Preventing pressure injuries at home: turning, cushions and skin checks

Pressure injuries, sometimes called bedsores, form when skin is pressed against a bed or chair for too long. They can start in hours and take weeks to heal. For someone who spends most of the day in bed or a wheelchair, a few daily habits prevent most of them.

Where they form

Pressure injuries form over bony places: the heels, ankles, knees, hips, spine, tailbone, elbows, shoulders and shoulder blades, the back of the head and the ears.¹

Check the skin every day

Look at the skin head to toe every day, especially those places.¹ Early signs are redness, warm areas, skin that feels spongy or hard, and broken top layers of skin.¹ Redness can be harder to see on darker skin, so feel for warmth and texture too.¹

Change position often

In bed, change position every one to two hours.¹ Don’t drag the person across the sheets; lift or use a draw sheet.¹ Keep the head of the bed at 30 degrees or lower when you can.¹ Use pillows or foam between knees and ankles and under the calves so the heels float, but not directly under the knees.¹

In a wheelchair, shift weight every 15 to 20 minutes by leaning forward and side to side.¹

Cushions and mattresses

Use a foam or gel cushion in a wheelchair, and a foam, gel or air mattress in bed.¹ Avoid donut-shaped cushions.¹ Make sure the wheelchair fits.¹

Keep skin clean, dry and fed

Clean the skin right away after any accident with urine or stool, and dry it well.¹ Use pads to absorb wetness, keep skin moisturized, and ask about protective creams.¹ Skip talc and strong soaps.¹ Eating enough calories and protein and drinking enough water help skin stay strong.¹

When to call

Call if redness or a skin change lasts more than a few days, or if a sore becomes painful, warm or drains pus.¹ A home health nurse can treat wounds, set up a turning schedule and help you get the right mattress or cushion.