How to Prevent Pressure Ulcers in Bedridden Patients

Bedsores, also known as a pressure ulcer, pressure sore, or decubitus ulcer, occur when seniors are immobilized and confined to bed for a prolonged period of time. Unrelieved pressure on specific areas of the body can result in an injury that causes skin breakdown and an open sore. Bedsores typically form over a bony area such as the back, tailbone, buttocks, hip, heels, elbows, and shoulders.

If left untreated, bedsores can require surgery and result in complicating health conditions including sepsis, bone and joint infections, and even cancer.  Studies have found decubitus ulcers account for 34,320 deaths annually. In addition, pressure ulcer treatments total over $11 billion in hospital costs each year.

Preventing pressure sores among bedridden elderly patients is a major concern for healthcare providers and caregivers. Here are ways to prevent this potentially deadly medical condition:

• Reposition the person every 2 hours, at minimum. Older persons who remain in bed need to be turned to avoid prolonged pressure on the body. When helping the person move in the bed, use a lifting device such as a Hoyer lift or lifting sheet to avoid dragging the person’s body on the sheets and causing excess friction on the skin.

• Record the time that you turned and positioned the person in addition to other observation about the person’s care. Caregivers should use a tool to document if the person is eating and drinking properly among other daily  critical care points.

• Use pressure-reducing aids such as cushions, mattresses, beds, booties, and elbow pads to reduce pressure on the skin. Cushions that contain foam, gel or air are particularly effective. Do NOT use any donut type devices because they create uneven pressure that can lead to pressure ulcers.

• Position the head of bed to be as flat as possible. Elevating the head at an angle forces the body to slump down deeper into the mattress, causing potentially damaging shearing force on the skin.

• Perform a daily skin inspection to identify vulnerable areas. Look for signs of redness in areas where bedsores are more likely to occur: bony areas including the buttocks, tailbone, knees, shoulders, hips, and ears.

• Make sure skin is kept clean from dampness and perspiration, which can accelerate breakdown. Clean the skin with mild soap and warm water. Avoid products that contain alcohol, as they will dry the skin. Do not rub hard, but use gentle strokes when cleansing the person. Pat dry with a soft towel.

• Lubricate the skin with body lotion. Use talcum powder on areas where moisture is likely to develop, such as under the breasts or armpits.

• Change bedding immediately if it becomes wet. Wash, rinse and dry all linens. Opt for sheets that are wrinkle-free and softened.

• Monitor fluid intake. Adequate hydration is critical for skin health. The average person needs to consume at least eight glasses of water per day. Pay attention to signs of dehydration such as darker urine, dry mouth, and constipation.
• Maintain a nutritious diet. Encourage the person to eat a protein rich diet. A physician may prescribe dietary supplements such as nutrition shakes, omega-3, and zinc. Make meal time a happy experience and make sure to document if the person if eating their whole meal or refusing portions.