Pressure point injuries or ulcers are commonly found on the skin due to constant pressure from lack of mobility or laying in one position for too long. They can occur when blood flow to that area of the body stops and cells eventually die, causing painful skin breakdown and open wounds. They can develop on the skin quickly sometimes within hours of little to no movement.

Once pressure point injuries develop, they can take a long time to heal, or some turn into a chronic wound that requires ongoing wound care. The ulcers can also cause potential infection with more serious complications like mental confusion, rapid heart rate or weakness. Those with chronic illnesses like diabetes and those who are undernourished are at greater risk. People who smoke or have fragile skin are also at greater risk for sores.

If found and treated quickly, pressure injuries should heal within a matter of weeks. But if left untreated, they can quickly worsen. Seniors are at higher risk because as skin thins, it loses elasticity and becomes more fragile with age. Family caregivers caring for elders who are bedridden or wheelchair bound must be particularly careful to prevent pressure ulcers from forming.

The Journal of the American Medical Association (JAMA) notes that the most common places for pressure injuries to occur are; the tailbone; back; heels; back of the head and elbow–all places where patients often don’t move when hospitalized. 

According to Cedars-Sinai Medical Center, there are four stages of pressure injuries:

Stage 1. The area looks red and feels warm to the touch. With darker skin, the area may have a blue or purple tint. You may feel that it burns, hurts, or itches.

Stage 2. The area looks more damaged and may have an open sore, scrape, or blister. You have a lot of pain and the skin around the wound may be discolored.

Stage 3. The area has a crater-like appearance because of damage below the skin's surface.

Stage 4. The area is severely damaged and a large wound is present. Muscles, tendons, bones, and joints can be affected. Infection is a large risk at this stage. 

Some pressure point injuries (bedsores) can be caused by the following:

• Being unable to move around easily due to old age or illness.
• Weight loss - you may have less padding over bony areas.
• Sliding down in a bed or chair - pressure on the skin cuts off blood supply because the skin is being pulled in different directions (called shearing) 

1. Change position and keep moving as much as possible, but at least every 2 hours.
2. Ask your caregiver to reposition you regularly if you can't move.
3. Use special pressure relieving mattresses and cushions.
4. Maintain a healthy weight.
5. Keep the skin clean and clear of bodily fluids.
6. Use foam wedges to relieve pressure on bony parts of the body.

To prevent painful pressure ulcers, movement is key. For people who are immobile or bedridden, it falls to their nurse or caregiver to make sure they get a chance to shift positions, move, have soft padding in wheelchairs or beds to reduce pressure; keep clean dry skin; and maintain a healthy diet. All these factors together with a good care team can keep skin healthy and in good condition. The most important prevention is keeping a close eye on the skin and knowing what to look for and when to take action or seek treatment.

Related links:

• Retrofitting a Home for Aging in Place