Keeping the Pressure Off: Tips for Preventing Bed Sores

In my last post, I provided an overview of what bed sores are and the primary risk factors. One of the messages of that post is that bed sores pose a very serious threat, particularly to bedridden seniors. The good news, however, is that bed sores are virtually always avoidable. They are also easier to prevent than heal. It's therefore critical for caregivers to take as many precautionary measures as possible to reduce the risk of their patients developing bed sores. Here are some of the main ways bed sores can be prevented.

Routine Repositioning. Repositioning or rotating the body at least once for every two hours spent in bed, or for every 30 minutes in a wheelchair, is essential to preventing bed sores. For example, if a patient has been lying on his or her back for some time, he or she should be turned to the side. For bedridden patients, use of a lifting device such as a Hoyer lift or a lifting sheet can help reduce friction on the skin while he or she is being moved. If a patient has been leaning in one direction in a wheelchair for some time, he or she should be repositioned to lean to the opposite direction. Regularly changing positions results in less pressure being exerted on the skin, which reduces the risk of developing bed sores.

Bed Support. Providing the patient with a special mattress that contains air, foam, water, or gel in a bed that can be adjusted regularly is also a helpful prevention tool. Note, however, tat the head of the bed should remain positioned as flat as possible. If the head is raised any more than 30 degrees, there’s a greater risk that the skin can be damaged because the body is forced into a position that slumps down into the mattress.

Pillow Support. Placing pillows between parts of the body that press against each other is another important prevention method. The National Institute of Health suggests that pillows be placed under the tailbone, shoulders, elbows, and heels. You can also protect the heels by placing a pillow under the calves to lift up the heels. A patient lying on his or her side should have a pillow between his or her knees and ankles. A patient should never be left lying directly on the hipbones, and the knees and ankles should never be touching. While most types of pillows are effective, steer clear of donut shaped pillows, as they create uneven pressure and can actually increase the risk of bed sores. Also, pillows should never be placed under the knees, as this too reduces blood flow.

Keeping Skin Clean and Dry. Skin that’s kept clean and dry is less vulnerable to bed sores. Use warm water and mild soap to clean the skin. Make sure to use a soft sponge or cloth and not to scrub hard. When cleaning areas that are difficult to reach, you may need another person to help. After cleaning the skin, take a towel and pat the skin dry. Avoid rubbing too hard, as this can irritate the skin.

Exercise. Exercise may be the last thing on a patient’s mind if he or she can’t even get out of bed. However, there are some types of exercise that can be done in bed that can help prevent bed sores from forming. Simply lifting the arms and legs and holding the position for five to ten seconds is a good start. Light weight lifting is also helpful. If a rehabilitation program is an option, that can be very effective in improving the patient's movement and independence and, correspondingly, lowering his or her risk for getting a bed sore.

Regular Inspection. Caregivers must check their patients every day from head to toe. Special attention should be paid to red areas and areas most prone to developing bed sores. If bed sores are identified in the early stages of formation, there’s a much greater likelihood that they can be healed. Caregivers should also inspect the bedding frequently. Wet sheets should be changed immediately, and sheets that are soft and wrinkle-free should always be used.