How to Treat Bed Sores in Elderly? Causes & Prevention!

Older adults are usually at risk of wide-ranging health problems ranging from cognitive decline, reduced muscle strength, poor balance, and gait. The risk factors and probability of occurrence of these conditions vary from one person to the other. However, nearly all seniors are usually at risk of developing bedsores, commonly known as pressure sores. These occur when pressure builds up in a specific body part, compromising the skin’s integrity over time. This guide will look at the main causes of these sores, prevention, how to treat bedsores in the elderly, and stages.

What are Bed Sores?

Bedsores, also known as pressure sores [1] or decubitus ulcers, are injuries to the skin and its underlying tissue caused by a pressure build-up on the skin. Most time, these sores develop on skin parts that cover the body’s areas such as the tailbone, hips, ankles, and heels. Typically, the people most prone to bedsores are those who have difficulties adjusting positions when in bed. These sores can develop in days, and at times, hours. In terms of treatment, some mild sores heal by themselves, but more serious ones need medical attention.

When an older person is immobile, bedridden, or has lost the skin’s sensitivity to pain, they can easily develop pressure sores. Seniors who spend prolonged time in a wheelchair are also at risk of developing these sores as the pressure builds up over time. Those with circulation problems, diabetes, or malnutrition are also overly prone to pressure sores.

It is worth noting that not all pressure sores are the same. There are four distinct stages [2] characterized by varying symptoms and severity levels.

What Causes Bed Sores?

Here is a look at the common reasons behind the occurrence of pressure sores.

Pressure Buildup

When continuous pressure is exerted on the skin, the blood flow to that part of the skin gradually becomes limited. When this inadequate blood supply is coupled with limited mobility, the skin becomes vulnerable to damage, resulting in the development of pressure sores. The damage normally happens as a result of oxygen and nutrient deprivation on the affected skin part.

Limited Mobility

If an elderly person spends too much time sitting or lying in bed, any body part that is not well padded with muscles or fat is prone to pressure sores. Body parts such as the tailbone, shoulder blades, tailbone, and hips are particularly at risk of bedsores in individuals who barely move.

Friction and Shear

Friction might occur in areas where the skin comes into contact with rough fabrics. Continuous friction can make a senior’s fragile skin more susceptible to injuries, especially when the skin is wet. Shear, on the other hand, occurs when two bodies move in opposite directions. For example, when a bed is elevated, the senior might slide a bit downwards. The skin on some parts in contact with the bed might tend to stay in place, resulting in shear, essentially a pull in the opposite direction.

Risk Factors

Numerous lifestyle factors can place one at more risk of developing pressure. Here are some common ones.

  • Limited movement: If an older adult rarely moves and is confined to a wheelchair or bed, they are more at risk of developing these sores.
  • Medical conditions: Health issues that affect one’s blood flow can also contribute to bedsores. Some of these conditions include vascular diseases and diabetes.
  • Dehydration and poor nutrition: A healthy human needs sufficient minerals, vitamins, proteins, and fluids to prevent skin tissue damage. In the case of malnourishment and dehydration, the skin is deprived of these essentials and becomes easily prone to damage.
  • Loss of sensory perception: Neurological problems, spinal injuries, and other medical conditions can lead to the loss of sensory perception. In simple terms, a person can not feel discomfort or pain and is therefore prone to developing pressure sores since their body cannot perceive the pain.
  • Incontinence: The skin can become more vulnerable to damage if it’s continually exposed to stool and urine.

How to Prevent Bed Sores

While pressure sores might sound quite scary, the good news is that there are numerous prevention steps one can take to minimize the sores’ occurrence.

Change Sitting or Sleeping Positions

We have determined that bedsores often occur as a result of extended pressure build-up. To avoid this, help the older adult change their sleeping or sitting position frequently. Doing this ensures that pressure is well distributed and not only affecting a single part. If the senior has sufficient muscle strength, you may remind them to turn every once in a while.

Keep the Skin Dry and Clean

The drier and cleaner a person’s skin is, the less likely it is to develop pressure sores. If the older person is bedridden, you can clean their skin using mild soap and water to prevent sores’ formation. After cleaning, ensure you dry off the skin completely. Any residual moisture is essentially a risk factor for the formation of pressure sores.

Use Pillows

This does not entail the conventional use of pillows. To prevent sores, place pillows between body parts that are frequently in contact. You could place a pillow under the senior’s tailbone, between the knees, and between the ankles.


Exercises might sound impossible for bedridden people. However, you can have the senior try simple range-of-motion exercises such as lifting an arm or a leg if they have the adequate muscle strength to do it. The older adult should hold the lifting position for a few seconds and then repeat the exercises severally, making sure to alternate the legs or arms.

Review Your Bedding

Some mattresses have excellent pressure-relief attributes and might go a long way in preventing the formation of pressure sores. You might also consider purchasing a mattress with pumps to enhance airflow into the mattress and subsequently to the person sleeping on it.

How to Treat Bed Sores in the Elderly

The specific treatment for pressure sores depends on the severity of the condition. However, here are some common treatment options [3] you can try at home or that your doctor could recommend.

  • Pressure relief: Relieving the pressure that comes with bedsores involves the use of pillows and foam pads to elevate the affected areas. This prevents the affected part from experiencing additional pressure.
  • Cleaning the wound: Try cleaning the pressure sores with a saline solution after every dressing change. For minor sores, try cleaning with mild soap and water.
  • Apply some dressing: Dressings protect the wounds that might have developed from the pressure sores. One can purchase hydrocolloids or antimicrobial dressings for enhanced effectiveness.
  • Apply a topical cream: You can use barrier creams or antibacterial creams to treat bedsores. The former protects already damaged skin while the latter combat infections.
  • Solve the incontinence problem: If the pressure sores occur as a result of incontinence, solving this underlying problem is guaranteed to solve the sore formation. To combat incontinence, you could use fecal management devices, incontinence pads, barrier creams, and cleansers. Most of these products are readily available in online stores.
  • Address dead tissue: This can be done using surgical tools or high-pressure water jets. Eliminating dead tissue from the area surrounding the pressure sore can help the wound heal.
  • Take the prescribed antibiotics: Your doctor may prescribe antibiotics to combat the skin or bone infections associated with pressure sores.
  • Consider surgical options: In the case of closing exposed wounds or removing excessive dead tissue, you might want to consider the available surgical options.
  • Changes in diet: Protein supplementation may help reduce the wound size and enhance healing. Additionally, ensure you take sufficient fluids and nutrients.

Stages of Bed Sores

As mentioned earlier, pressure sores may form over the course of days or, in some scenarios, hours. Here is a look at the four stages of decubitus ulcers.

Stage One

The first stage of pressure sores is also the mildest. In this stage, the sores only affect the skin’s upper layer. The symptoms may include itching, burning, and mild pain. The affected area might also feel cooler, warmer, softer, or firmer than surrounding areas. Other symptoms of stage one sores include a reddening of the skin, discoloration, and poor blood flow.

To alleviate the pressure on sores in this first stage, ensure to change your sleeping position by making use of pillows and foam pads. If possible, try to walk around the house every few hours. You should also wash and dry the sore using water and mild soap.

Stage Two

Stage two pressure sores develop deeper into the skin and manifest in broken skin, pus-filled blisters, and open wounds. The affected section is usually red, swollen, and may ooze some clear fluid. It is worth mentioning that these sores can be quite painful. To deal with the sores, follow the steps outlined in stage one. If the pain is too much, consult your doctor regarding the possible use of pain relievers.

Stage Three

Stage three pressure sores develop past the skin’s second layer to the layer made of fat tissue. At this point, the sore may have a strong unpleasant odor, and the open wound might be quite wide. The tissue surrounding the sore might have blackened or died entirely. The wound might show signs of drainage, pus, and redness.

Stage three pressure sores are better off handled by a qualified medic. Your doctor might prescribe antibiotics and take measures to remove dead tissue. If the condition is too severe, you might have to get a special pressure relief mattress.

Stage Four

Stage four pressure sores are severe and might even affect a person’s ligaments and muscles. The sores are significantly deep at this stage, and the surrounding skin area has darkened and shows visible signs of infection. Occasionally, one might see bone, muscles, or tendons through the sore. If sores get to this stage, the patient needs immediate medical care and might even require surgery. The sore might then take months, sometimes even a year, to heal completely.


Bed sores are among the most common health-related issues synonymous with bedridden older adults. If left unchecked, the conditions causing these pressure sores can lead to more serious problems over time. However, by following the guidelines, prevention tips, and treatment options outlined above, one can overcome this prevalent problem.


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