Preventing Bed Sores at Home: A Caregiver’s Guide

Bed sores (pressure injuries) develop when constant pressure reduces blood flow to the skin, usually over bony areas like the tailbone, hips, heels and elbows. People who spend most of their time in bed or a chair are at highest risk. Prevention focuses on regular repositioning (often every 2 hours in bed, more often in a chair), daily skin checks, keeping skin clean and dry, good nutrition and hydration, and pressure-relieving mattresses and cushions. Call the doctor or nurse at the first sign of skin that stays red or breaks open.

Bed sores can form in a matter of hours and take weeks or months to heal. They’re painful, can become infected, and are much easier to prevent than to treat. For families caring for a parent who’s bed-bound, recovering from surgery, or in the late stages of an illness, prevention is one of the most important parts of daily care. Preventing bed sores at home is one of the most important parts of caring for a parent who spends most of the day in bed or a chair.

This guide explains how pressure injuries develop, who’s at risk, and a practical prevention routine. Follow your parent’s care team’s specific instructions.

Who is at risk for bed sores?

• People who spend most of the day in bed or a wheelchair
• Those who can’t change positions on their own
• People with incontinence, since moisture damages skin
• People with poor nutrition or dehydration
• Those with diabetes or poor circulation
• People with reduced sensation or dementia, who may not feel or report discomfort
• Anyone recovering from surgery or a serious illness

Where do bed sores usually form?

• Lying on the back: Tailbone, buttocks, heels, shoulder blades, back of the head
• Lying on the side: Hips, knees, ankles, shoulders, ears
• Sitting in a chair or wheelchair: Tailbone, buttocks, spine, back of arms and legs

What are the stages of pressure injuries?

• Stage 1
  • What it looks like: Skin is intact but red (or darker on darker skin) and doesn’t fade when pressed; may feel warm, firm or painful
  • Action: Relieve pressure immediately; tell the nurse or doctor
• Stage 2
  • What it looks like: Shallow open sore or blister
  • Action: Medical guidance needed
• Stage 3
  • What it looks like: Deeper wound into the tissue below the skin
  • Action: Medical treatment required
• Stage 4
  • What it looks like: Very deep wound reaching muscle or bone
  • Action: Urgent medical treatment

Report any skin that stays red or discolored, blisters, or open areas right away.

How do you prevent bed sores at home?

1. Reposition regularly. Many care teams recommend turning bed-bound people at least every 2 hours, and shifting weight in a chair more often. Follow your care team’s schedule.
2. Use pillows or wedges to keep bony areas from touching, such as between the knees and under the calves to float the heels.
3. Keep the head of the bed as low as is safe to reduce sliding and friction, unless the doctor advises raising it.
4. Check the skin daily, especially pressure points, during bathing or changing.
5. Keep skin clean and dry, changing incontinence products promptly and using a barrier cream.
6. Avoid friction: lift rather than drag when repositioning, and keep sheets smooth.
7. Support nutrition and hydration, especially protein.
8. Use pressure-relieving surfaces: special mattresses, overlays and wheelchair cushions.
9. Encourage movement if your parent is able, even small shifts in position.

What equipment helps?

• Pressure-relieving or alternating-pressure mattresses
• Wheelchair cushions designed for pressure relief
• Heel protectors
• Positioning wedges and pillows
• A hospital bed for easier repositioning

Ask the doctor about equipment; some may be covered by Medicare, Medi-Cal or hospice.

How does incontinence affect skin?

Moisture from urine or stool breaks down skin quickly. Change products promptly, clean gently, pat dry and use a barrier cream. See personal care services.

How can a caregiver help?

Trained caregivers follow repositioning schedules, check skin during personal care, keep your parent clean and dry, encourage food and fluids, and report changes early. For bed-bound parents, this often requires extended hours or 24-hour care. Wound treatment itself is handled by nurses, home health or hospice. See personal care assistance, 24-hour home care.

What does a daily skin check look like?

A quick daily skin check is one of the most effective ways to catch pressure injuries early, when they are easiest to treat. It takes only a few minutes and fits naturally into bathing or dressing.

• Check the high-risk spots. Look at the tailbone, hips, heels, ankles, elbows, shoulder blades, and the back of the head.
• Look for color changes. Redness on lighter skin, or purple, blue, or darker patches on darker skin, can be early signs.
• Feel for changes. Areas that feel warmer, cooler, firmer, or softer than surrounding skin deserve attention.
• Press gently. Skin that stays red after light pressure may be an early pressure injury.
• Ask about pain. Burning, soreness, or itching can come before visible changes.

Write down what you find and share any concerns with the doctor or nurse promptly. Early action can prevent a small problem from becoming a serious wound.

How does nutrition help prevent bed sores?

Skin needs good nutrition to stay strong and heal. Seniors who eat poorly, lose weight, or do not drink enough fluids are at higher risk of pressure injuries.

Offer meals and snacks with protein, such as eggs, yogurt, beans, fish, or chicken, and encourage regular fluids unless the doctor has set limits. If your parent has a poor appetite or is losing weight, talk with the doctor about whether a dietitian or nutritional supplement would help. Preventing bed sores at home works best when good nutrition is part of the plan along with repositioning and skin care.

When should you call the doctor about a pressure injury?

Call the doctor or nurse if you see an open area, blistering, skin that stays discolored, drainage, a foul smell, or signs of infection such as fever or increasing pain. These need professional assessment and may require wound care from a licensed nurse.

Non-medical caregivers can help with prevention and report changes, but wound treatment should be guided by a medical professional.

Frequently asked questions

How often should a bedridden person be repositioned? Often at least every 2 hours in bed, and more often when seated, but follow the care team’s instructions.

What are the first signs of a bed sore? Skin that stays red or discolored and doesn’t fade when pressed, sometimes warm, firm or painful.

Can bed sores be prevented at home? Most can, with regular repositioning, skin checks, moisture control, nutrition, and pressure-relieving surfaces.

Who treats bed sores? Doctors, nurses, home health and hospice teams. Caregivers help with prevention and report changes.

Does Medicare cover pressure-relieving mattresses? Medicare may cover certain support surfaces when medically necessary with a doctor’s order.

Preventing bed sores at home: key takeaways

Preventing bed sores at home depends on regular repositioning, daily skin checks, clean and dry skin, good nutrition and hydration, and pressure-relieving equipment. Pressure sore prevention is far easier than treatment, so know the bed sore signs in the elderly, such as red areas that do not fade.

How often to reposition a bedridden patient? Often every 2 hours in bed and more often in a chair, but follow the care team’s guidance. Skin care for bed-bound seniors should include gentle cleaning after incontinence and protective creams. Learn the stages of pressure injuries so you can call the doctor early. A caregiver can make repositioning consistent, and in-home care costs $40 to $50 per hour depending on the level of care. See our personal care services and 24-hour home care services.