A reddened area on the tailbone, heel or hip bone may be the first sign of a pressure ulcer. It deserves attention, even if it initially seems small and there is no visible open wound. This guide to pressure ulcer prevention at home explains how family caregivers, people in need of care and community care providers can prevent pressure damage early and incorporate suitable aids into everyday life.<\/p>\n
A pressure ulcer, also called a bedsore, develops when the skin and underlying tissue are pressed against a hard surface for a prolonged period. Blood flow is restricted, cells receive too little oxygen and can become damaged. Areas of the body where bones lie close beneath the skin are particularly at risk: heels, ankles, knees, tailbone, sitting bones, hips, shoulder blades, elbows and the back of the head.<\/p>\n
However, pressure alone does not explain every pressure ulcer. Shearing forces also play a role, for example when someone slides down in bed or is pulled across a seat while being transferred. Moisture from sweating, incontinence or wound drainage softens the skin. Malnutrition, dehydration, circulatory disorders, diabetes, sensory impairment and certain medications can further increase the risk.<\/p>\n
Limited mobility does not automatically mean a high risk of pressure ulcers. The overall situation is what matters: Can the person change position independently? Can they reliably feel pressure or pain? What is the condition of their skin? If immobility develops after surgery, a stroke or an acute illness, the risk should be assessed early.<\/p>\n
Skin checks should be a regular part of the daily routine. Examine areas at risk in good lighting, preferably in the morning and evening, as well as after prolonged periods of lying or sitting. Look for localized redness, hardening, warmth, swelling, blisters, weeping areas or pain. Redness is not always clearly visible on darker skin. Other signs may include a change in skin color, a shiny appearance, warmth, hardness or tenderness to pressure.<\/p>\n
A practical test for lighter skin: briefly press a finger on the reddened area. If it does not turn pale, this may indicate non-blanchable redness. The area should then not be subjected to further pressure. Do not rub or massage reddened areas. This can cause further damage to tissue that is already at risk.<\/p>\n
Seek medical advice promptly if there is non-blanchable redness, a blister, open skin, increasing pain or fever. People with diabetes, circulatory disorders or reduced pain sensation should have any changes assessed by a medical professional as early as possible. An existing pressure ulcer requires professional wound care and an individualized pressure-relief plan.<\/p>\n
Pressure relief is the most effective measure. Anyone who is able to should be encouraged to make small, regular movements: change position in bed, shift their weight in a chair, move their feet or briefly stand with support. Small, frequent movements are often more realistic and gentler than infrequent, strenuous attempts to mobilize.<\/p>\n
For people who cannot reposition themselves, positioning should be planned individually. A rigid schedule based on the clock does not work for everyone. Skin condition, mobility, pain, sleep quality, mattress type and time spent sitting all determine how often pressure needs to be relieved. Qualified nursing staff or the treating physicians can establish a suitable repositioning schedule. At night in particular, a balance must be struck between necessary pressure relief and restful sleep.<\/p>\n