There may be black tissue in or around the sore.
  4. Stage 4. The skin has turned black and has red edges, pus, odor, and drainage. Tendons, muscles, and bones may become visible in the sore.

As you can see, you want to catch bedsores early.

Treating Bedsores

As with symptoms, the treatment is different at each stage.

  1. Stage 1. Change your or the person's position so they are not lying or sitting on the sore. If this is not feasible, such as sores caused by a wheelchair, add padding. Wash he sore with mild soap and water. Drink plenty of water and increase intake of vitamins A and C as well as iron and zinc.
  2. Stage 2. Follow the same steps, but also clean the wound with water or a salt-water solution and dry it gently. Keep the sore covered with moist gauze or a see-through dressing. If you see pus or redness or have a fever, call your doctor.
  3. Stage 3. Call your doctor. Likely they will remove any dead tissue and prescribe antibiotics.
  4. Stage 4. Call your doctor right away. A stage 4 bedsore needs immediate attention and may require surgery or skin grafts.

Preventing Bedsores

The best way to "treat" bedsores is to prevent them from happening in the first place. There are a number of things you can do to prevent bedsores from developing.

These include:

  • Reposition a bedbound person every two hours.
  • Make sure the person drinks plenty of water and fluids.
  • Make sure they have a healthy diet, as much as possible. Use supplements if needed.
  • Bathe regularly and keep the skin clean and dry.
  • Ensure that if they are using a wheelchair they have good posture, sitting upright, and changing position regularly. Wheelchair users who are able to do so should do wheelchair pushups every so often, raising their body off the seat by pushing on the arms of the chair.
  • Use padding as needed to reduce pressure.
  • Inspect the skin every day for areas of redness, especially on bony areas.
  • Don't elevate the head of an adjustable bed more than 30 degrees.
  • Use moisture barrier creams on areas of the skin affected by incontinence.
  • Change bedding and clothing frequently and make sure bedding is not wrinkled.


A home health aide can make sure all of these things are done, helping your loved one bathe and checking them frequently for bedsores. Having a home aide can help keep your loved one from getting bedsores and other problems while making your own life easier. Are you interested in learning more about home health care services? Call us today and we'll be glad to 

Written by: Leah Ganz
Director of Patient Services

Leah Ganz, RN, BSN is the Director of Patient Services at Elite Home Health Care. She has an extensive background in homecare and previously worked in various specialties including pediatrics, pain managemnet and internal medicine. She oversees allpatient services across Elite's departments.