How to Prevent Bed Sores in Seniors

Written by Evelyn Mercer

Reviewed by Dr. Kisore Ganatera

Last updated // October 31, 2025

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Caring for someone who is bedridden can feel overwhelming, and the worry about bed sores is a heavy weight to carry. Please know that feeling this concern is a sign of how much you care.

It’s completely normal to feel a little lost about where to start.

Think of this not as a list of difficult rules, but as a gentle guide. We’ll walk through simple, practical steps you can take to protect your loved one’s skin and bring them more comfort. We’ll even explore how simple things, like the right pillows, can enhance comfort and safety.

We’re going to go through this together, one small step at a time.

Recognizing the Early Signs of Bed Sores in Seniors

One of the kindest things you can do is learn to spot the earliest signs of trouble. Bed sores, also called pressure ulcers, don’t appear suddenly as open wounds. They begin quietly, with subtle changes to the skin.

Catching them at this early stage makes all the difference.

Common Sites for Pressure Ulcers in Elderly Men and Women

Pressure ulcers tend to form where bones are close to the skin’s surface, creating high-pressure points. Knowing where to look is the first step in your daily skin check routine.

For someone who is mostly in bed, be sure to gently check:

The back or sides of the head
Shoulder blades
Hips
The lower back and tailbone
Heels, ankles, and the skin behind the knees

For wheelchair users, the pressure points shift slightly. The focus should be on the tailbone and buttocks, shoulder blades, and the backs of the arms and legs where they rest against the chair.

Early Symptoms to Watch For

During your daily checks, you are looking for more than just broken skin. The earliest warnings are changes in the skin’s color and texture. According to Johns Hopkins Medicine, this is known as a Stage 1 pressure ulcer.

Look for reddish or purplish patches. A key test is to gently press on the red area. If the redness doesn’t briefly turn white (a sign of “non-blanching erythema”), it means blood flow is already impaired, and it should be taken seriously.

Other gentle warnings from the skin include:

An area that feels warmer or cooler to the touch than the surrounding skin.
A spot that feels firmer or softer than nearby tissue.
Swelling or tenderness reported by your loved one.

A 2022 study highlighted that a pressure injury can begin to form in as little as one to two hours. This is why consistent, gentle care is so important.

If you notice any of these signs, it is a signal to relieve pressure from that area immediately and increase your prevention efforts. You are not just preventing a sore, you are providing comfort and care.

Strategies to Prevent Bed Sores in Seniors

Preventing bed sores comes down to a few core ideas: relieving pressure, reducing friction, and providing the right support. These strategies are the heart of your care plan.

Frequent Repositioning

Changing position regularly is the single most effective way to prevent bed sores. It gives the skin a chance to recover by restoring blood flow to those vulnerable, high-pressure areas.

The standard guideline is to help your loved one change positions at least every two hours in bed. For wheelchair users, the need is even more frequent, with a weight shift recommended every 15 minutes.

A gentle technique that nurses often recommend is the “30-degree lateral tilt.” This involves using pillows to tilt the body just slightly to one side, which is enough to relieve pressure on the hips without putting full weight on them. When moving someone, always lift the body rather than dragging it to avoid friction that can tear delicate skin. Using a simple slide sheet can make this process much smoother and more comfortable.

Use of Specialized Mattresses and Cushions

The right support surface can make a world of difference by distributing body weight more evenly and reducing pressure on bony areas. It acts as a 24/7 partner in your prevention efforts.

There are several types of surfaces designed for this purpose:

Alternating Pressure Pads (APPs): These overlays for mattresses have air cells that automatically inflate and deflate in a cycle, constantly shifting the points of pressure.
Low Air Loss (LAL) Mattresses: These advanced surfaces not only redistribute pressure but also have tiny holes that allow a small amount of air to escape. This helps manage moisture and keep the skin dry, a key factor in prevention.
Gel or Foam Cushions: For wheelchairs, specialized cushions made of gel, memory foam, or a combination can significantly reduce pressure on the buttocks and tailbone.

It’s important to avoid doughnut-shaped cushions. While they seem like a good idea, they can actually cut off blood flow to the tissue in the middle, making the problem worse.

The Role of Pillows in Comfort and Prevention

Never underestimate the power of a few well-placed pillows. They are simple, accessible tools that play a huge role in both comfort and the prevention of bed sores.

Pillows allow you to fine-tune body alignment and offload pressure from specific spots. For example, placing a pillow lengthwise between the legs keeps the knees and ankles from pressing together. A small pillow under the calves can “float” the heels, completely removing pressure from one of the most at-risk areas.

Wedge pillows are particularly helpful for maintaining that 30-degree side tilt. By filling the gaps between the body and the mattress, you reduce the risk of your loved one sliding down, which creates harmful shear forces on the skin. This simple, gentle strategy is a cornerstone of effective care.

Skin Care and Maintenance for Elders

Healthy, resilient skin is the body’s first line of defense. A gentle daily routine to keep the skin clean, moisturized, and protected is a loving act that provides immediate comfort and long-term protection.

Keeping the Skin Dry and Clean

Moisture from sweat or incontinence can weaken the skin and make it much more susceptible to breaking down. The goal is a gentle, daily cleansing routine.

Use a mild, pH-balanced cleanser, like CeraVe or Cetaphil, with warm (not hot) water. When drying, always pat the skin gently with a soft towel, as rubbing can cause damage. After cleansing, applying a moisture barrier cream is essential, especially in areas prone to wetness. Look for products containing zinc oxide or dimethicone, which form a protective layer on the skin.

A crucial tip from wound care specialists is to never massage bony areas that look red. This was once common advice, but we now know it can damage the underlying tissue and make a pressure sore more likely.

If incontinence is a concern, use absorbent pads or briefs and check them frequently. Keeping the skin clean and dry is one of the most direct ways you can prevent discomfort and injury.

Using Moisturizers to Prevent Dryness

As we age, our skin naturally becomes drier and more fragile. A good moisturizer helps restore the skin’s protective barrier, keeping it supple and more resilient to pressure.

Apply a fragrance-free moisturizer daily, ideally after bathing when the skin is still slightly damp to lock in hydration. Look for products with ingredients like ceramides or hyaluronic acid, which are known to be highly effective for hydrating and protecting mature skin. Gently massaging the lotion into the skin is a wonderful way to check for any new areas of concern while providing a moment of soothing connection.

Nutritional Guidelines to Support Skin Health and Prevent Bed Sores in Seniors

What we put into our bodies is the raw material for building strong, healthy skin from the inside out. Good nutrition and proper hydration are not just details, they are fundamental to preventing bed sores.

Importance of Hydration

Proper hydration is absolutely essential for skin elasticity and overall health. Dehydrated skin is brittle and much more prone to injury. The goal is generally around 6 to 8 cups of fluids per day, unless a doctor has advised otherwise due to a condition like heart or kidney disease.

If your loved one doesn’t enjoy drinking plain water, you can get creative:

Offer herbal teas or diluted fruit juices.
Provide hydrating foods like soups, broths, watermelon, or cucumbers.
Make homemade ice pops from fruit puree.

Recommended Diet for Skin Integrity

The body needs specific nutrients to build and repair tissue. Think of it as providing the right tools for the job of keeping skin strong.

Protein is the most important building block. For adults at risk of pressure ulcers, the National Pressure Injury Advisory Panel (NPIAP) recommends a daily intake of 1.25 to 1.5 grams of protein for every kilogram of body weight. You can find this in foods like lean meats, fish, eggs, and beans.

Other key nutrients include:

Vitamin C: Found in citrus fruits, strawberries, and bell peppers, it’s vital for creating collagen, which gives skin its strength.
Vitamin A: Carrots, sweet potatoes, and leafy greens provide this vitamin, which supports cell turnover.
Zinc: This mineral, found in nuts, whole grains, and meat, is critical for wound healing.

Sometimes, a doctor may recommend a nutritional supplement drink, such as Juven, which is specifically formulated with nutrients to support tissue building and wound healing.

Addressing and Managing Underlying Health Conditions

Certain health conditions can make someone more vulnerable to developing bed sores. Working closely with a healthcare team to manage these issues is a key part of a holistic prevention plan.

Managing Diabetes and Circulation Issues

Conditions like diabetes and peripheral artery disease can impair blood flow, especially to the legs and feet. This means less oxygen and fewer nutrients reach the skin, making it harder for it to stay healthy and repair itself.

For individuals with diabetes, keeping blood sugar levels under control is critical. High blood sugar can stiffen blood vessels and damage nerves, reducing sensation. Regular monitoring with a glucometer and consistent check-ups with a doctor, including a podiatrist for foot care, are essential.

Gentle movements, even if done from a chair or bed, can help encourage circulation. Simple leg lifts or ankle rotations can make a difference.

Importance of Regular Medical Check-ups

Regular appointments with a doctor or nurse are so important. These visits are a chance to assess a person’s overall risk for developing pressure ulcers.

Healthcare professionals often use a tool called the Braden Scale to evaluate risk. It’s a simple checklist that scores six factors: sensory perception, skin moisture, activity, mobility, nutrition, and friction or shear. A lower score indicates a higher risk, which helps the care team create a more targeted prevention plan.

These check-ups are also your opportunity to ask questions, share your concerns, and feel supported in your role as a caregiver. You are a vital member of the care team.

Learning how to prevent bed sores is a journey of constant, gentle care. It’s about the small, consistent actions you take every day.

Through regular skin checks, frequent repositioning, and thoughtful attention to nutrition and skin care, you provide an incredible gift of comfort and well-being.

Your loving vigilance is the most powerful prevention tool there is.

How to Prevent Bed Sores in Seniors

Recognizing the Early Signs of Bed Sores in Seniors