Bedsores in Older Adults

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Bedsores, also called pressure ulcers or decubitus ulcer, are injuries to skin and underlying tissue from constant pressure on the area for a long time. Older adults with limited mobility have an increased risk of bedsores. For example, this includes seniors who are not able to get out of bed or change their position, or who always use a wheelchair or sit in a chair throughout the day. This pressure can lessen blood flow to the affected area, which may lead to tissue damage and tissue death. Bedsores often form on the skin covering bony areas of the body, such as the back, tailbone, hips, buttocks, elbows, heels, and ankles.

Signs and Symptoms of Bedsores

  • Changes in skin color and swelling, warmth, tenderness, and pain in the affected area;
  • Untreated bedsores may crack, blister, or break open and form a sore or ulcer;
  • Pus-like drainage;
  • Bedsores often heal slowly and if not treated can damage tissues deep under the skin, including fat, muscle, and bone.


Pressure sores are grouped by the severity of symptoms from stage I (mildest) to stage IV (worst).

  • Stage I: A reddened, painful area on the skin that does not turn white when pressed. This is a sign that a pressure ulcer may be forming. The skin may be warm or cool, firm or soft.
  • Stage II: The skin blisters or forms an open sore. The area around the sore may be red and irritated.
  • Stage III: The skin now develops an open, sunken hole called a crater. The tissue below the skin is damaged. You may be able to see body fat in the crater.
  • Stage IV: The pressure ulcer has become so deep that there is damage to the muscle and bone, and sometimes to tendons and joint.


Prevention and Treatment

You can prevent the sores by:

  • Keeping skin clean and dry;
  • Changing position every two hours;
  • Using pillows and products that relieve pressure.


Stage I or II bedsores will often heal with the following home treatment:

  • Relieve the pressure on the area. Use special pillows, foam cushions, booties, or mattress pads to reduce the pressure.
  • Change positions often. In a wheelchair, change positions every 15 minutes. People in bed should be moved every 2 hours.
  • Care for the sore as directed by your medical provider. Keep the wound clean to prevent infection. Clean the sore every time dressing is changed.
  • Wash the area around a Stage I sore with mild soap and water.
  • Clean Stage II sores with a salt water (saline) rinse to remove loose, dead tissue. Do not use hydrogen peroxide or iodine cleansers which can damage the skin.
  • Keep sores covered with a special dressing(glaze, gel, film, or foam) to protect against infection.
  • See your physician for treatment of Stage III or IV bedsores.



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